1. Family Group November 2009

2. Family name Address and Telephone number Type of Family Life cycle stage Role and Functions Index PatientDiagnosis Latest Lab Results and Medications Plans LOMOHAN 939 Dos Castillas St. Sampaloc, Manila #0908 5204944 Mini-Nutrirional Assessment: malnourished Unilaterally extended Family in later life 1.Breadwinner Mary Jane (daughter) 2.Decision maker Lourdes Lomohan (wife) 3. 1˚ Caregiver Lourdes Lomohan (wife) 4.MCSI Madalas- 3 Minsan- 3 Halos hindi- 4 Fernando Lomohan Male 64 y/o s/p CVA, R MCA (June 2008); HPN st.II controlled Amlodipine 5mg/tab 1 tab OD Aspirin 80mg/tab 1 tab OD pc Multivitamins 1 tab OD Medical: 1.Update immunization (pneumococcal, influenza, tetanus) 2.Daily BP monitoring 3.Maintain good personal hygiene Rehabilitative: 1.Passive ROM exercises c/o caretakers 2. Refer to Rehab Med for PT Wellness: 1.Encourage diet rich in protein, low salt, high fiber (green leafy vegetables, citrus fruits) 2.Strict compliance with medications 3.Ensure 2 glasses and encourage 8 glasses of water a day Psychosocial: 1.Seek and maintain personal interests (listening to the radio, reading the newspaper, watching TV) 2.Encourage involvement with friends

3. LOPEZ 957 Dos Catillas St. Sampaloc, Manila # 7313224 Mini-Nutrirional Assessment malnourished Unilaterally extended Family in later years 1.Breadwinner Eden Lopez (wife) 2.Decision maker Eden Lopez (wife) 3. 1˚ Caregiver Eden Lopez (wife) 4.MCSI Madalas- 1 Minsan- 10 Halos hindi- 1 Dominador Lopez Male 76 y/o Parkinson’s disease s/p tracheostomy s/p PEG insertion Biperidine 2mg OD Levodopa/Carbid opa 200/50mg/tab 1 tab OD Multivitamins 1 tab OD Acetylcytsteine prn Medical: 1.Continue strict compliance with medications 2.Regular follow up 3.Maintain position that provides optimum ventilation 4.Continue strict turning schedule to avoid bed sore formation 5.Perform passive ROM exercises 6. Suctioning of secretions from tracheostomy tube as needed 7.Asepsis and anti sepsis technique in handling and cleaning tracheostomy tube and PEG Wellness: 1.Continue vitamin supplementation 2. Ensure two glasses daily Psychosocial 1.Sharing of responsibilities in taking care of patient

4. San Pedro 965 Adelina St. Sampaloc Manila Phone # 735-6775 Mini- Nutritional assessment:: not at risk for malnutrition GDS - normal MMSE- Extended Life Cycle Stage 1.Breadwinner Beatriz San Pedro 2.Decision maker Magdalena Amoranto (sister) Beatriz San Pedro Female 83 y/o Hypertension St. I, controlled Bronchial asthma, NIAE Osteoarthritis, both knees Hypothyroidism s/p total thyroidectomy (1988) s/p CVA (2004) Vitamin B Complex OD Nifedipine 20 mg OD Levothyroxine 100 mg OD Cilostazol 50 mg BID Calcium BID Simvastatin 40 mg ½ tab OD Medical 1. Continue present medications 2. BP monitoring 3. Follow-up with physician 4. Multivitamins 1 tab OD 5. Refer to Rehab 6. Vaccination – Pneumococcal, Tetanus, Influenza Wellness 1. Advice balanced diet, with low fat, low salt, high fiber diet (green leafy vegetables and citrus fruits) 2. Encourage to drink 8-10 glasses of water daily 3. Educate patients on benefit of healthy living and seeking to improve one’s health

5. San Pedro 965 Adelina St. Sampaloc Manila # 735-6775 Nutritional assessment: not at risk for malnutrition GDS- normal MMSE Extended1.Breadwinner self 2.Decision maker Self Magdalena San Pedro- Amoranto female 79 y/o St. II, controlled Cataract s/p EOL,OS Felodipine 5mg/tab, 1 tab BID Medical 1. Continue medications 2. BP monitoring 3. Increase oral fluid intake 5. Vaccination – Tetanus, Influenza, Pneumococcal Wellness 1. Advice balanced diet, with low fat, low salt, high fiber diet (green leafy vegetables, citrus fruits) 2. Encourage to drink 8-10 glasses of water daily 3. Educate patients on benefit of healthy living and seeking to improve one’s health

