# Care Coordination Record Template

For the method in
[Coordinating an Ageing Parent's Care Without Losing Their Voice](/articles/ageing-parent-care-coordination).
Complete the consent conversation before filling in the rest.

## Not for

Overriding your parent's stated preferences for coordinating siblings' convenience, or as a
substitute for legal authority (power of attorney, guardianship) where that applies.

## Step 1: Consent, in their own words

Ask, while your parent can participate fully:

| What | Comfortable sharing? (yes/no/partial) | Who specifically | Their exact words (not a paraphrase) |
| --- | --- | --- | --- |
| Medical appointments (that they happen) | | | |
| Specific diagnoses / what was discussed | | | |
| Medication list | | | |
| Financial details for care costs | | | |
| Day-to-day wellbeing notes | | | |

**Date this consent was given:**
**Revisit by (suggest every 6-12 months, or after any health change):**

## Step 2: Emergency information (short, current, accessible without a login)

- Current medications and dosages:
- Allergies:
- Critical conditions (e.g. pacemaker, severe allergy):
- Primary doctor, contact:
- Emergency contact order: 1) 2) 3)

Keep this section printable or on a card — not buried in a shared drive.

## Step 3: Administrative information (detail is fine here)

- Upcoming appointments:
- Care worker schedule:
- Financial arrangements for care costs:
- Routine wellbeing notes:

## Step 4: Access rules

| Section | Who has access | Matches Step 1 consent? |
| --- | --- | --- |
| Emergency | | ☐ |
| Administrative | | ☐ |

Flag anything without a clear "who can see this" answer instead of guessing:

-

## Step 5: My parent's own words

Ask directly and record their answers, not a summary:

- Who they want present at appointments:
- What kind of help they find useful versus intrusive:
- Preferences for specific scenarios they've thought about (not a legal directive):

## Pitfalls check

- [ ] Consent conversation happened before the record was built, not after
- [ ] No single document is visible to everyone by default beyond what was agreed
- [ ] Emergency section stays short — administrative detail lives elsewhere
- [ ] Record has been revisited since the last major health change
- [ ] Decisions affecting my parent included their voice, not just siblings' discussion

## The three prompts to reuse

**1. Draft consent questions**

```text
Help me draft a short, plain-language list of questions to ask my
parent about what they're comfortable having shared among family
members who help coordinate their care — for example: medical
appointments, specific diagnoses, medication lists, financial details,
and day-to-day wellbeing notes. Keep the questions neutral and let each
one have a clear yes/no/partial answer, not a leading question.
```

**2. Split emergency vs administrative**

```text
Help me organize this list of care-related information [paste your
rough notes] into two clearly separated sections: "Emergency" (only
what someone would need in the first ten minutes of a crisis — current
medications, allergies, primary doctor contact, critical conditions)
and "Administrative" (everything else — appointments, care worker
schedule, financial arrangements). Do not add any information I did
not provide.
```

**3. Structure access rules**

```text
Given this consent summary [paste what your parent agreed to share, and
with whom] and this organized information [paste emergency/admin
lists], help me draft a simple record structure — which sections exist,
and a one-line note next to each about who has access. Flag anything
in the information that doesn't have a clear "who can see this"
answer yet, rather than guessing.
```