- 11 Apex Drive, Suite #300A, Marlborough, MA 01752
- Office Phone: (833) 902-9898
- info@epphomecares.com
Live-In Caregiver – Providing 24/7 Dedicated Assistance
PATIENT *
ADDRESS *
EMPLOYEE *
EMPLOYEE ID # *
Providing Compassionate & Professional Patient Care
A Certified Nursing Assistant (CNA) plays a vital role in enhancing patient well-being by delivering exceptional care, comfort, and support. From assisting with daily activities to monitoring health conditions, CNAs ensure that each patient receives the highest standard of care.
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DATE:
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TIME STARTED:
Monday
Tuesday
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Sunday
TIME FINISHED:
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Tuesday
Wednesday
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LIVE IN:
Monday
Tuesday
Wednesday
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Sunday
24/7 Supervision & Personal Care Support
- Provide constant companionship and supervision.
- Assist with bathing, grooming, dressing, and incontinence care.
- Reposition and support bed-bound or mobility-limited clients.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Daily Living Assistance & Household Management
- Help with meal preparation, laundry, and housekeeping.
- Ensure a clean, comfortable, and organized living space.
- Assist with grocery shopping, errands, and home maintenance tasks.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Medication Management & Health Monitoring
- Remind and assist with medication schedules.
- Observe for changes in health, appetite, or behavior.
- Report concerns to family members, nurses, or healthcare providers.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Mobility Support & Transportation Assistance
- Assist with walking, transfers, and repositioning to prevent injuries.
- Provide transportation to doctor’s appointments, therapy sessions, and outings.
- Encourage safe physical activity and social engagement.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Companionship & Emotional Well-being
- Foster a supportive and trusting relationship.
- Offer comfort and encouragement in daily routines.
- Engage in meaningful conversations and recreational activities.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Overnight Assistance & Emergency Response
- Remain available for nighttime needs and emergencies.
- Ensure clients feel safe and secure throughout the night.
- Contact healthcare professionals in case of urgent medical concerns.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
End-of-Shift Responsibilities
- Provide a detailed update on care and observations.
- Ensure the next caregiver is informed of any changes or special needs.
- Maintain thorough documentation of care activities and progress.
Monday
Tuesday
Wednesday
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Sunday
Additional Responsibilities as Needed
- Accommodate special care requirements based on individual health needs.
- Adjust caregiving tasks based on physician or family requests.
Monday
Tuesday
Wednesday
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Saturday
Sunday
Patient Signature
Patient Signature
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Aide Signature
Aide Signature
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TUE
WED
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SUN
Employee acknowledges and certifies to Evergreen Palm Primary Home Care Services That employee has actually worked the bumber of hours during the period set forth and as further certified by the patient or his authorized agent. Unsigned Duty sheets will not be accepted. Patient acknowledges and certifies that the hours set forth were actually worked and that the work was performed in a satisfactory manner. The patient should not pay the employee directly under any circumstances.
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