Free Personal Care Profile

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Create Your Free Personal Care Profile

  1. Answer a few simple questions
  2. Email, download or print instantly
  3. Just takes 5 minutes

Personal Care Profile

Beliefs


Beliefs



Frequently Asked Questions
Why should I include information about my personal beliefs?As we age, our spiritual and religious beliefs can provide comfort. Including your beliefs can allow family and caretakers to ensure you receive the emotional and psychological care, comfort, and support you desire.


Your Personal Care Profile

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PERSONAL CARE PROFILE

for ____________________________ of __________, Virginia

These guidelines outline the activities and pursuits that give ____________________________’s life meaning. This document may also include personal beliefs, such as religion or spirituality, and preferences for how ____________________________ likes to be interacted with. Caretakers can use this information as a guide when performing their role and to enhance ____________________________’s quality of life.

This document is not intended to be interpreted as a Last Will and Testament or Living Will. These guidelines are only intended to help family and caretakers in ensuring ____________________________’s senior years are fulfilling.


MISCELLANEOUS

Interaction
I have no preferences for how caretakers interact with me.

Veteran
I am not a military veteran but may be eligible for benefits through Medicaid and state-sponsored programs such as the Program of All-Inclusive Care for the Elderly.

Personal Belongings
I have not recorded the personal belongings I have with me.

SIGNING

I recognize that it may not be possible for my appointee to fulfill all of my wishes and request that my caretakers act to follow the spirit of these wishes as well as they can and within the limits of any applicable law.

Signature

Date:

_________________________

________________ ____, ________

____________________________

 

Personal Care Profile Information

What is a Personal Care Profile?

A Personal Care Profile is a document in which you describe your interests, beliefs, and other personal information to the person who will be responsible for your care (i.e. your caregiver) if you become ill, lose your mental capacity, or simply as you age.

Who can use a Personal Care Profile?

Anyone preparing for their senior years can use a Personal Care Profile, as this document can benefit the people who support seniors as they transition away from an independent lifestyle. For example, the information in a Personal Care Profile can provide guidance in the following situations:

  • If you're moving to a senior housing facility, staff will have an idea of your personality and preferences so they can find activities you're likely to enjoy.
  • If you're hiring a personal care assistant (i.e. a formal caregiver who gets paid for their services), details about your general preferences and health history will aid them as they strive to maintain your standard of living.
  • If you're selecting someone to care for a family member, this document can help you identify the characteristics of an ideal caregiver (e.g. if a Personal Care Profile describes a physical limitation like inflammatory arthritis, you would likely consider this limitation and search for people who have experience dealing with it).

How does a Personal Care Profile differ from a Living Will?

A Personal Care Profile and a Living Will are similar in that they both describe personal preferences when it comes to certain health care decisions. However, there are characteristics of a Living Will that distinguish it from a Personal Care Profile:

  • When properly executed, a Living Will is a legally binding document. Generally, health care providers are required to follow the instructions in this document.
  • A Living Will contains specific directions regarding medical treatments (e.g. you can specify whether or not you want life support if you ever fall into a coma). These directions exist for situations in which you are unable to communicate your wishes.
  • LawDepot's Living Will can be combined with a Medical Power of Attorney, which allows you to name someone to make your health care decisions. Your representative can only act on your behalf once a doctor determines you are incapable of making decisions for yourself.

In contrast, a Personal Care Profile:

  • Is not legally binding or enforceable
  • Specifies personal details (e.g. personality traits, dietary restrictions, physical limitations, etc.) that are meant to be used as guidelines for your caregiver as they help you manage the tasks of daily life
  • Cannot be used to grant someone legal authority to make health care decisions on your behalf

While a Personal Care Profile and a Living Will are two distinct documents, together they can address your personal preferences when it comes to health care decisions in several different situations (e.g. where you're dependent on a caregiver or are incapacitated). As such, these two documents are important to consider when thinking about your future and creating your Estate Plan.

How can a Personal Care Profile help my caregiver?

A Personal Care Profile can remind a caregiver of all the ways they can help make you comfortable, whether they know you personally or not. With this document your caregiver can learn personal details they might not have thought to ask about, which can guide their interactions with you so the experience is positive for everyone involved.

LawDepot's Personal Care Profile template allows you to provide information about your preferences regarding:

  • Entertainment: You can describe your hobbies and interests so your caregiver can easily find entertainment you are sure to enjoy. For example, you can mention any clubs you're a part of, activities you're interested in, or places you enjoy visiting.
  • Beliefs: If you are religious, your caregiver may be able to find community activities (such as church services or charity events) that may resonate with you on a spiritual level.
  • Health: It is important for your caregiver to know of any physical limitations or dietary restrictions you may have so they can ensure your safety. In addition, you can mention any fears or phobias so your caregiver can avoid placing you in unpleasant situations (e.g. if you have a fear of dogs, your caregiver can avoid taking you to parks where dogs are allowed off leash).
  • Miscellaneous: You can describe how you prefer to be interacted with (e.g. you can specify if you're hard of hearing or sensitive to loud noises so your caregiver can adjust the volume of their voice and control which environments they bring you to), the personal belongings you would like to keep close (if you're ever required to move homes), and whether or not you are a veteran (so your caregiver can ensure you claim any benefits you may be entitled to).

Related Documents:

  • End-of-Life Plan: a document that describes how you want your body to be dealt with after you pass away, as well as the services that you want held in your name
  • Living Will: a document that outlines your preferences regarding health care treatments or appoints a personal representative to make health care decisions on your behalf
  • Last Will and Testament: a document that specifies how you would like your property and assets to be distributed after you pass away
  • Power of Attorney: a document that grants authority to someone so they may manage legal and financial affairs on your behalf
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