What’s in your tool kit? Getting prepared for a senior emergency

It’s a Thursday night in your hometown.  Your mom, who had been sound asleep until a minute ago, gets up to go to the bathroom.  She does not bother to turn on a light because she knows every square inch of her bedroom like the back of her hand.  Except she has forgotten that she  used her electric hot pad before going to sleep that night and its cord is lying across her path to the WC.  Your mom’s slippered feet get caught up in the cord and before she can correct herself, she falls to the floor, hitting her head on a heavy bureau on the way down.  She tries to get up but is stopped by the searing pain in her left leg.  

Meanwhile, 1,200 miles away, you have just fallen asleep after another long day of juggling a project deadline, office politics, a nearly empty refrigerator and the needs of your beloved spouse and high-school aged daughters.  The phone rings and an unfamiliar voice tells you that your mother has just called for help using her “I’ve fallen and I can’t get up” button.  The paramedics are on their way now . . . .

Like a good scout, “Be Prepared.”

Emergencies are inherently stressful, but preparing in advance can pay dividends in reduced wear-and-tear on you and your family if you have to respond to one.  Organizing what you need so that you can easily access it when the time comes is critical, so below is a list of some things you will want to have at hand that will make things easier on your end if a loved one has to go the hospital for emergency medical treatment:

  • Legal Documents
    1. Health Care Power of Attorney:  If your loved one wants you to make medical decisions on their behalf, it is imperative that they put it in writing and make it official.  They can go to a local attorney for assistance with this, or it is possible to take the DIY route and use online resources to produce their own.  AARP offers an excellent, plain-English guide to the finer points of these important documents.
      1. Pro Tip:  You may not need a lawyer to create a power of attorney document but that does not mean that you will not need a little help from your friends.  Rules vary from state to state, so do your research, but it is very likely that you may need one or more people to witness the signing of the document and you may even need it to be certified by a notary.  Also, if your health care power of attorney will include specific end-of-life care instructions, you will probably need to have your doctor sign off on this part as well.  More on that in the next paragraph.
    2. Advance Directive:  Sometimes, an Advance Directive (also known as a Living Will) is included in the Health Care Power of Attorney document.  This provides doctors with critical information about how a patient wants to be cared for in certain life-and-death situations.  Since the specifics of these decisions can be pretty technical, a doctor must explain and sign off on them in order for the document to be valid in an emergency.  So, it is important to factor in having this conversation with the doctor as part of the process of getting your medical-emergency “ducks in a row.”
      1. Pro Tip:Coordinate with your loved one around getting these documents completed.  Most people do not want to think about things like disability and death and a common response to both is avoidance.  So, it may take gentle support from you to make sure that the appointment gets kept, the documents are brought to the appointment, and the conversation takes place.
  • Health Information:  Getting legal documents in order requires a bit of coordination between your loved one (the patient), their health care provider and possibly an attorney and witnesses.  Medical information, in contrast, requires the involvement of far fewer people.  In reality, it is not unrealistic to say that you should be able to put together what you need during a pleasant meeting in person, via email exchange or through the mail.  The trick is to keeping the information current as all of this information is subject to (frequent) change.
  • Medicare and insurance Cards:  This is likely one of the simplest tasks involved in creating your emergency preparedness dossier.  Since most of us do not travel with a device that used to be called a Xerox machine, the quickest way to get a copy of these important documents is to use the camera on your phone. Snap pictures of the front and back of these cards and make sure they are in focus.  Long strings of numbers are really hard to read if they are blurry.  If you and your loved are too far from each other to have a face-to-face exchange of documents, coordinate with him or her to get a hard copy to you.  The part about hard copy here is important because the numbers on a Medicare card are just the kind of information identity thieves love. Not the kind of thing that belongs all over the Interweb.

The information on a Medicare care is essentially unchanging, but the details of a person’s health insurance can change from year to year during the October to 15 to December 7 open enrollment period.  So, once you have your loved one’s current card, it is a good idea to check in with them at the end of the calendar year to find out if they have changed their policy.

