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Long-term Care Complex Behaviour Referral
Format: mm/dd/yyyy
Has MRP / NP been notified?
Was the person hospitalized in the last 3 months for this behaviour?
Recent Changes in medication?
What RISKS does the behaviour present?
Is an AGG Alert in place?
Have you consulted the BC BPSD Algorithm?
Has a P.I.E.C.E.S. Worksheet been completed?
Changes to the RAI Outputs (CAPs, outcome scales)
Is a psychiatrist involved?
Is Mental Health services involved?
Is Acquired Brain Injury services involved?

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