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| Project Name: Senior Companion Care |
| Project Location: Maryland Heights, MO |
| Date: 03/28/2012 |
| Age:: Age: |
| Care recipient: Mother |
| Living situation:: Home (lives with spouse) |
| Companion services:: Other activities |
| Transportation needed: No |
| Care type:: Visiting care |
| Personal services: None |
| Estimated need:: 11 to 20 hours/week |
| Expected funding: Private |
| Gender:: Male |
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| Project Name: Senior Companion Care |
| Project Location: Maryland Heights, MO |
| Date: 02/26/2012 |
| Care recipient: Myself |
| Companion services:: Other activities |
| Transportation needed: No |
| Care type:: Visiting care |
| Personal services: None |
| Expected funding: Both private & other |
| Gender:: Female |
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| Project Name: Clean House Interior (Maid Service) |
| Project Location: Maryland Heights, MO |
| Date: 01/06/2012 |
| Cleaning Type Needed: Recurring Service |
| What kind of location is this?: Home/Residence |
| Desired Completion Date: Timing is flexible |
| Request Stage: Planning & Budgeting |
| Recurring Service Requested: Bi-weekly |
| Comment: just need some light houseekping and some help with organization |
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| Project Name: Senior Personal Care |
| Project Location: Maryland Heights, MO |
| Date: 01/01/2012 |
| Age:: Age: |
| Care recipient: Mother |
| Living situation:: Home (lives alone) |
| Companion services:: Meal prep |
| Companion services:: Medication reminders |
| Transportation needed: No |
| Care type:: Visiting care |
| Personal services: Bathing |
| Personal services: Eating/feeding |
| Personal services: Dressing/grooming |
| Personal services: Yes |
| Estimated need:: 21 to 40 hours/week |
| Expected funding: Private |
| Gender:: Female |
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| Project Name: Senior Companion Care |
| Project Location: Maryland Heights, MO |
| Date: 12/02/2011 |
| Care recipient: Other Relative |
| Living situation:: Home (lives alone) |
| Companion services:: Errands/Shopping |
| Transportation needed: No |
| Care type:: Visiting care |
| Personal services: None |
| Estimated need:: 21 to 40 hours/week |
| Estimated timing: Immediately - within 1 week |
| Expected funding: Private |
| Estimated budget:: $251 to $500/week |
| Gender:: Female |
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| Project Name: Senior Companion Care |
| Project Location: Maryland Heights, MO |
| Date: 11/01/2011 |
| First Name:: First Name: |
| Care recipient: Spouse |
| Living situation:: Home (lives with spouse) |
| Companion services:: Meal prep |
| Companion services:: Errands/Shopping |
| Transportation needed: No |
| Care type:: Visiting care |
| Personal services: Toileting |
| Personal services: Yes |
| Ambulation:: Wheelchair - can propel self |
| Estimated need:: 21 to 40 hours/week |
| Estimated timing: Immediately - within 1 week |
| Expected funding: Private |
| Estimated budget:: $251 to $500/week |
| Receptiveness:: Very receptive |
| Gender:: Female |
| Comment: Karen's husband just had a brain shunt. He is not able to get around very well in the home. He needs help getting meals as they have a split level home. He also needs help getting to the toilette. |
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| Project Name: Senior Companion Care |
| Project Location: Maryland Heights, MO |
| Date: 10/31/2011 |
| Care recipient: Other Relative |
| Living situation:: Home (lives alone) |
| Companion services:: Errands/Shopping |
| Transportation needed: No |
| Care type:: Visiting care |
| Personal services: None |
| Estimated need:: 21 to 40 hours/week |
| Estimated timing: Immediately - within 1 week |
| Expected funding: Private |
| Estimated budget:: $251 to $500/week |
| Gender:: Female |
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| Project Name: Senior Personal Care |
| Project Location: Maryland Heights, MO |
| Date: 09/21/2011 |
| Age:: Age: |
| Care recipient: Mother |
| Living situation:: Home (lives with spouse) |
| Companion services:: Medication reminders |
| Transportation needed: No |
| Care type:: Visiting care |
| Personal services: Bathing |
| Personal services: Dressing/grooming |
| Personal services: Toileting |
| Personal services: Yes |
| Estimated need:: 11 to 20 hours/week |
| Expected funding: Both private & other |
| Gender:: Female |
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| Project Name: Senior Personal Care |
| Project Location: Maryland Heights, MO |
| Date: 09/19/2011 |
| Age:: Age: |
| Care recipient: Spouse |
| Living situation:: Home (lives with spouse) |
| Companion services:: Meal prep |
| Companion services:: Medication reminders |
| Transportation needed: No |
| Care type:: Visiting care |
| Personal services: Bathing |
| Personal services: Eating/feeding |
| Personal services: Dressing/grooming |
| Personal services: Toileting |
| Personal services: Yes |
| Estimated need:: Up to 10 hours/week |
| Expected funding: Private |
| Gender:: Male |
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| Project Name: Senior Companion Care |
| Project Location: Maryland Heights, MO |
| Date: 08/06/2011 |
| Care recipient: Mother |
| Living situation:: Home (with care services) |
| Companion services:: Errands/Shopping |
| Transportation needed: No |
| Care type:: Visiting care |
| Personal services: None |
| Estimated need:: 41 to 60 hours/week |
| Estimated timing: Immediately - within 1 week |
| Expected funding: Private |
| Estimated budget:: $1,001 to $1,500 per week |
| Receptiveness:: Very receptive |
| Gender:: Female |
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