What matters most

Why this matters

When families skip this step, decisions tend to revolve around what is available, cheapest, or easiest to staff — not what the person actually cares about. Over time, that can show up as regret, conflict, or a nagging feeling that “this doesn’t really fit them.”

A simple exercise you can do together

Use these prompts with the person at the center of care, if they are able to participate. If not, you can use them with people who know them well.

• “On your best days now, what does a good day look like for you?”
• “What routines or activities would you most hate to lose?”
• “What are you most afraid of as things change?”
• “If we have to make trade-offs, what would you rather prioritize — comfort, independence, staying near certain people, staying at home as long as possible, avoiding certain settings, etc.?”
• “Are there any clear ‘no’ lines for you? Things you really don’t want if we can avoid them?”

Write the answers down in simple language. Keep them to a page or less — the goal is clarity, not a life story.

Turning this into a short statement

After you talk through the questions, try to capture a few key points in 3–6 sentences. For example:

• What kind of day they’re trying to protect (routine, independence, social connections).
• What they are most worried about or strongly want to avoid.
• What they would rather prioritize if you cannot get everything at once.

This is not a legal document. It is a way to remind everyone what you are actually aiming for when the options start to blur together.

Using “what matters most” in real decisions

When you are comparing options, you can ask:

• “Which option fits these priorities best, even if it’s not perfect?”
• “If we choose this path, which parts of their ‘good day’ routine can we protect?”
• “Which worries can we address directly, and which might we need to accept or soften?”

You can bring this short statement to appointments, care conferences, and family meetings. It can help professionals suggest options that line up better with the person’s actual values.