My Health Care Planning Checklist
Start to make your personal plan with a easy to use Checklist.
My Health Care Planning Checklist is designed to help you create a personal care plan centered around your decision-making abilities, unique needs and care choices.
The Checklist's 5-step planning process protects your right to make decisions where you are able, and helps you build in help and supports to meet your essential health, personal and safety needs.
You can personalize your plan writing in comments and using the free planning documents and resources included in the checklist.
Every adult can start to make a plan using the Checklist. It is especially helpful for adults who can make some or all health care and personal decisions with the help and support of others.
Many thanks to our Partners and Friends who contributed their expertise to the Checklist. See Acknowledgements below.
Make a Plan: 5-Step Planning Process
Here's how it works:
You can fill out the step-by-step checklist yourself or with the help of anyone you choose—a family member, a supportive person or care professional.
The Checklist has 5 steps. In each step, simply check the boxes that apply to you and add in personal comments of where help is needed. Here are the 5 Steps:
- Step 1- Identify your decision-making abilities and things you can decide and do;
- Step 2 - Note your health and personal needs and where you need help;
- Step 3 - Make care choices and complete planning documents;
- Step 4 - Build in any help, services, supports and alternatives to meet your essential health and personal needs and avoid an unnecessary Guardianship or Conservatorship;
- Step 5 - Consider the steps to pursue a Guardianship or Conservatorship only if your essential needs remain unmet and help is needed after exploring all supports and alternatives.
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- If you are currently under a Guardianship or Conservatorship and your essential needs are met with supports and alternatives, explore steps to modify or terminate.
Make a plan
Use your completed Checklist to make your personal plan. Each of the 5 steps above has free planning documents and tool kits on page 7 to write down your care choices. Explore the list of resources on pages 8-10 to build in needed help, supports and alternatives. The summary page helps you share your Checklist with others to get the care you need and want.
Go at your own pace.
To get started- use the fillable PDF Checklist or download a paper copy to fill out by hand. You can complete yourself with with the help of anyone you choose.
Quick Links to Tools and Resources List
The Checklist includes a comprehensive list of Honoring Choices planning tools and multilingual documents, and a List of Resources to build in needed help, supports, accommodation and alternatives. The fillable PDF Checklist has direct links on pages 7-10. If you are using a paper copy Checklist you can access the links below.
Here are the expanded tools and resources with additional quicks links to personalize your plan.
- Honoring Choices MA Planning Documents and Tools
- List of Supports, Accommodations and Alternatives
- Alternatives to Guardianship and Conservatorship
- Steps to Pursue a Guardianship and Conservatorship
- Steps to Modify or Terminate a Guardianship and Conservatorship
- All Resources.
Many Thanks to Partners & Friends
We are very grateful to the Honoring Choices Partners and Friends who contributed their expertise and experience to developing the checklist and valuable resources.
Many thanks to:
- Kate Granigan, LICSW, C-ASWCM, Alder
- The Administrative Office of the Probate and Family Court
- Nicole McGurin, Alzheimer's Association, MA/NH Chapter
- Elizabeth H. Connell, Mass Association of Councils on Aging
- Adam Delmolino, Massachusetts Health & Hospital Association
- Morgan K. Whitlatch, Center for Public Representation
- Nora Bent, The Arc of Massachusetts
- Christine McMichael, Hospice & Palliative Care Fed/MA
- Colleen Pierro, Home Care Alliance of MA
- Clarence Richardson, JD, MassNAELA
- AWynn Gerhard, JD, Massachusetts Guardianship Policy Institute
- Attorney Rebecca Benson, Access to Justice Fellows Project
- Ann Phelan, Perkins Transitions Center
- Paula Griswold, Mass Coalition for the Prevention of Medical Errors
- Stephanie Baker and Laura Vanderhill, Healthcentric Advisors
- and the adults and families of the Honoring Choices Consumer Health Equity Advisory Group
Everything you need is on the Resources Page.
You can find complete information and many additional videos, fact sheets and multilingual tools on the Honoring Choices MA Resources page. Learn more here.