Caregiving Checklist

Patient Name: Thomas J. Aquinas

Age: 82
Chore's and Checklist
Tasks Time Mon Tue Wed Thu Fri Sat Sun
Personal Care
Take a bath 7:00 am       
Clean Teeth 7:20 am       
Change Clothes 7:30 am       
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Meals
Breakfast 8:00 am       
Lunch 12:00 pm       
Snacks 4:00 pm       
Dinner 7:00 pm       
Activities and Exercise
Walk Around(slow & fast pace) 9:00 am       
Read Books & News Articles 11:00 am       
Watch TV 2:00 pm       
Listen to Favorite music 2:30 pm       
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Households
Prepare the Laundry 2:00 pm       
Washing Dishes 2:15pm       
Disposal of Trash 2:00 pm       
Clean Bedroom 2:05pm       
Ｃｌｅａｎ Ｋｉｔｃｈｅｎ 2:15pm       
Pickup the Laundry 4:10pm       
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Medicines
Morning Medicine 8:20 am       
Evening Medicine 7:20 pm       
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Medical
Vital Signs 8:00 am       
Medical Appointments 1:00 pm       
Organizing the medicines 2:00 pm       
Going to the Doctor 3:00 pm       
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Date: Raymark C. Del Rosario

Caregivers Name and Signature