When our loved one with dementia cannot clearly express their own wishes, it becomes a guessing game. When you stumble across an unanswered question in your role as caregiver, just think of the difference guidance from your loved one would have made! So it is clearly important that we do our own preparation for our own potential caregiving needs. Documenting your wishes for your future will be a much-appreciated tool for your own loved ones.

A Personal Care Planning Notebook can be an invaluable tool. It should include:

• A Physicians Orders for Life Sustaining Treatment (POLST) form (update it regularly)
• An Advanced Health Care Directive
• A Power of Attorney document that goes into effect only when you become incapacitated
• A copy of your birth certificate, wedding certificate and the birth certificates of your children
• A will including a nomination for personal representative
• Location of your trust document
• Your health insurance, dental insurance and Medicare cards
• A list of the doctors you normally see
• A Quality of Life Statement

A Quality of Life Statement is a document for your family that describes the care you want:

• Where would you like to receive that care? Get as specific as you like.
• Who would you permit to bathe you, etc.?
• If your finances are depleted, what are other finance options for your continued care?
• Include details about life support or physical conditions you would find acceptable.
• What treatment or loss of physical ability would you not accept?
• A topic that also needs to be addressed is what you consider to be a “good death.” Do you want to be left alone or be surrounded by family? You will lessen stress for your loved ones by providing this important information in advance.

Start on your Personal Care Planning Notebook today and update it at least once a year — your
family will be eternally grateful to you.


THE CAREGIVER FOUNDATION (501(c) 3 nonprofit)
926 3rd St, Pearl City, HI 96782
808-625-3782 | gary@thecaregiverfoundation.org
www.thecaregiverfoundation.org
Contact Gary for a more complete notebook list.