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My Choices Resource

My Choices Resource

An A-Z of personal choices and practical preparations to facilitate end of life support, a resource from Baptist Care SA

 

Introduction to My Choices, A-Z indexes, and Worksheets

Making decisions is a part of everyday life. This includes making difficult choices such as: ‘What job will I take?’, ‘Will I marry?’, ‘Will we have children?’, ‘When should I retire?’, ‘How do I want to spend my final days?’, ‘How do I want to be cared for?’ What would happen if you became suddenly ill and could no longer communicate with your family? Would they know how you prefer to be cared for? Would someone know where your important paperwork is? Would they know what payments to stop? Which friends would you like contacted and what is the best way to reach them?

 

Thinking about these issues and having discussions about them long before it is necessary is really helpful to you, your family and your caregivers. It reduces your stress and the stress of everyone involved in supporting you. This is even more essential if your family and significant people live far away.

 

We have three resources to prompt your thinking about your end of life support and assist you to create a personal record either electronic, hard copy, or a mixture of both to document your choices.

 

My Choices

1. My Choices

This book is a valuable guide to show you how to use the worksheets. It will help you initiate the conversations with family, and provides examples of how you can use the A-Z indexes and worksheets. We recommend you use the book to assist you when completing your worksheets. The book is available from Baptist Care SA for $15 plus postage and handling.
 
Click here to order My Choices…

 

A-Z Index

2. A-Z Index

Each of the five sections has an A-Z index prompt your thinking regarding the relevance and importance of each topic for your end of life support. The indexes will help you reflect on what you value, so you can describe your wishes and preferences more accurately when you document them. You can use the worksheets or another system such as a binder with an A-Z index, or an indexed notebook to document your choices.
 
Click here to download full A-Z Indexes now!
 

Worksheets

3. Worksheets

We have provided you with a series of worksheets in digital form using MS Word or as PDFs to document your choices. Be sure to keep your personal information and your financial details, usernames and passwords secure. Do not share private information.
The worksheets are a resource to collate your information. Each worksheet has instructions on how to complete it. The My Choices book has more information to guide completion of each worksheet. You can use as many copies as you need of each worksheet and complete as much of each sheet as is relevant to your situation. Some worksheets may have no relevance to you at all. Record as much or as little as you want on the worksheets. You should review and update your document as your preferences change. The choice always remains yours. Some of the larger worksheets have been broken into smaller sections so you can download the sections that are relevant to you.
 
Click here to download a PDF of the complete Worksheet series now!
Click here to download a Word Document of the complete Worksheet series
Click here to download individual Worksheets
 

Advanced Care Plans

My Choices is not a legal Advance Care Directive. However, it may prompt your thinking and assist you to complete that form. Visit the Advance Care Planning website for information and to download the correct forms for your Australian state or territory https://www.advancecareplanning.org.au/ or ring 1300 208 582
 

Security

Some of the worksheets in My Choices contain private information and they should be stored in a secure place. We recommend that you keep those worksheets in a fireproof, locked box because they hold important information that should remain confidential and secure.
Other worksheets can be made available to your support worker/s and they can be kept in a separate file that is readily accessible to your workers.
If you want to record secure identity numbers, passwords, security identifications etc. then you must keep that information in a separate document and store it in a locked, fireproof safe, in order to keep your information secure. That information should not be stored in your My Choices file.
Do not share your secure private information.
Be sure to keep your personal information, financial details and passwords secure.
 

Disclaimer

While all care has been taken in preparing this publication, Baptist Care (SA) Inc. expressly disclaims any liability for any claims, damages, losses, expenses the user may incur as a result of or associated with, the use of the information contained herein for any reason whatever.

About My Choices

1An A-Z of personal choices and practical preparations to facilitate end of life support, a resource from Baptist Care SA

 

My Choices is structured into five sections, these are:

 

Section 1: My Personal Contacts

Records the contact details of your next of kin, family, friends, carers, health professionals, and other service providers that support your care, and any people you may want to inform in the event of a serious illness/accident, or death.

 
My Choices Worksheet for Section 1
1.1 My Personal Contacts

A-Z Index 1 My Personal Contacts

 

Section 2: My Personal Administration

Documents the information required for your personal administration. This could include: regular bills, assets, debts, charities, subscriptions, memberships, social media accounts, etc. Collate the information in one place to make it easier for someone supporting you to administer your affairs and keep things going while you are seriously unwell, or cancel them after you die.

If you complete any of these forms ensure the security of these documents.
 

My Choices Worksheets for Section 2


 

Section 3: My Health

Record how you manage your health and your medical care plans so your workers and carers can effectively support you and care for you.

 
My Choices Worksheets for Section 3
3.1 My Medical History – broken into the following sections

 

Section 4: My Care

Note your personal preferences about how you want to be supported and cared for if/when the need arises. This information will help family, carers and support workers know your choices when you are unable to explain them. It clarifies your routines, and your directions, making it more likely that your support will be effective. It also means that you don’t have to keep restating your preferences as new workers come in and out of your life.

 
My Choices Worksheets for Section 4



 

Section 5: My Death

Document your wishes regarding the final stages of dying. Collate information for use with your death certificate, death notice (obituary), and/or eulogy. Provide information on religious or cultural rituals and remembrances you have created. Include personal arrangements you have already made such as pre-paid funeral plans.

