Form 2189 - dads state tx-2025

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The document is a form from the Texas Department of Aging and Disability Services, designed to assist in documenting palliative care for residents in nursing facilities. It outlines expected health outcomes and necessary care measures for residents nearing end-of-life, including management of weight loss, skin integrity, dehydration, comfort measures involving catheters, and medication needs. The form emphasizes the collaborative responsibility of nursing facilities and hospice agencies to create a comprehensive care plan that addresses the specific needs of each resident.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the resident's name and room number at the top of the form. This information is crucial for identifying the individual receiving palliative care.
In the diagnosis section, have the attending physician specify any expected outcomes related to the resident's condition. This may include weight loss, skin breakdown, or dehydration.
For each expected outcome, detail the measures that will be implemented by the facility to address these issues. Use clear language to ensure all parties understand their responsibilities.
Complete the 'Other' section if there are additional considerations or specific needs for this resident that should be documented.
Finally, ensure both the requesting resident/family and attending physician sign and date the form at the bottom to validate it.

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