Equipment |
Check if applicable |
Usage( time of day, location, etc.) |
Notes |
Cane |
|||
Walker |
|||
Manual wheelchair |
|||
Motorized wheelchair |
Device |
Check if applicable |
Usage( time of day, location, etc.) |
Notes |
Glasses |
|||
Hearing aids |
|||
Grab bars |
|||
Raised toilet seat |
|||
Bedside commode |
|||
Tub / shower chair |
|||
Lift chair |
|||
Communication device |
|||
|
Smart devices
( e. g., Alexa, watch)
|
|||
CurePSP Prepare to Care 29 |