Windermere Senior Health Center/ Hospice of Michigan / Windermere/ Hospice of Michigan / AT HOME IN A NURSING HOME IN A HOSPITAL / University of Chicago/ Hospice / IN A HOSPITAL / University of Chicago Study / Hospice of Michigan / /
MedicalCondition
Pick’s disease / CNS infection / frontal temporal syndrome / pain / Probable Alzheimer’s disease / Alzheimer’s disease / Normal pressure hydrocephalus / Parkinson’s disease / MIXED DEMENTIA / HIV / Drug abuse / PRIMARY ETIOLOGIES THOUGHT TO PLAY AN ESSENTIAL ROLE IN PATIENT’S DEMENTIA / dementia / Possible ischemic vascular dementia / Head trauma / Depressive mood disorder / Alcohol abuse / Metabolic disorder / illness / Progressive supranuclear palsy / Probable ischemic vascular dementia / Cerebrovascular disease / Lewy body disease / patient’s dementia / /
Organization
University of Chicago Study / Windermere Senior Health Center / University of Chicago / /
P.D. CASE ID#________ Interview site _________ Interviewer _________ Date_________ PEACE ID#_________