Ellie's Care Binder
Last updated: __________ by __________
How to use this binder
- This binder lives on the kitchen counter, by the phone. Please put it back there.
- Write in pencil. Phone numbers, doses, and schedules change.
- When you change something, update the date and your name at the top.
- Bring this binder to every doctor visit.
- In a hurry? Go to Section 1.
1. Emergency Quick Reference
In an emergency, call 911 (or your local emergency number) first.
| Item | Details |
|---|---|
| Full name | Eleanor "Ellie" Brooks |
| Age | 81 |
| Date of birth | __________ |
| Home address | __________, Dayton, OH |
| Main contact | Karen Brooks-Lee (daughter) 937-555-0142 |
| Backup contact | Linda Ortiz (neighbor) 937-555-0123. Has spare key. |
| Primary doctor | Dr. Patel, Kettering Family Practice 937-555-0101 |
| Preferred hospital | __________ |
| Pharmacy | CVS on Far Hills Ave 937-555-0177 |
Allergies: Penicillin (rash)
Conditions:
- Type 2 diabetes
- High blood pressure
- Mild cognitive impairment
Safety notes:
- Uses a walker.
- Mild hearing loss. Speak on her right side.
- Early memory issues (per her doctor).
- Diabetic. Meals matter.
- Lives alone. Gets daily check-ins.
- Can get anxious with new people.
Where to find:
- Medication list: Section 6
- Insurance cards: Section 8 (cards are in her purse)
2. About Ellie
Who she is
- Eleanor Brooks. She goes by Ellie.
- She is 81.
- She is very independent.
Where she lives
- Her own house in Dayton, OH.
- She lives alone.
- Family checks in every day.
Daily abilities and needs
- Walks with a walker.
- Has mild hearing loss.
- Has early memory issues.
- Has diabetes, so meals matter.
- Rosa (aide) helps with shower and lunch on Mon, Wed, and Fri.
Talking with Ellie
- Stand or sit on her right side.
- Speak clearly. Face her.
- Give her time to answer.
What upsets her
- Being rushed.
- New people can make her anxious.
What calms her
- Time and patience. Go at her pace.
Tips for a new helper
- Before your first visit, ask Karen to tell Ellie your name and when you're coming.
- Knock and say who you are, even if you have a key.
- Say your name each visit. Say why you're there.
- Sit on her right side when you talk.
- Let her do what she can by herself.
- Ask before you help. Offer choices.
- Don't hurry her. Plan extra time.
- Make sure she gets her meals. Ask Karen what to do if a meal is missed.
- If she seems upset or confused, stay calm and call Karen: 937-555-0142.
More about Ellie (fill in)
- Favorite foods: __________
- Favorite topics or hobbies: __________
- Things she likes to do herself: __________
- Daily habits that matter to her: __________
3. Contacts Directory
Family & Friends
| Name | Role | Phone | Notes |
|---|---|---|---|
| Karen Brooks-Lee | Daughter (main) | 937-555-0142 | Calls every morning |
| Tom Brooks | Son | 937-555-0188 | Saturdays |
| Linda Ortiz | Next-door neighbor | 937-555-0123 | Has spare key. Emergency backup. |
Medical
| Name | Role | Phone | Notes |
|---|---|---|---|
| Dr. Patel | Primary care | 937-555-0101 | Kettering Family Practice |
| Dr. Huang | Eye doctor | Number on fridge | Copy number here: __________ |
Pharmacy & Supplies
| Name | Role | Phone | Notes |
|---|---|---|---|
| CVS on Far Hills Ave | Pharmacy | 937-555-0177 | |
Home Help & Services
| Name | Role | Phone | Notes |
|---|---|---|---|
| Rosa | Home aide (BrightCare agency) | 937-555-0150 | Mon/Wed/Fri 9am-1pm |
| BrightCare agency | Aide agency | __________ | |
| Meals on Wheels | Meal delivery | __________ | Mon/Wed/Fri around 11:30 |
Insurance & Benefits
| Name | Role | Phone | Notes |
|---|---|---|---|
| Medicare | Insurance | __________ | Card in her purse |
| AARP supplement | Insurance | __________ | Card in her purse |
Other
| Name | Role | Phone | Notes |
|---|---|---|---|
| Church | Sunday 10am | __________ | Linda drives |
| Hair salon | Monthly | __________ | First Thursday |
4. Care Team & Weekly Schedule
Who Does What
| Person | Tasks | When | Contact |
|---|---|---|---|
| Karen (daughter) | Morning call. Evening visits. Pays bills. | Every morning. Weekday evenings. | 937-555-0142 |
| Tom (son) | Saturday help. Drives to doctor visits. | Saturdays | 937-555-0188 |
| Rosa (aide) | Shower and lunch | Mon/Wed/Fri 9am-1pm | 937-555-0150 |
| Linda (neighbor) | Emergency backup. Sunday church. | Sundays 10am | 937-555-0123 |
Weekly Grid
| Day | Morning | Afternoon | Evening |
|---|---|---|---|
| Mon | Karen calls. Rosa 9am. | Rosa until 1pm. Meals on Wheels ~11:30. | Karen visits |
| Tue | Karen calls | Karen visits. Trash out (who: ______) | |
| Wed | Karen calls. Rosa 9am. | Rosa until 1pm. Meals on Wheels ~11:30. | Karen visits |
| Thu | Karen calls | Karen visits | |
| Fri | Karen calls. Rosa 9am. | Rosa until 1pm. Meals on Wheels ~11:30. | Karen visits |
| Sat | Karen calls. Tom (time: ______) | Tom (time: ______) | |
| Sun | Karen calls. Church 10am, Linda drives. |
Hair appointment is the first Thursday of the month. Who drives: __________
5. Appointments & Routines
Upcoming Appointments
| Date & Time | With / Where | Purpose | Driver / Done |
|---|---|---|---|
| March 14, 10:30am | Dr. Patel, Kettering Family Practice | 3-month checkup | Tom ☐ |
| Sometime in April (need to schedule) | Dr. Huang (eye doctor) | __________ | ______ ☐ |
| ☐ | |||
| ☐ | |||
| ☐ | |||
| ☐ | |||
| ☐ | |||
| ☐ |
Regular Routines
| What | When | Who | Notes |
|---|---|---|---|
| Meals on Wheels | Mon/Wed/Fri around 11:30 | Delivery | |
| Hair |