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Free caregiver printable

Mobility & Personal Care

Share how to assist safely with walking, transfers, falls, daily personal care, devices, and changes that need attention.

2 pages · US Letter · Print in color or grayscale · Fill in by hand

Preview of the Lighthouse Mobility and Personal Care caregiver printable

Make current care instructions easier to share

Mobility and personal care are highly individual. A person may use different equipment in different spaces, need a particular cue before standing, or have preferences that protect privacy and dignity during bathing, dressing, grooming, or toileting.

This printable helps caregivers record current instructions and helpful routines for a trusted helper. It is designed to support a conversation and hands-on training, not replace either one.

How to prepare the worksheet

  1. Use the current care plan or therapist’s instructions for walking, weight bearing, transfers, and equipment.
  2. Add the person’s preferences, consent, privacy needs, and the level of help they want.
  3. Review warning signs and decide who a helper should contact if something changes or a fall occurs.

Never attempt a lift or transfer unless you are trained and it is safe to do so. Call emergency services when urgent help is needed.