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Alzheimer's & Dementia - Looking after your loved one
Information for people filling-in
Last updated: Friday, November 02, 2007
Completing this section will give whoever’s filling-in for you an insight into your loved one’s life, helping them understand the significance of stories and names and provide a basis for casual conversation.

 
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Birthdate:


Birthplace:


Favourite name(s):


Spouse’s name and birthday:


Terms of endearment:



Wedding anniversary:


Years together:


Children: Name(s) and birthdays:





Grandchildren: Name(s) and birthdays:





Close friends: Name(s) and birthdays:





Place(s) lived:





Job(s)/Occupation:




Other useful information:







For more information visit: Dementia SA: http://www.dementiasa.org/ or Alzheimer’s South Africa: http://www.alzheimers.org.za/
 
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