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United Way of the Adirondack Region, Inc.
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Vital Link Program
The Vital Link Program is a collaborative effort by American Red Cross, CVPH Medical Center, and the United Way of Clinton & Essex Counties, Inc.
Vital Link Goals
Vital Link Components
Community-wide program targeted to persons 60 or older by key health care providers and agency staff to include:
o Completion of the Vital Link form which outlines basic medical history and medications.
o A magnetized plastic holder for posting the Vital Link Form on refrigerator.
o Importance of bringing "brown bag" with all medications and "Vital Link" form to doctor or pharmacist.
o Review of pamphlet outlining rules for safe medication use.
o Education of all health care providers.
Vital Link Medication Record
Here is a sample of the Vital Link Medical Record. Participants are encouraged to place this on the front of their refrigerator, use it to keep a record of their medications, and bring the record when they visit their doctor or health care provider and ask them to help them keep it updated.
____ ___________________________________________________________________________ Name:________________________________________ Allergies:____________________________________ (First) (M.I.) (Last) ____________________________________
Address:________________________________________ ____________________________________ (Street, Apt #) (City) (State, Zip code)
Phone:_____________________ Date of Birth:_____________
Number in Household:_____________ Pharmacy:___________________________
CURRENT MEDICATIONS...(Include prescription and non-prescription)
DOCTOR/S NAMES AND PHONE NUMBERS...
____________________________________ ____________________________________ Insurance Information:_________________ ____________________________________
ADVANCE DIRECTIVES: Non-hospital DNR (Do Not Resuscitate)____yes____no (attach original) Health Care Proxy____yes____no (attach a copy)
IN CASE OF EMERGENCY...
Name: __________________________________________________________ (First) (M.I.) (Last)
Address: ________________________________________________________ (Street,Apt.#) (City) (State, Zip Code
Phone: ___________________________
Relationship: ______________________
PAST
MEDICAL HISTORY...( Heart Problems: ________________________ Pacemaker: ____________________ Breathing Problems: _____________________ Bleeding Problems: ______________ Seizures: ______________________________ Diabetic: ______________________ Hearing Problems: _______________________ Sight Problems: ________________ Prosthesis: _____________________________ Depression: ___________________ Hearing Aid: _______________________ Contacts: _________________________ Glasses: __________________________ Dentures: _________________________ Other: ____________________________
Other/Comments: __________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________
Good Pill, Bad Pill Program The Good Pill, Bad Pill Program is designed to educate patients regarding drug interactions. It encourages participants to review with their doctors/pharmacists all medications they are taking to avoid drug interactions. Below is some information about this GOOD PILL?
(Art donated by Sid Couchey) BAD PILL? Play it safe with medicines! Older Americans take more than 443 million prescription drugs annually, and about half are taken incorrectly. This often leads to serious illness and hospitalization. Play it safe with your medicines by following these rules:
About Drug Interactions Medicines can interact with other medicines, with foods and beverages, or with medical conditions. These interactions can make a medicine less effective or even harmful for you. This is a concern for people of all ages, but seniors are at the greatest risk because they generally take more medicines. More than nine million adverse drug reactions occur in older Americans annually. Remember that eye drops, prescription shampoos or lotions, vitamin supplements, pain relievers, sleep aids, cold remedies, and laxatives should be considered drugs and may react with other medicines. When you make your medication record or take your medicines for a checkup, be sure to include all of them!
Take Your Medicines for a Checkup! Put all your prescription and nonprescription medicines (don't forget vitamins, pain relievers, sleep aids, cold remedies, and laxatives) in a bag and take them with you the next time you visit your doctor or pharmacist. He will answer any questions you might have and check to see that:
The Vital Link Program Information was provided as part of a public awareness campaign by a coalition of concerned community health care agencies and financed by the CVPH Medical Center Foundation and United Way of Clinton & Essex Counties, Inc.
To find out more about the Vital Link Program or to access forms to help you record all your medical information you can contact: American Red Cross - 561-7280 United Way of Clinton & Essex Counties, Inc. - 563-0028 CVPH Medical Center - 561-2000
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United Way of the Adirondack Region, Inc. * 45 Tom Miller Road * Plattsburgh, NY 12901
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