Assist in identifying signs and symptoms indicating physical, emotional, or behavioral change in participants and reporting these signs to the center staff and/or supervisor, including but not limited to, any changes in skin integrity, bowel and bladder status, food/fluid intake, or changes in ambulation. The Gary and Mary West PACE (Program of All-inclusive Care for the Elderly), affiliated with West Health (www.westhealth.org), is a non-profit that delivers medical, social, and behavioral services to the frail elderly to the North County of San Diego.