Table 1.

Adaptation and Restructuring of Domains in PIECES of My PERSONHOOD Tool

Original: PIECES of My PERSONHOOD	Adaptation: PIECES of my RELATIONSHIPS	Adaptation: Family Supplement
Preferred name	Who I Am Greeting, my name is … what is yours? Is this the name you use most often? Where did you come from, can you tell me? Where were you born? Who are your parents? Have you ever raised or taken care of an animal? What did you call them? What was their name? Who is the one who looks after all your affairs? Is there anyone who comes around to take you on outings? Who is it that tells you not to climb on stairs to reach up high on your own?	Was your loved one always loved? Were they ever treated poorly by a partner?
Preferred language
Family background
Pets/names
Significant persons in life/ relationship
Mealtime preferences	A Day in My Life Are you happy to eat with others? What foods taste good to you/don’t taste good to you? Are there any foods that don’t look or feel good in your mouth? Do you sleep well? When do you go to sleep, or lay down? What do you do to prepare before going to sleep? When do you wake up, or get up? What do you like to do when you get up in the morning? Are you happy with visitors? What do you enjoy doing while visiting? (Watching TV, playing cards, something else?) What do you try doing when you are feeling lonely?
Sleep/wake preferences
Socialization preferences
Personal preferences
I am most proud to be known as/for…	What Keeps Me Going Of all the things that kept you busy in your life, what did you enjoy the most? How about in the spring? Summer? Fall? Winter? What are you still doing now? What kinds of things were you very good or gifted at?	What kinds of things are they very good or gifted at? How are they able to still give back?
Life role/previous occupation
Interests/hobbies
Significant high point(s) in life
Significant dates and meaning
Sources of: hope/comfort/joy/ inspiration/favorite things
Significant low point(s) in life/ trauma	How to Keep Me Safe What memories do you carry in your heart? Is there something that you have a fear of that scares you? (Like a spider, snake, or other superficial fear?) Do you have a deep-down fear? (Like the sound of thunder?) Do you ever use smudging to clean your home? Are there sounds you don’t like? Is there anything you find bothers you, makes you uneasy, worried, or frustrated? How can others tell when you’re feeling sad, frustrated, worried, or lonely?	Is there anything that bothers your loved one, makes them uneasy, worried, or frustrated? How can others tell when your loved one is feeling sad? Frustrated? Angry? Worried? Lonely? What are the things that can be done or said to help your loved one feel comfortable? Does your loved one ever have to use smudging to clean their home?
Coping mechanisms/validation phrases
Dislikes/fears
Significant dates and meanings
Expression of emotions
Spirituality, religion, and traditions	How I Care for my Whole Being What are some of the things you did when you were sick? What about now? What are some of the ways you express you are thankful? Do you need some sort of support when you pray? (With rosary, tobacco, traditional offering, syllabic hymn books, gospel prayers, signing songs in your language, prayers in your language?) When do you prefer to be alone?	Does your loved one need some sort of support when they pray? (With rosary, tobacco, traditional offering, syllabic hymn books, gospel prayers, signing songs in your language, prayers in your language?)

Notes: To the left are the domains from the original PIECES of my PERSONHOOD tool. In the middle column, new domains have been created to combine original domains. Questions are included in the new tool to assist workers in guiding the conversation. The final column includes questions that loved ones may be uncomfortable answering due to the personal nature of them or because of the cultural value of humility.