In order to assist our staff in providing personalized and meaningful care to the residents who have made this community their home, we ask you, as a key member of the care team, provide us with a brief historical profile of the resident you represent. This biography, as well as the "Book of Life Stories" that we hope will interest you (see last page), will provide us with important information to incorporate into their lives with us. This will allow us to provide care tailored to their particular needs, interests and pleasures in life. Note to friends and family members filling out the bio on behalf of a resident, please read the “you” in all questions to mean resident, as if they were filling out the form themselves.Resident Name: Room #:Name by which (you/he) prefers to be called:DAILY ROUTINE1.a. What time do you (the resident) want to get up in the morning?b. Do you prefer to stay in bed for a while or get up immediately after waking up?2. Briefly describe what (your) waking routine is like (bathing, brushing hair, brushing teeth, etc.).3. Do (you) have breakfast in the morning? If so, what are (your) favorite breakfast foods?4. What kind of clothes do you prefer to wear during the day?- 2 –5. Do you like taking naps during the day? If so, when, where and for how long do you usually rest?6. What kind of nightwear do you prefer?7. What time do you like to go to bed at night? Do you enjoy a snack or drink before bed?8. What type of assistance do you need? (Support when walking, help with dressing, going to the toilet, bathing, taking care of your feet, etc.). PERSONAL PREFERENCES Please list some of your (you/residents) favorite and least favorite things in the following categories and perhaps note whether they have a special meaning for (you/them) and why.1. Food and drink2. TV shows and movies- 3 –3. Books4. Favorite things brought from home5. Favorite time of year (e.g. Autumn or Christmas time)6. Special holidays or anniversaries7. MusicBACKGROUNDPlease tell us something about (yourself) and (your) family.1.a. What is (your) marital status? (Married, widowed, divorced, never married, etc.).b.
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