Questions for patients |
1. Tell me a little about your life history; what are some of the most important and memorable times? When did you feel most alive? |
2. How has your relationship with your loved one influenced your life? |
3. What are some things you want your loved one to know about you, or to remember about you? |
4. What do you think are your most important and meaningful accomplishments in life (family, career, community)? |
5. What do you think your loved one is most proud of you for, or appreciates about you? |
6. What do you appreciate most about your loved one? |
7. Are there particular things that you want to thank your loved one for? |
8. Are there particular things that you would like to ask forgiveness for, or offer forgiveness for? |
9. What teachings, advice, or words of guidance do you want to pass on to your loved one? |
10. What are your hopes and dreams for the future, for yourself, your loved one and your family? |
11. In creating this permanent record, are there other things that you would like to include? |
12. Before the session ends, are there things that you would like to take time to say again? |
Questions for family caregivers |
1. Tell me a little about your life history with your loved one; what are some of the most important and memorable times you had together? When did you feel most alive with your loved one? |
2. How has your relationship with your loved one influenced your life? |
3. What are some things you want your loved one to know about you, or to remember about you? |
4. What do you think are your loved one’s most important and meaningful accomplishments in life (family, career, community)? |
5. What do you appreciate most about your loved one? |
6. What do you think your loved one is most proud of you for, or appreciates about you? |
7. Are there particular things that you want to thank your loved one for? |
8. Are there particular things that you like to ask forgiveness for, or offer forgiveness for? |
9. What teachings, advice, or words of guidance have you received from your loved one, and would like to pass on to other family members? |
10. What are your hopes and dreams for future for your loved one, yourself and your family? |
11. In creating this permanent record, are there other things that you would like to include? |
12. Before the session ends, are there things that you would like to take time to say again? |