/depts/,/depts/uwmf/,/depts/uwmf/patient-resources/,/depts/uwmf/patient-resources/social-guide/,/depts/uwmf/patient-resources/social-guide/manual/,/depts/uwmf/patient-resources/social-guide/manual/population-specific/,/depts/uwmf/patient-resources/social-guide/manual/population-specific/transplant/,/depts/uwmf/patient-resources/social-guide/manual/population-specific/transplant/heart-transplant/,/depts/uwmf/patient-resources/social-guide/manual/population-specific/transplant/heart-transplant/pre-heart-transplant/,/depts/uwmf/patient-resources/social-guide/manual/population-specific/transplant/heart-transplant/pre-heart-transplant/pre-heart-transplant-vad-evaluation/,/depts/uwmf/patient-resources/social-guide/manual/population-specific/transplant/heart-transplant/pre-heart-transplant/pre-heart-transplant-vad-evaluation/outpatient-smarttext/,

/depts/uwmf/patient-resources/social-guide/manual/population-specific/transplant/heart-transplant/pre-heart-transplant/pre-heart-transplant-vad-evaluation/outpatient-smarttext/

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UWHC,

Patient Services,

Social Work Services Quick Guide,Social Work Manual,Population Specific,Transplant,Heart Transplant,Pre-Heart Transplant,Pre-Heart Transplant VAD Evaluation

Outpatient SmartText

Outpatient SmartText - Social Work Services Quick Guide, Social Work Manual, Population Specific, Transplant, Heart Transplant, Pre-Heart Transplant, Pre-Heart Transplant VAD Evaluation

Focus

Social Work Outpatient Pre-Heart Transplant/VAD Psychosocial Assessment

Pt Prefers To Be Called

Information Provided By

Concerns Identified By Team

Primary Medical Issues

History Of Illness/referral For Transplant/VAD

Description Of Family System

Support System/emergency Contacts

Caregiving Status

Current Home Equipment

Current Home Services

Plan For Post-Transplant/VAD Assistance

Plan For 24 Hour Caregiver Post-Discharge

Plan For Madison-area Housing Post-Discharge

Payment Source For Housing

Payment Source For Meals

Housing

Abuse/Neglect

Transportation

Education/Learning

Advance Directives/Guardianship

Cultural Issues

Religion/Spirituality

Financial Resources

Income

Insurance/RX

Veteran Status

Other Current Stressors

Mental Health

Adaptation/Reaction To Illness

Stress Reduction Techniques/Tools

Adherence To Medical Plan

Nicotine Use

Alcohol Use

Illicit Drug Use

Legal Issues

Prior Personal Experiences With Transplants/VADs

Expectations For Transplant/VADs

Patient/family Concerns About Transplant/VADs

 

OTHER Reviewed risk of depression, anxiety, PTSD, guilt post heart transplant.

INFORMATION PROVIDED

Care pages

Estate planning

Internet Sites

Medicare/Anti-Rejection Rx

POA-HC

Readings

Return to Work Pre-Planning

Self Nurture

Support Groups

Social Worker Business Card

UNOS Brochure "What Every Patient Needs to Know"

IMPRESSIONS

No known psychosocial obstacles to transplant/VAD

Known psychosocial obstacles to transplant/VAD

RECOMMENDATIONS

Patient is currently a transplant/VAD candidate from a psychosocial perspective

More information is required before a decision can be made
Patient is a high risk transplant/VAD candidate from a psychosocial perspective

SUMMARY

Support

Employment

Nicotine Hx

Years in School

Insurance

ETOH Hx

Cultural

Emotional

Illicit Drug Hx

Spiritual

Compliance

Other Concerns

Recommendations