Self-Care Assessment 2021
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  • Self-Care Assessment

  • Those of us who are grieving, or have experienced life-changing events, or who care for others in our everyday lives must harness the creative ability to care for ourselves first. This self-care is a necessity. If we don’t care for ourselves, we have nothing left for others. Self-care is like the oxygen mask that falls from the ceiling on an airplane when the cabin pressure changes. The flight staff instructs us to put on our own oxygen mask first, then assist anyone around us. So we practice self-care in order to care for others.

    In our self-care program, we focus primarily on The 5 Pillars of Self-Care: nutritious food, clean water, fresh air, exhilarating exercise and rejuvenating rest. I’d like to know a little about your physical self-care habits. Please answer the questions below about the 5 Pillars as accurately and honestly as possible.  We will use this assessment to help develop you Self-Care Process.  After you follow your process for the next four weeks, you will complete the assessment again.  The improvement may astound you!  It's all a matter of practice.  Let's get started!

  • Nutritious Food

  • Clean Water

  • Fresh Air

  • Exhilarating Exercise

  • Rejuvenating Rest

  • There is more to self-care than the physical.  We also must attend to our mental, emotional and spiritual needs.  I will help you find balance in your life when your busy world seems to be spinning out of control.  I will help you assess your attitude, adjust your environment, alleviate stress and locate and get the support you need.

    Please sign below, indicating your agreement with yourself tha this information is as accurate as possible so that we can properly assess where you are in the practice of the 5 Pillars of Self-Care.  We need accurate information so we can develop a program with you that will help you get the balance you need.  The key is to improve all areas of Self-Care to get you to a healthy place.  In four weeks, we will take another assessment to see how much your newly developed program has helped you find your balance and incorporate all 5 Pillars of Self-Care into your life.

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