 

My Choices Worksheets for Section 5

My Choices Worksheets

Below we have provided you with a series of worksheets in digital form using MS Word or as PDFs to document your choices. Be sure to keep your personal information and your financial details, usernames and passwords secure. Do not share private information.

 

Worksheets
 

Click here to download a PDF of the complete Worksheet series now!

Click here to download a Word Document of the complete Worksheet series now!
 
The worksheets are a resource to collate your information. Each worksheet has instructions on how to complete it. The My Choices book has more information to guide completion of each worksheet. You can use as many copies as you need of each worksheet and complete as much of each sheet as is relevant to your situation. Some worksheets may have no relevance to you at all. Record as much or as little as you want on the worksheets. You should review and update your document as your preferences change. The choice always remains yours.
 

Some of the larger worksheets have been broken into smaller sections so you can download the sections that are relevant to you.

Section 1

1.1 My Personal Contacts (Word Document)

1.1 My Personal Contacts (PDF)

 

Section 2

2.1A My Identity Records (Word Document)

2.1A My Identity Records (PDF)

2.1B My Entitlements Records (Word Document)

2.1B MY Entitlements Records (PDF)

2.2 My Digital Identity (Word Document)

2.2 My Digital Identity (PDF)

2.3A My Financial Assets (Word Document)

2.3A My Financial Assets (PDF)

2.3B My Other Assets (Word Document)

2.3B My Other Assets (PDF)

2.4 My Debts and My Bills (Word Document)

2.4 My Debts and My Bills (PDF)

 

Section 3

3 Private & Confidential Details Form (Word Document)

3 Private & Confidential Details Form (PDF)

3.1 My Allergies or Sensitivities (Word Document)

3.1 My Allergies or Sensitivities (PDF)

3.1 My Family Medical History (Word Document)

3.1 My Family Medical History (PDF)

3.1 My Immunisation History (Word Document)

3.1 My Immunisation History (PDF)

3.1 My Medical History Body Chart (Word Document)

3.1 My Medical History Body Chart (PDF)

3.1 My Screening and Diagnostic Test Checklist (Word Document)

3.1 My Screening and Diagnostic Test Checklist (PDF)

3.1  My Significant Health and Hospitalisation History (Word Document)

3.1  My Significant Health and Hospitalisation History (PDF)

3.2  My Current Medications (Word Document)

3.2  My Current Medications (PDF)

3.3  My Current Health Issues (Word Document)

3.3  My Current Health Issues (PDF)

3.3  My Upcoming Appointments (Word Document)

3.3  My Upcoming Appointments (PDF)

3.4  My Equipment and Aids (Word Document)

3.4  My Equipment and Aids (PDF)

3.5  My Emergency Plans and Preparations (Word Document)

3.5  My Emergency Plans and Preparations (PDF)

Section 4

4.1  Choosing My Support Workers (Word Document)

4.1  Choosing My Support Workers (PDF)

4.2  About Me (Word Document)

4.2  About Me (PDF)

4.2  My Culture (Word Document)

4.2  My Culture (PDF)

4.2  My Home (Word Document)

4.2  My Home (PDF)

4.2  My Important Connections (Word Document)

4.2  My Important Connections (PDF)

4.2  My Interests and Activities (Word Document)

4.2  My Interests and Activities (PDF)

4.2  My Occasional Connections (Word Document)

4.2  My Occasional Connections (PDF)

4.2  My Pets (Word Document)

4.2  My Pets (PDF)

4.2  My Places of Connection (Word Document)

4.2  My Places of Connection (PDF)

4.2  My Story (Word Document)

4.2  My Story (PDF)

4.2  My Support People (Word Document)

4.2  My Support People (PDF)

4.2  My Support (Word Document)

4.2  My Support (PDF)

4.3  My Routines (Word Document)

4.3  My Routines (PDF)

4.4  My Environment (Word Document)

4.4  My Environment (PDF)

4.5  My Personal Care (Word Document)

4.5  My Personal Care (PDF)

4.6  My Home Support (Word Document)

4.6  My Home Support (PDF)

4.7  My Food Allergies (Word Document)

4.7  My Food Allergies (PDF)

4.7  My Nutritional Support (Word Document)

4.7  My Nutritional Support (PDF)

4.8  My Spiritual Support (Word Document)

4.8  My Spiritual Support (PDF)

 

Section 5

5.1 My Dying Wishes (Word Document)

5.1 My Dying Wishes (PDF)

5.2A My Information (Word Document)

5.2A My Information (PDF)

5.2B My Information (Word Document)

5.2B My Information (PDF)

5.3 My Funeral and My Remembrances (Word Document)

5.3 My Funeral and My Remembrances (PDF)


 

Feedback Form 

My Choices Feedback Form (Word Document)

My Choices Feedback Form (PDF)

A-Z Index

Each of the five sections has an A-Z index to prompt your thinking regarding the relevance and importance of each topic for your end of life support. The indexes will help you reflect on what you value, so you can describe your wishes and preferences more accurately when you document them. You can use the worksheets or another system such as a binder with an A-Z index, or an indexed notebook to document your choices.

 

A-Z IndexClick here to download the complete A-Z Indexes now!

 

Click below to download the Indexes…


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