The Care File: Documents to Gather Before You Need Them
A care file is one place holding the facts someone would need to act on an older adult's behalf: who their doctors are, what they take, who to call, and what they have decided about their own care. Build it with them.
Emergency departments, new clinicians, and after-hours services tend to ask the same questions. Having the answers in one place saves a lot of looking.
What goes in it
Identity and basics
- Full legal name, date of birth, and home address
- Preferred language, and whether an interpreter is needed
- Medicare, Medicaid, or insurance numbers and plan details
Medical
- Primary care clinician and any specialists, with phone numbers
- Preferred pharmacy, including the branch and its number
- Current medications with doses and what each is for, including over-the-counter items and supplements
- Allergies and past reactions
- Major diagnoses, surgeries, and implanted devices
- The hospital the family would choose, and how they would get there
People
- Emergency contacts in the order they should be called
- The local contacts from your local support circle
- Who is named in which legal document, and how to reach them
Legal and financial
- Advance directive or living will
- Health care proxy or medical power of attorney
- Financial power of attorney
- Will, and where the signed original is kept
- Attorney, accountant, or financial adviser contacts
- Where bills, banking, and insurance policies are handled
Practical
- How to get into the home, if the older adult agrees to share it
- Pets: names, vet, food, and who would take them
- Alarm codes, utility accounts, and the landlord or building contact
Where to keep it
Put a printed one-page summary somewhere obvious in the home, where someone else could find it. The fridge door is the traditional spot. Keep the fuller version somewhere the family can reach from anywhere, and make sure at least two people know how to open it.
A care file gathers a lot of sensitive information in one place, so it is worth thinking about where it lives. A shared cloud folder or a password manager works well. Keep the access list short, and known to the older adult. Pick somewhere you can change access later, in case the circle changes. A group chat is worth avoiding, since it is hard to take something back out of one.
Update it when things change: a new medication, a new doctor, a move, or a new phone number.
Starting the conversation
For some families this conversation is the hardest part. It tends to go better when it is framed around what the older adult wants, rather than what is convenient for the family. The file exists so their decisions get followed.
It also helps to start with the least loaded parts. Medications and doctors' numbers are practical and uncontroversial. Wills and powers of attorney can come later, in their own conversation, with the right professional involved.
Where a lawyer helps
A care file is a place to keep track of things. Whether anyone can act on another person's behalf, and what paperwork that takes, is a separate question, and an elder-law attorney is the right person to answer it for your family and where you live. This is the part most worth a professional's time.
Additional reading
- When a provider may share information with family (U.S. Department of Health and Human Services)
- HIPAA and your family and friends (U.S. Department of Health and Human Services)
Next: choosing technology, with consent
This information is for general educational purposes and is not medical, legal, financial, or employment advice. In an emergency, call 911 or your local emergency number.