‘MY LIFE STORY’
I like to be called:
Introduction to my Life:
Date of Birth: _______________________
Place of Birth: _______________________________
Mother’s name and occupation:
Father’s name and occupation:
Position in family (i.e. oldest, youngest etc.):
Names of sisters and brothers: (eldest first)
Grandparents or other family members such as aunts or uncles
What do you remember about your early childhood?
What are your memories from school? What were your best lessons? What were you good at? What did you struggle with? Are there any particular memories of home life you like to recall? Write down any significant memories from your childhood.
My Working Life
What did you do as your first job?
Where did you work? (including work in the home)
What was it like? Did you go on to do different jobs?
If you had your time again, would you do the same job or something else? Write down any significant memories about work.
Who were the significant people in your life i.e. friends/ family? Did you get married or have a long-term partner?
Memories of your wedding day- the place, the dress, weather etc. Did you have children?
If so, how many and what were their names?
Did you have any favourite pets? (Include any photos)
Where would you say has most been ‘home’ to you?
What memories do you have of the place you lived the longest or spent your happiest times? i.e. the buildings, shops, countryside, local people and community? Are there any other places that were and are particularly important to you e.g. holiday places, places where significant things took place etc.?
(Include any photos/ pictures/postcards)
Social Activities and Interests
What did you like to do in your spare time? What were your interests? Include anything that was important i.e. significant places, regular activities/ outings, favourite music etc. (Include any photos /pictures)
Significant Life Events
Was there any thing or event that had a significant impact on your life e.g. war, travel, loss of a loved one etc. Later life/retirement
What were the highs and lows of getting older? e.g. grandchildren travel or time to pursue interests? Write down anything that influenced you in your retirement i.e. events, people, illness etc.
My Life Now
What is important to me now?
Food and drink
Do you have any particular preferences about mealtimes?
Do you need any support with eating/drinking?
Things I like:
Things I don’t like:
What is important to you about your appearance?
e.g. clothes, hair, nail
Do you need any help with dressing/personal care?
How would you prefer to be supported?
Do you have any preferences for bathing /personal care e.g baths/showers, soap, perfume/aftershave etc.? Do you have any particular habits/ routines that you would like people to know about?
Interests and Hobbies
What types of music do you like to listen to?
Include some favourite songs/ pieces of music...