Printables for Caregivers
These basic documents are free for your own use. Print as often as you need.
These forms and documents are a part of the foundation of information necessary for caregivers. Having up to date information will save you time, and help you be prepared to meet the constant changes that occur. Knowing where to go for information and WHAT information you need, not only saves you time, but it will let you make informed decisions. Up-to-date medical record allows doctors and other professionals to provide the best care possible. Being informed makes you a stronger advocate for yourself and for your loved one. This is a growing list so check back often.
As always, if you have a suggestion or a question, please email caregiver@apinchofjoy.com
FINANCIAL INFORMATION FORMS FOR CAREGIVERS
Why: It is important that someone other than the person being cared for, has access to financial information, to keep bills paid and to keep track of income/outgo so that there are no long term financial consequences to an illness.. Often it will fall to the spouse or SO of the patient or other family members to take on this responsibility. This is not a comprehensive list — more to come.
Finance calendar Note important dates and deadlines
Expense Tracker Note expenses as they occur
Monthly Budget Note estimated bills, expenses and income for the month
Income Tracker Note sources and amounts of income as they occur
Password Tracker Necessary for accessing patient portals, bill payments, etc online. Where are electronic passwords stored and what is the password for that service?
HOUSEHOLD INFORMATION AND RECORDS FOR FAMILY CAREGIVERS
Grocery List Keep a running list of needed groceries and supplies
To Do List Reminders of chores and anything else you need to schedule
Routine checklist Mark each routine chore to track what has been done and what needs to be done. Morning chores could include wash face and hands, put in hearing aids, take vitamins,for example.
LEGAL INFORMATION FORMS FOR CAREGIVERS
MEDICAL INFORMATION FORMS FOR CAREGIVERS
Why: Patient portals have limitations. It will be much easier, quicker and more accurate for you to keep your own records. Doctors do not always have access to portals at other locations or they don’t have time to go back and research what was done, when and what the results were. The more complex the history, the more important it is to maintain your own records and have them with you at all times — in your phone, in a file or notebook. More to come
Emergency Contacts Make two copies. One for home and one for your take everywhere records.
Medication List Note which medications were discontinued and why, save time and unwanted side effects.
Current Medication Up to date medications
Medical Health Record Note history as well as current diseases and conditions
Medical Insurance This is a back up in case insurance card is lost. Also make notes about insurance information and coverage.
MULTIPLE CAREGIVERS – FORMS FOR COMMUNICATION
Care Giver Calendar A month’s schedule at a quick glance to keep all caregivers on the same page
Caregiver Daily Reports Necessary for communication between multiple caregivers
Detailed report for use by multiple caregivers Use when a more detailed report is needed to communicate
NOTES AND RECORDS FOR DAILY CARE
PERSONAL FOR CAREGIVERS
Blank Self-Care Checklist Create a self-care list of daily goals, customized just for you.
Suggested Self-Care Checklist Basic and simple — for those busy times.
PLANNERS AND CALENDARS
Yearly Planner January – June undated
Yearly Planner July – December undated
Monthly Overview