A worksheet for your parent to fill in, in their own words, about what matters most to them as things change.
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2 pages, ready to print on standard letter paper.
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What’s on it
- What matters most, what they enjoy now and what they worry about
- Where they want to live, and what would make that possible
- Help they would accept, and help they wouldn’t want yet
- Who they want involved in decisions, and the people they trust most
- How they’d like to be told hard news, and by whom
- What they want the family to know about their values and health care
How to use it
Your parent fills it in at their own pace, alone or with you. It’s a record of what matters to them, to guide the family’s decisions.
It isn’t a legal document. It doesn’t name a health care agent or replace an advance directive.
Where it comes from
This tool comes from Chapter 4, “Talking With Mom or Dad,” of When Mom or Dad Can No Longer Manage Alone by Mark Duda. The chapter covers how to talk with a parent about what’s changing.
Related reading on this site
All 18 tools from the book are on the printable tools page.
The tools may be printed and copied for personal use within your own family. They are not medical, legal or financial advice.