Daily Routine Preference Communication tool: Root Cards

Ground your care team in individuals’ daily routine and care preferences using Root Cards!

Purpose statement: The purpose of Root Cards is to communicate individuals’ personal care preferences to care partners—promoting person-centered care and fostering meaningful interactions.

Root Cards are an easy tool to exchange information at a glance about an individual’s important preferences related to their daily personal care routine. Root Cards are intended for use by direct care staff, such as CNAs, STNAs, and others who may be involved in supporting the person’s day-to-day activities.

Root Cards briefly profile each individual and highlight preferences for bathing, toileting, and dressing. You can gather information from the Personal Care questions in the Preferences for Everyday Living Inventory (PELI) interview.

What about HIPAA? Personal preferences are not considered protected health information (PHI).  Since individuals are able to type anything into the template, we recommend that PHI (such as medical histories, dates, or conditions) not be included on the Root Cards. However, due to the sensitive nature of the information on the Root Card, we recommend placing the information with permission from the resident or their family in private locations, such as the inside of a closet door, behind a resident’s restroom door, or on the inside door of the medicine cabinet.

This tip sheet provides step-by-step instructions on how to create Root Cards using a customizable Microsoft Word template.

Step 1: Getting started

Here’s what you’ll need to get started:

• Printable Root Card template

• Preference questionnaire:
  • 19 items about personal care pulled from the PELI-NH (recommended)
    • OR
  • The 8 personal care items from the 16 MDS 3.0 Section F

Explain the purpose of Root Cards to staff so they are aware. As a community, discuss and reach a consensus on one location where Root Cards will be placed in all individuals’ rooms. Doing so ensures that staff will know where to find the card when they enter each individual’s room.

Also, in preparation, your community should consider the answers to key procedural questions such as:

• When will the Cards be updated?
• What happens if an individual’s Card goes missing?

Step 2: Plan and conduct an interview

Root Cards summarize important personal care preferences gathered through PELI interviews. Be sure to explain the purpose of the Root Card and ask the individual if they would like a Root Card created for them.

You could say something like “We’d like to create a card with a brief profile about you and your care preferences. If you agree, this card will be placed in a private location in your room. This information will help staff understand the important aspects of your daily routine. Is this something we can do for you?”

• If this is your first time conducting a PELI interview, see our short training video on conducting a PELI interview. Use the PELI Root version that contains only the daily routine/personal care questions.

• If you have already completed a PELI interview with the individual, review their responses to the personal care questions listed in this interview guide. You may want to consider a follow-up interview with the individual if several months have passed or if there have been changes in the individual’s abilities or health since their last interview. This will ensure that the Card contains the most accurate information.

Try to gather as much detail as possible about preferences the individual deems “important” or “very important.” Ask open-ended follow-up questions, such as, “Can you tell me more about that?” to gather these details. Greater detail results in a unique and accurate Root Card for the individual. For more tips, see our PELI interview tip sheet.

Step 3: Using the Root Card Template

• Download the Root Card template here from the Preference Based Living website.

• In the first section, add the individual’s first name and a brief biography (including nickname, favorite activities, things they like to talk about, etc.). Insert the date the card was created. If you revise the card in the future, be sure to change the date.

• In the second section of the card, place the information you’ve gathered about the person’s important routine/care preferences. Be sure to include the details you picked up during the interview in order to truly personalize the card.
  • NOTE: If the person indicated that a certain preference was “not important”, make sure to state “not important” on the card.  Don’t leave any preference category blank.

• Save and print the document. Laminate the card, if possible.

Step 4: Approving and Placing the Root Card

• Show the finished Root Card to the individual and/or family member and ask whether it accurately reflects the individual’s preferences. Make changes as needed.

• Once approved, place it in the location agreed upon by your community in Step 1.  

Step 5: Using the Root Card

When you are ready to begin using Root Cards, be sure to share why Root cards are important with direct care staff. Sharing can be done in staff huddles, included in an organization email, newsletters, or discussed in meetings with family members. Encourage direct care staff to use the cards as a way to promote person-centered care and foster meaningful interactions while providing care to the individuals in the community.

Check out the sample Root Card below: