From: Deployment of assistive living technology in a nursing home environment: methods and lessons learned
Date: ____________ | Patient: __________ | Â | Â | Â | Â | Â |
---|---|---|---|---|---|---|
 | Where is patient right now? | Did patient shower for too long? | Did patient forget to turn off tap? | Did patient forget to flush toilet? | Did patient wander around aimlessly? | Did patient ask for something? |
 | -Bedroom | -Yes | -Yes | -Yes | -Yes | -Yes |
 | -Bathroom | -No | -No | -No | -No | -No |
 | -Dining area | If so what did (S)he ask for? |  |  |  |  |
 | -Common area |  |  |  |  |  |
 | -Other |  |  |  |  |  |
Hour 1 | Â | Â | Â | Â | Â | Â |
Hour 2 | Â | Â | Â | Â | Â | Â |
... | Â | Â | Â | Â | Â | Â |