Advance Care Planning for Aging at Home

Planning before a health change or caregiving crisis gives an older adult time to state what matters, choose trusted decision-makers, and organize practical support. Use this checklist to start the conversation while the person can participate fully, then revisit it when health, housing, finances, or family roles change.

1. Start with the person’s priorities

Hold a family meeting at a calm time rather than waiting for an emergency. Ask the older adult where they hope to live, which daily routines matter most, who they want involved, and what kinds of help they would accept. Record questions and decisions, including points that still need a clinician, attorney, benefits counselor, or other qualified professional.

For a broader look at housing, support, and quality-of-life decisions, use the CaregiverRelief advanced planning guide.

2. Choose decision-makers and complete the right documents

Advance care planning includes discussing future medical care and documenting a person’s wishes. An advance directive is a legal document that provides instructions for future health care. A durable power of attorney for health care is a type of advance directive that names a person — often called a health care proxy, agent, representative, or surrogate — to make health care decisions if the individual cannot communicate those decisions.

Names, forms, signing rules, and the authority given to a proxy vary by state. Use current state forms and ask a qualified attorney or health care professional when the situation is complex. The National Institute on Aging explains advance directives and health care proxies, including how to find state-specific forms. CaregiverRelief also has an overview of making health care wishes known before a crisis.

Once documents are completed, keep the originals secure and make copies available to the people and care teams who may need them. Review beneficiary designations, financial powers of attorney, wills, and other estate documents separately with an appropriate professional; health care documents do not automatically cover financial decisions.

3. Plan for care and services at home

List the help currently needed with personal care, meals, transportation, medication organization, household tasks, mobility, and supervision. Then note which needs are handled by family, friends, paid caregivers, community programs, or licensed health professionals. Reassess after a hospitalization, fall, new diagnosis, or meaningful change in daily function.

“Home care” and “home health care” are not interchangeable. Home health services generally involve skilled care ordered and delivered under specific eligibility rules, while nonmedical home care may focus on daily activities and companionship. Coverage and out-of-pocket costs depend on the service, program, insurance plan, and location. Review Medicare’s current home health coverage information and confirm details with the relevant insurer or program before making financial commitments.

4. Check home safety and backup plans

Walk through entrances, stairs, bathrooms, bedrooms, lighting, flooring, kitchen access, and emergency exits. Consider whether mobility, vision, hearing, memory, or medical equipment creates a new hazard. Changes should fit the individual; an occupational therapist or other qualified professional can help assess needs when safety is uncertain. See CaregiverRelief’s guide to aging in place at home for related planning questions.

Create a backup plan for caregiver illness, severe weather, power loss, transportation failure, and urgent health changes. Keep an up-to-date list of medications, allergies, clinicians, emergency contacts, insurance information, and essential equipment instructions where authorized helpers can find it. For immediate danger, contact local emergency services.

5. Review costs, benefits, and practical support

Build a realistic monthly picture of housing, utilities, food, transportation, insurance, medical care, paid caregiving, home modifications, and legal or financial help. Identify who is authorized to view accounts or pay bills, how receipts will be tracked, and how family contributions will be documented. Avoid relying on broad estimates of caregiver income loss or future care costs; the effect is different for every household.

The federal Eldercare Locator can connect U.S. families with local aging services. A benefits counselor, insurer, financial professional, or attorney can clarify eligibility, taxes, employment consequences, and planning options for the specific household.

6. Document, share, and revisit the plan

• Write down the person’s priorities, agreed next steps, responsible people, and target dates.
• Share only the information each person or provider needs, with the older adult’s permission whenever possible.
• Store important records securely and tell authorized people how to access them.
• Schedule a review at least after major health, housing, financial, or family changes.
• Discuss end-of-life preferences separately and at the person’s pace; this end-of-life planning guide can help frame the next conversation.

Updated: August 15, 2026. This checklist offers general educational information and is not a substitute for individualized medical, legal, or financial advice.