1. ____<<Insert Name Here>>____
My Life Story Book
This life story book has been created to provide you, the health care-giver, with information about…
____<<Insert Name Here>>____

2. Purpose of the Life Story Book
While I may sometimes have difficulty remembering things or communicating clearly, I am a unique person with my own memories, experiences, and preferences.  I have helped to create this book because it is my hope that this information will help you to provide compassionate and personalized care for me. 
Thank you for taking the time to read this, and for providing care.

3. Purpose of the Life Story Book
Information in this book is:
condensed and simplified;
provides a quick “snap-shot” of this person’s story and special care needs;
Contains the most important personal information for care:
My Life Reflections
My Family and Home Life
Helping Me in Everyday Life
I Look Forward to…/ Hopes and Dreams

4. This book can help you to…
Examples:
…tailor direct care to better meet my personal preferences
…guide and add meaning to conversations with me
…support my sense of self-worth & self-esteem;
engage me in activities that are meaningful and continue my life experiences

5. My Life Reflection
I am…/ I was…/ I did… (List Major Life Achievements and Accomplishments)
“This is a
long ago photo of me’
“Back then I…”

6. My Life Reflection
I always… (Identify Life-long Habits that would help provide care)
“This is a
long ago photo of me’
“Back then I…”

7. My Life Reflection
I remember…When I… (Identify significant positive memories, familiar family stories, etc.)
“This is a
long ago photo of me’
“Back then I…”

8. My Life Reflection
When I was… (identify significant life &/or historical landmarks, e.g., marriage, children, war years, immigrating)
“This is a
long ago photo of me’
“Back then I…”

9. My Family and Home Life
Family, friends and pets who are important to me are: (List names & relationships)
Current
Past
This is
Here I am with….
We went to…

10. My Family and Home Life
My favourite memory(ies) of time with… (family, friends, pets) is/are…
This is
Here I am with….
We went to…

11. My Family and Home Life My special memories of home are (specify)…
This is
Here I am with….
We went to…

12. Helping me in everyday life
My personal preferences when helping me with my care include:
Examples:, Sleeping position; Food/Beverage favourites
This is a picture of me when I was…
…Independent…
…enjoying…
…doing…

13. Helping me in everyday life
I like talking about…
This is a picture of me when I was…
…Independent…
…enjoying…
…doing…

14. Helping me in everyday life
I like it when others ask me…
This is a picture of me when I was…
…Independent…
…enjoying…
…doing…

15. Helping me in everyday life
I am most comfortable when…
This is a picture of me when I was…
…Independent…
…enjoying…
…doing…

16. Helping me in everyday life
What gives me pleasure is… (especially sensory information)
This is a picture of me when I was…
…Independent…
…enjoying…
…doing…

17. I am looking forward to…
My favourite traditions, holidays, seasons are
Here is a
picture of me
celebrating…

18. I am looking forward to…
I always celebrate…(describe)
Here is a
picture of me
celebrating…

19. My Hopes and Dreams (List Known Aspirations and Hopes) I want to see…
I hope to…
Here is a
picture of me
celebrating…

20. Hopes and Dreams List Known Aspirations and Hopes (continued):
I always wished…
I would like to participate in…
Here is a
picture of me
celebrating…