Elder Care Organizer for an Assisted Living or Memory Care Move | Power of Attorney, Medicaid, Capacity | Fillable PDF — Caregiver

• A fillable elder-care and care-transition organizer that opens with The Essentials — the few things a family reaches for first when a parent moves out of their home and into care, captured in one short sitting.
• A one-page care-situation map, “open only what applies,” routes you to the parts your situation calls for — in-home or facility, a capacity question, Medicaid or veteran benefits, working alone or with siblings — with a page number beside each.
• Behind the map is the complete record: twelve parts covering the legal and financial groundwork, the care-setting choice, winding down the household, the move, and the handoff to whoever coordinates care next. Eleven parts include registers you open only when your situation needs them.
• A built-in family conversation helps you name who holds legal authority and who carries the daily work — the split that is common and rarely said out loud — and prepare the talk with siblings or with the person in your care.
• You write where things live, not what they hold — where the power of attorney is kept, not the document; the pointer to an account, not the number. That is what lets you get the first things down in about twenty minutes, when your attention is needed elsewhere, instead of stalling on a long form. (Nothing sensitive sits in the file, so there is no file of details to lose.)
• Informational only — never legal, financial, medical, or tax advice. Built to make your conversations with an attorney, a benefits or Medicaid-planning professional, and the care team more productive.
• Instant digital download. Fill in free Adobe Acrobat Reader on a computer; print at home.

Most families facing a care transition mean to get organized and never quite know where to start — the work feels endless while you are inside it. Caregiver is built so the part that matters most comes first. It opens with The Essentials: who can legally act and where the documents live, the current medication list and the main medical contacts, how the bills keep getting paid, and the one decision that cannot wait. One short sitting, and you have your footing.
After The Essentials, a one-page map of your care situation points you to the parts your circumstances call for, and you leave the rest for later. Behind the map is the complete record — twelve parts that carry the legal and financial groundwork, choosing the care setting, winding down the household, the move itself, care coordination going forward, decision-capacity and authority, benefits and financing, home-safety, a directory of the professionals you may need, and a defined finish. Eleven parts include registers — repeating tables for people, documents, contacts, and responsibilities — that you open and print only when your situation needs them.
One page is given to the conversation families find hardest: naming who holds legal authority and who carries the daily work, so siblings or the person in your care are part of the plan rather than surprised by it.
It is finishable because of one design choice: you write where things live, not what they hold — where the power of attorney is kept, never its contents; the pointer to an account, never the number. That is what lets you be useful to the person you are caring for in one short sitting, rather than a form you set aside when the day gets hard. A side benefit of the same choice: there is no file of your details for anyone to lose, and Listheim never sees, stores, or transmits anything you fill in.

How to use: download and open in free Adobe Acrobat Reader on a computer, fill the highlighted fields, and print at home. Informational only — never legal, financial, medical, or tax advice; Caregiver organizes the work and prepares the questions and points you to an attorney licensed in the person’s state, a benefits or Medicaid-planning professional, and the physician or care team where a decision belongs with them. Updates included for the active life of the product, typically five or more years from launch. Published by Analyticus Enterprises LLC d/b/a Listheim.
Refund Policy. Instant digital download — non-refundable once delivered. Technical-issue exception: contact Operations [!at] listheim.com within 30 days; we re-deliver, troubleshoot, or refund if unresolvable. Etsy Purchase Protection is a separate platform program. Full policy at listheim.com/policies.