6. Rosales Address 1070 Don Quijote St. Sampaloc, Manila Phone # Nutritional assessment: At risk of malnutrition Blended Life Cycle Stage Launching Family 1.Breadwinn er Teresita Rosales 2.Decision maker Genaro Rosales 3. Caregiver Lauro 4.MCSI Jerry Rosales Gender: Male Age: 53 y/o DM type 2 SAH Stage 1, controlled CKD sec to DM nephropathy s/p AKA, L secondary to Diabetic foot Psychosocial problems Emotional support Amlodipine 5mg/tab OD Amlodipine 10mg/tab OD Acarbose 50mg/tab TID HN 18 ‘u’/SC pre-BF and 8 ‘u’/SC pre dinner Medical 1. Assure of compliance with medications 2. Assure of compliance with thrice a week hemodialysis 3. Regular follow-ups Wellness 1.Strict compliance to diet provided by physician/dietician 2.Suggest improvement of home ventilation 3.Periodic BP monitoring 4.Annual Lipid profile/Renal profile/Cardiac profile 5.Annual Opthalmologic consult Psychosocial 1.Suggest involvement in social groups 2.Encourage more outdoor activities

7. Cudal 1016 Eloisa St. Sampaloc Manila #735-7539 Mini-Nutritional Assessment Score: GDS: MMSE: Communal Family in Later life 1. Breadwinner: Dra. Efegenia Soliven- daughter who is living in the USA 2. Decision- maker: Dra. Efegenia Soliven- daughter who is living in the USA 3. 1˚ Caregiver: Cecilia Cabais 4.MCSI Madalas- Minsan- Halos hindi- Cudal, Dorothea Female 97 y/o Dementia Hearing Loss, AU s/p hip replacement (2004) Multivitamins, 1 tab OD Calcium Carbonate, 1 tab BID Medical 1. Continue Multivitamins and Calcium 2. Osteoporosis screening 3. Maintain low salt and low fat diet 4. Encourage passive ROM exercises Psychosocial 1. Patient has good personal relationship with caregivers. 2. She is able to talk to her daughter who lives in USA by telephone. She sees her daughter and family once a year. 3. We can encourage the family to make their visit more often and call her more often.

8. Miguel 1016 Eloisa St.Sampaloc Manila #735-7539 Mini-Nutritional Assessment Score: GDS: MMSE: Communal Family in Later years 1. Breadwinner : Lydia Miguel 2. Decision maker: Lydia Miguel 3. Caregiver: Mely Valdez 4.MCSI Madalas- Minsan- Halos hindi- *Patient owns the house and rents it to boarders. It is her source of income. Miguel, Lydia 60/F SAH Stage II, poorly controlled Atenolol (Therabloc) 50mg, 1 tab OD Multivitamins, 1 tab OD Folic Acid, 1 tab OD Medical 1. Continue current medications. *Patient is currently in Ilocos for renovation of their house. Caregiver said that they talk to her often on the phone and claims that she has good BP control. Psychosocial 1. Maintain good relationship with caregiver. 2. Encourage her to vent feelings regarding the unexpected financial burden of rebuilding her house which was destructed because of the typhoon Pepeng.

9. Lanot 1134 Prudencio St. Sampaloc Manila #0907 162 8213 Mini Nutritional Assessment Score: GDS & MMSE: cannot be assessed Unilaterally extended Family in Later years 1. Breadwinner : Susan Lanot (daughter) 2. Decision maker: Susan Lanot – daughter 3. 1˚Caregiver: Bella (informal caregiver) 4.MCSI Madalas- Minsan- Halos hindi- Lanot, Anicia Female 76 y/o Diabetes Mellitus type 2, uncontrolled SAH stage II, controlled ASHD, CAD, LVH, NIF, Class IIB s/p CVA (2003) s/p UGI endoscopy 11/3/08 s/p AKI secondary to Acute Blood loss, resolving Metoprolol 50mg/tab, 1 tab BID Amlodipine 5mg/tab, 1 tab OD Insulin 26 U am and 14 U pm Medical 1. Continue current medications 2. Daliy BP monitoring 3. Glucose monitoring TID 4. Follow-up referral to ENT (hearing loss) and Ophtha (blurring of vision). *Patient is being seen by Endo-Med as well, for her DM. Patient’s caregiver already consulted the dietary for nutrition counseling for the patient and is following their advice. *Patient had episodes of Epigastric pain and was given Domperidone which gave relief. 5. Encourage passive ROM exercises by caregiver Psychosocial 1. Maintain good interpersonal relationship with caregivers and relatives in the household