Customizable Care Binder
Create your own personalized binder using a range of customizable templates designed to help you plan and manage your loved one’s care.
All pages are available in single-page PDF format, so you can pick and choose the pages that are helpful for you. With your personalized care binder you’ll be sure to have the right information at your fingertips when you need it.
Download the full caregiving binder, or select the pages that matter to you & create your own binder.
Binder Covers
Personal Information
Personal Information Tab
An introductory tab for the “Personal Information” section of
the binder.
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Inside Cover
A page where you can provide the name and photo of the individual receiving care.
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Person-Centered Description
A page where you can describe how to best support the person receiving care.
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Care Recipient Information
A form to help you gather crucial information about the care recipient, such as birthday, preferred names, and identification numbers, along with a checklist to track the location of important documents.
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Caregiver Contact Information
A form for listing the names and contact details of individuals who routinely offer care to the recipient.
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Other Contacts
A document for cataloging personal and community support contacts who frequently interact with the care recipient.
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Health
Medical Profile
A page to record information about the care recipient that is commonly needed in both emergency and non-emergency medical scenarios.
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Health Care Directory
A page to list the care recipient’s insurance and medical record number, medical emergency contacts, and their primary care physician.
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Health Care Directory (Specialists)
A page to list the contact information of the care recipient’s medical specialists.
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Preferred Medical Locations
A page to record where your loved one would like to go to receive medical care.
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Medication List
A page to list all prescriptions, over-the-counter drugs, vitamins, and supplements your loved one uses.
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Medical History
A form to document the medical history of the care recipient, including medical conditions and the use of adaptive devices.
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Surgery & Procedure History
A chart to document any surgeries or procedures your loved one has had in their life.
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Allergies
A chart to document any known or suspected allergies your loved one has, what happens when they are exposed, and what the protocol is for each.
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Emergency ID Cards
Cards for you and your loved one to carry, providing emergency personnel with contact information for urgent situations.
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Health Information Checklist
A document to record the location of crucial health information and documents, including advanced directives, wills, and insurance policies.
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Home & Finances
Home & Finances Tab
An introductory tab for the “Home & Finances” section of the
binder.
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Financial Contacts
A page to record who should be contacted about your loved one’s finances, such as advisors, banks, and tax preparers.
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Additional Financial Contacts
An additional page to record your loved one’s financial contacts.
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Finance Checklist
A document to record the location of crucial financial information and documents, including bank records, tax returns, and trust documents.
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Routine Bills
A page to itemize recurring charges to your loved one’s bank account, such as mortgage or rent, utilities, and cable services.
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Additional Routine Bills
An additional page to detail the care recipient’s other routine bills and subscriptions.
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Important Home Information
A document to catalog essential information about the care recipient’s home, including details on the HVAC, water, and electrical systems, along with emergency plans.
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Transportation
Transportation Tab
An introductory tab for the “Transportation” section of the binder.
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Transportation Checklist
A page to outline your loved one’s transportation information, covering details about their vehicles, insurance policies, and transportation service arrangements.
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Vehicle Maintenance Checklist
A page to document your loved one’s vehicle maintenance history and maintenance schedule.
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Assessments
Activities of Daily Living (ADL) and Independent Activities of Daily Living (IADL)
A page describing how evaluating Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) can benefit caregivers and the individuals they assist.
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The Katz Index of Independence in Activities of Daily Living
An assessment and explanation of the Katz ADLs.
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The Lawton Instrumental Activities of Daily Living Scale
An assessment and explanation of the Lawton IADLs.
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Home Safety Assessment
A checklist for assessing the safety of your loved one’s home, designed to help identify potential modifications that could facilitate aging in place more effectively.
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Self-Care Assessment
A brief assessment for caregivers to complete, aimed at evaluating their self-care practices to help prevent burnout.
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Planning
Daily Planner
A daily organizer template for caregivers, designed to track their mood, manage their daily schedule, keep a checklist of tasks, and record other vital daily information.
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Weekly Planner
A weekly organizer template for caregivers to record weekly priorities, events or appointments, or other important tasks to be completed.
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Monthly Planner
A monthly organizer template for caregivers to record monthly goals, tasks, and events.
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Other
Immigration Checklist
A checklist for caregivers to record the locations of essential immigration documents belonging to their loved one.
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Public Benefits Checklists
A checklist to document the public benefits utilized by the care recipient.
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Notes
Blank note pages for caregivers to write down anything additional information about the care recipient, or to share messages between other caregivers who help.
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Find Resources to Help You Live Your Way
Can’t find the resources you are looking for? Call us directly to be connected with an Information & Assistance Specialist.