Tool 03 · Know the person

Life story form.
The person before the diagnosis.

To fill in with the person and with someone who knows them well. It helps the team choose activities, music, places and conversations that make sense for this person, and avoid what upsets them.

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Version

00About this form

Who filled it in, and when. Update it whenever you learn something new.

Filled in by

Date

01How they like to be addressed

The right name is the first gesture of respect.

Name

What they like to be called

Languages they speak or understand

02Where they come from

Places stay in the memory longer than almost anything else.

Where they were born and grew up

Other places they lived

The house or place they remember best

03Work and occupations

Here the person is the expert.

Jobs or occupations

What they are proudest of

04Important people

Family, friends, neighbours, pets. With names, so the team can mention them.

Who they are and their names

05Likes

As specific as possible: the name of the song, the dish, the place.

Songs and singers

Favourite foods

Places they love or would love to visit

Programmes, clubs, hobbies

06Routines

Small rituals that make the day feel safe.

In the morning

In the evening

07What helps and what upsets

Perhaps the most useful part for the team.

What calms them or brings comfort

What upsets them or should be avoided (topics, sounds, situations)

08For activities

What they would like to do, see or hear again.

Ideas and requests

Fill in only what the person wants to share. The personal data on this form is the responsibility of the institution that keeps it, under the GDPR.

With RVer headsets, the team can take the person to the places on this form. Discover RVer →

None of these tools assesses, measures or diagnoses. They help the team organise its work and do not replace clinical guidance or the individual care plan.

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