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Care Coordination Meeting Worksheet
Make responsibilities, information gaps, decisions, and backup plans visible before assumptions become problems.
Privacy-friendly: no account, no email, and no personal information submitted to this site.
Use this worksheet when a family member, friend, neighbor, caregiver, trusted helper, support person, or small group needs to coordinate care for an older adult.
Meeting participants:
This worksheet is for coordination only. It is not legal, medical, financial, tax, insurance, or benefits advice.
Do not write Social Security numbers, financial account numbers, passwords, or portal credentials on this worksheet.
Section 1
Current Situation
| Question | Notes |
|---|---|
| Why are we meeting? | |
| Immediate concerns | |
| Current care situation | |
| Recent changes | |
| Urgent decisions |
What feels most unclear right now?
Section 2
Who Is Involved
Include anyone who is part of the support picture: family member, friend, neighbor, caregiver, trusted helper, support person, care manager, or other contact.
| Name | Relationship | Contact Information | What They Currently Help With |
|---|---|---|---|
People who should receive updates:
People the older adult does not want involved, if known:
Section 3
Information Gaps
Major life transitions often fail because of coordination problems, not information problems. Start by naming what is missing or assumed.
What information is missing?
What documents are missing?
What questions remain unanswered?
What assumptions need verification?
Section 4
Responsibility Assignment
Make the work visible. If there is no backup, write "none yet" so the gap is clear.
| Task | Primary Person | Backup Person | Notes |
|---|---|---|---|
| Appointments | |||
| Transportation | |||
| Medications | |||
| Bills | |||
| Groceries | |||
| Home maintenance | |||
| Medical communication | |||
| Benefits research | |||
| Emergency response | |||
| Family/support updates | |||
| Pet care | |||
| Other: ____________________ | |||
| Other: ____________________ |
Tasks nobody has agreed to yet:
Section 5
Immediate Priorities
This Week
This Month
Longer-Term
Section 6
Backup Planning
This is a key section. A care plan is fragile if only one person knows what to do.
What happens if the primary helper is unavailable?
Who can step in?
What information would they need?
What responsibilities have no backup?
What needs to be written down before an emergency?
Section 7
Concerns And Risks
Use this section to name concerns without turning the meeting into blame.
| Concern Area | Notes |
|---|---|
| Safety concerns | |
| Financial concerns | |
| Medical concerns | |
| Caregiver stress | |
| Communication concerns | |
| Housing or home concerns | |
| Transportation concerns | |
| Other concerns |
Concerns that need professional help:
Section 8
Decisions Made Today
Write decisions down so people do not have to rely on memory later.
| Decision | Date | Notes |
|---|---|---|
Decisions not made yet:
Section 9
Questions For Professionals
Use this section to prepare for calls or appointments.
| Professional | Questions |
|---|---|
| Doctor | |
| Pharmacist | |
| Attorney | |
| Benefits counselor | |
| Care manager | |
| Social worker | |
| Other |
Who will ask the questions?
When will they report back?
Final Page
Follow-Up Checklist
Before ending the meeting, check:
- Responsibilities assigned.
- Backup plan identified.
- Information gaps listed.
- Questions documented.
- Follow-up date scheduled.
Who will send or share updates?
What must happen before the next meeting?