A detailed written plan that describes what is needed for an
individual’s care and provided by a range of health professionals, including
nurses, therapists, social workers, nursing or personal assistants. For those living
at home, a good care plan should also list the caregiving activities that family
members are able to do, need help learning how to do, and will be doing. “I”
Care Plans are written in the first person, as if the person receiving care wrote it
her- or himself, and express the desires of the individual for her or his care. Care
plans can describe the risks that an individual is prepared to take in exercising
his or her autonomous self-determination and choice. Creating the care plan
should involve an interdisciplinary team of the care recipient, caregivers, including
the nursing assistant, as well as the family as appropriate.
