![]() | Yes! I would like to be a member of the Alzheimer's Services Speaker Bureau. I am available to speak (with adequate notice) on the following days and times: |
Please
indicate all days and times that you are available:
Morning | Noon | Afternoon | Evening | |
| Monday | ||||
| Tuesday | ||||
| Wednesday | ||||
| Thursday | ||||
| Friday | ||||
| Saturday | ||||
| Sunday |
I
can present information on the following topics (check all that apply):
An
Overview of Alzheimer's Disease
Caring
for Someone with Alzheimer's Disease
What
is Alzheimer's Services of the Capital Area and the Services it Provides to the
Community?
Wandering
/ Safe Return
Communicating
with an Alzheimer's Patient
Managing
Aggressive Behavior
Nursing
Care of the Confused Client
Fall
Prevention Program
Psychotropic
Medications
Sundowning
Restraint
Reduction Measures
Managing
Caregiver Stress
Activities
for People with Dementia
Assessing
for Dementia
Care/Service
Plan Development
Validation
Therapy and other Ongoing Care Strategies
Late
Stage Care
Managing
Symptoms of Dementia - Depressions, Hallucinations, etc.
Legal
Questions
Getting
a Diagnosis / Seeing the Doctor
Tqaking
the Car Keys Away
Other_____________________________________________________________
Other_____________________________________________________
Other_____________________________________________________
| YES! I am also willing to appear on early morning TV shows (2une In, Nine News This Morning, 33 Today) to discuss Alzheimer's disease issues and promote local Alzheimer's Services events. |
Name:________________________________________________
Daytime Phone:_________________________
Mailing
Address:_______________________________________________________________________________
______________________________________________________________________________________________
Thank
you!
Please mail this form:
Alzheimer's
Services of the Capital Area
3772 North Blvd., Ste. B
Baton Rouge, LA 70806