We would like you to share a few things about your life – your background, your experiences, interests, people, places and events.
What you tell us will be used to assist your Care Partner to be able to personalise your care plan. This helps us get to know you better and understand what matters most so that we can tailor support that meet your unique needs, interests and preferences.
You do not need to complete every question or section, and you can tell us as much or as little as you like.
What you share with us will stay private and will only be used to help us understand and support you better. There are some prompts if you need them. Take as much time as you like or need, it's up to you.
If reflecting on your life experiences causes you concern or raises painful memories and you would like to discuss this with someone, please contact your Care Partner- Resthaven staff are here to help.
If you like, you could ask a family member or friend to help you, or, if you prefer, someone from Resthaven will be happy to help you to complete the form.
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Name:
Date:
Getting to Know Me
My birth, childhood and growing up - I am comfortable to share the following about my birth, childhood, and upbringing, including the parts that are meaningful to me and continue to shape who I am today
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I’d like to share the parts of my culture, heritage, family traditions, and any spiritual practices or beliefs that are important to me and that I would like to be respected, supported, and reflected in the care I receive
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My life as an adult - I would like to share the kinds of work, roles, or activities (e.g., Community volunteering) I have been involved in over the years
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I would like to share some of my achievements, milestones, or moments I am most proud of
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My relationships and friendships, past and present and those that support me include
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My intellectual and social interests (for example, reading, writing, learning new skills, watching or playing sport, exploring new ideas) include
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A good day for me includes
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I would like to tell you about a positive or negative past or present life experience(s) that may still impact my health and wellbeing or the way I engage with others
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I have experienced some difficult or challenging events in my life, and there may be certain situations, environments, or interactions that make me feel uncomfortable, anxious, or unsafe. I would like you to be aware of these so that you can support me in a way that feels safe and comfortable for me
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My Health and Life Choices
1] My communication needs and any preference related to sensory issues (hearing, vision or other sensory needs) includes
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2] My health issues and needs are identified in my Support Plan, but I would like to highlight the health issues that are important to me and impact my life (for example, medication, continence needs, nutrition and hydration requirements, allergies and sensitivities, mobility, or memory loss)
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3] Things I feel confident about or manage well in my life right now are
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4] What motivates me to do things to improve my health and wellbeing
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5] The following are the things I really want to be able to do or accomplish
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6] With the following support this is how I think I could accomplish these
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7] If you would like some help in an area not covered elsewhere in this form you may want to make some brief notes about the sort of help you would like and any aim you have in mind. Are there any additional health or lifestyle choices that you would like to share with us?
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Thank you for helping Resthaven to get to know you better.
