Directions/How to Use this Template: The content in this table does not have to be written in full sentences and can be presented in the form of bulleted lists. Once you have filled out this template, you will use it to inform the written narrative of your wellness recommendations plan, in Milestone Three.
Consider the following as you fill out the template:
CLIENT: Michael, who is 60 years old, smokes two-and-a-half packs of cigarettes every day and has for the past 30 years. He is not taking any medications and has no family history of asthma, allergy, or cardiovascular disease (CVD). He recently went to the emergency room and complained of being short of breath.
Michael was later diagnosed with chronic obstructive pulmonary disease (COPD), which requires oxygen. Michael has two estranged adult sons and an ex-husband. He lives in low-income senior housing. Michael came out as transgender to his family at age 40, and slowly transitioned. He has not seen his sons in nearly 20 years.
Specific Health Domain* |
Recommendations* |
Resources Required |
Order of Implementation |
Desired Outcomes (Improvement Measures) |
Justification |
COPD |
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Smoking |
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Depression |
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Transgender |
Directions/How to Use this Template: The content in this table does not have to be written...
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