The Elder Care Module
The legal authorities, insurance, providers, and personal preferences that govern care if assistance or incapacity arrives — healthcare and financial decision-makers, long-term care coverage, the care team, and stated care preferences.
Text file — the flexible one. Use it as-is, open it in any editor, or paste it into an AI tool to reshape the blank form to fit your family: rename a field, add a row, drop one you don't need.
Print / PDF — the ready-to-use one. Print it and fill it in by hand, or choose Save as PDF and complete it in your own offline PDF app. Either way it stays with you — the finished Secure Guide template goes inside your Vault.
One rule: only ever give an AI tool the blank template. Never paste your real information — passwords, account numbers, anything you'd keep secret — into an AI tool, an online service, or anywhere outside your own Vault. Customizing an empty form is fine; filling it in happens privately, offline. That's the same rule this site follows: nothing sensitive ever leaves your hands.
Secure Guide Starter Template
This template belongs in The Secure Guide, stored within The Vault. Review when documents, providers, or care arrangements change.
| Document | Designee | Location of Original | Attorney / Preparer | Date Executed | Last Reviewed |
|---|---|---|---|---|---|
For full estate document inventory, see the Estate Plan Module.
| Policy | Insurer | Policy Number | Agent Contact | Benefit Trigger | Daily / Monthly Benefit | Elimination Period | Location of Policy |
|---|---|---|---|---|---|---|---|
For complete insurance documentation, see the Insurance Module.
| Provider | Specialty | Practice / Facility | Phone | Patient Portal | Notes |
|---|---|---|---|---|---|
Preferred care setting if assistance is needed; preferred setting if independent living is no longer possible; facilities or arrangements to avoid; known preferences on hospitalization or aggressive intervention. For legally binding preferences, see the Advance Healthcare Directive.
| Name | Relationship | Role | Phone | Notes |
|---|---|---|---|---|
Family Guide Starter Template
This template belongs in The Family Guide. It names the decision-makers and summarizes care preferences in plain language.
The designated healthcare proxy (name, phone) if the person cannot make medical decisions. The Healthcare Power of Attorney document location is noted.
The designated power of attorney (name, phone) if the person cannot manage financial affairs. The Durable Power of Attorney document location is noted.
A plain-language summary of care preferences, written by the planner in their own voice. Not legally binding, but reflects genuine wishes.
Note that a policy is in place; policy number and agent contact are in The Secure Guide. Contact the agent before arranging paid care — the policy has a benefit trigger and elimination period.
Name, practice, and phone.