"Word version 6 About Me Typeable 2"
About Me! My Hospital Passport Take this with you whenever you go to the hospital This passport will give you important information about me and how you can support me when I access the hospital Hospital staff should read it before they help me with my support, care or treatment It needs to hang at the end of my bed and a copy should be put in my notes Name: I like to be called: Date of birth: Address: Telephone/ Email: Date plan was completed: Where was it completed/by? This passport belongs to me. Please return it when I leave. It can be used in any hospital This passport has been produced in partnership with: www.supportforliving.org.uk Brief medical history: Any operations, illness, medical issues you may have experienced in the past. Please also attach a list of current medications How I normally take my medication: How I communicate: (list the main things people need to know when supporting you in hospital – i.e. do you need time to speak, use communication aids, sign language, need support with understanding etc?) living on want If I get upset or distressed you can help me by: I express pain by: My drinking support needs are: My eating support needs are: My personal care support needs are: To keep me healthy and safe you should:(how I cope with medical procedures e.g. injections, blood pressure, x-rays, oxygen; any pressure relief required; mobility issues; moving and handling requirements; continence issues; etc) How to make appointments easier for me: (e.g: having the first/last appointment of the day, give me a double appointment, explain what is happening in a simple way, send me information that is easy to read, let me visit before my appointment, use simple language, give information to my carer etc ) Other important information: (Specific information that will help make you stay or visit more comfortable i.e. listening to music, having a favourite book with me; issues regarding capability and consent etc) Going home:(if there is any important information staff should know before you go home write it here: for e.g.: care arrangements that should be in place before you go home , people who must be contacted etc… My carer’s involvement when I’m in hospital? (this could be a family member, paid carer etc, this may need to be agreed with the ward sister/manager) Next of Kin : Relationship to me: Phone number: Address: I would like to be flagged on the hospital computer system so staff can make reasonable adjustments for me Yes No Signed: Other important contacts/ information: For hospital staff Please complete appropriate care plans, discharge checklist and ensure information only: the patient is offered a patient survey when they leave, copies of all must remain in the patients notes. Full details on EHT intranet. To find out more about the Treat Me Right! project or to download a passport, check out our website: www.supportforliving.org.uk If you are interested in getting information translated into “easier to read” email Elsa on email@example.com