The One Minute Past Medical History

  1. Allergies and Reactions to Drugs (What happened?)
  2. Current Medications (Including "Over-the-Counter")
  3. Medical/Psychiatric Illnesses (Diabetes, Hypertension, Depression, etc.)
  4. Surgeries/Injuries/Hospitalizations (Appendectomy, Car Accident, etc.)
  5. Immunizations
  6. Tobacco/Alcohol/Drug Use
  7. Reproductive Status for Females:
  1. Birth History/Developmental Milestones for Children
  2. Marital/Family Status
  3. Occupational Hazards/Chemical Exposures

 

 

List of Family Responsibilities for Elders or Terminal Conditions

  1. Social and Family Information
  2. Legal/Powers of Attorney/Wills/Personal Care Directives
  3. Homekeeping – What is the Status of the Patient’s Residence or Current Living Situation?
  4. Dietary Habits, Allergies and Food Preferences
  5. Medical History
  6. Medical/Personal Equipment
  7. Activities of Daily Living - Personal Care Record of Person's Normal Daily Schedule
  8. Difficult or Problem Behaviors
  9. Applications for Long-Term Care Log