  • Current medication list:  Maintaining an up-to-date list of for the average older American can be quite a task because pharmaceutical changes seem to be made frequently.  This said, start with an accurate list and do your best to keep it updated; checking for changes every six months would be a realistic schedule for a lot of people.
  • Life Hack:  Do not assume that the printed after-visit summary provided by a doctor includes an accurate medication list.  While doctors and their staff do their best to keep accurate records, in the real world these lists are often incorrect. Getting an accurate list of what a person is actually taking may require referencing the prescription bottles themselves. Sometimes, the pharmacy itself can help out by printing out a record of a patient’s active medications, but the bottles themselves are your best guide.
  • Contact information for healthcare providers: Compose a list of medical providers that includes your loved one’s primary care provider and any specialists that he or she sees for chronic health conditions.  Dentists, podiatrists and acupuncturists do not need to be included.  What you’re aiming for is the contact information (name and phone number) for people who have clinical insight into the patient’s medical history.
  • Local support providers:  If you live far away from your loved one you will need a contact list of “boots-on-the-ground” helpers who can assist with things that you cannot take care of over the phone.  This list, with current phone numbers and email addresses, is especially important when your loved one resides in a community that you have no personal connection to.  In other words, if your mom still lives in the house you grew up in, you probably already have contact information for those people who can be called on in a pinch. On the other hand, if mom is living in a different community—even if it is one geared to seniors—you may not know the names, much less the phone numbers of her new friends and supports unless you ask.  And count yourself lucky if your loved one is using a smartphone because getting this information is made really easy if you use the “share contact” tool included in their phone’s address/contact list because you can then send them to your smart phone for safekeeping, no old-fashioned typing of lists necessary.
    1. Friends and neighbors:  We all get by with a little help from these folks, but the last thing you want to do is have to scramble for their names and numbers in the middle of a hospital admission.  So, to take this stress of your plate, ask your loved one for the names and numbers of two friends he or she trusts who could lend a hand in a medical emergency as well as the name, address and number for a neighbor who would be willing to help bring in mail and move garbage cans during an unplanned absence.  You may want to have this information gathering process include actually reaching out to these people while you are with your loved one, just to ensure that these friends know that they could be called upon to help in an emergency.Not only is doing so good manners, you could save yourself some stress in the event that the people your loved one thinks can be helpful are unwilling or unable to pitch in.
  • Who will look after Fluffy or Fido?  Find out how your loved one handles pet care during planned absences and gather contact information for those people or services as well.  Also get the name and phone number for the pet(s)’ veterinarian.  Pet care can be tricky to arrange in the middle of a crisis, especially if care is contingent on vaccination records and other details.  Knowing where to look for the pet carrier will also make transporting companion animals offsite less hair-raising.
  • Scheduled helpers:  Are there services that will need to be suspended during an extended absence from home?  Think gardeners, housekeepers and the exterminator.  If your loved one will be gone for an extended period, these people should be notified of a suspension of service.  Home health aides and the folks who come to the home to provide nursing or therapy services also really appreciate it when they are made aware when someone goes to the hospital or rehab.  This way, they don’t make a trip for a patient who is not there to open the door for them.  This latter group of basically personal care and medical helpers changes its roster depending on the person’s specific needs, so the best way to find out if your loved one is receiving services from one or more of these professionals is to ask your loved one once she or he has a diagnosis and you know what the treatment plan is at the hospital.
  • “Springing” helpers:  These are professional helpers whose services are activated when a person has a specific need, like going to the hospital for emergency treatment.  If contracted by an individual or a family, a care manager, also known as an Aging Life Care Professional, can step in to help ensure that the moving parts of their client’s life keep running in synchrony.  If all of the above planning feels daunting and you have your doubts as to whether coordinating things for a sick or injured loved one is something you can manage while keeping your own life from spinning out of control, seriously consider exploring whether an alliance with one of these local professionals would be a good fit for all concerned.  Of course, if your loved one is a forward-thinking type who has already made contact with an Aging Life Care Professional, then the only number you will need in your emergency tool kit is theirs!

Get It Together!

Remember way back in grade school how every once in a while the whole school was uprooted from its daily routine by a fire drill?  At the time, the clanging bell probably signaled a much-appreciated release from the tedium of practicing long division or some other skill our smartphones now do for us, but the real point was to make sure that everyone in the building didn’t have to think about how to get out in the event of an emergency.  By having a drill, we were all learning a specific route to safety, one that would allow everyone to exit without incident.

Your “In Case of Emergency” folder serves the same basic purpose as your grade school fire drill.  By placing hard copy of all of these documents in a folder that you always keep in the same place, you know you can find your way out of the “burning building” of a loved one’s health emergency without having to scramble to get what you need from a dozen different places.  You’ve set things up in a way that allows you to use your energy on helping resolve the crisis instead of coming to the situation already stressed and tired after going on a search for the information that the doctors and nurses need in order to help the person in the hospital.

If your loved one is as prepared for emergencies as you are, they should have a copy of this kind of document in an easy-to-find place.  For a simple Do Not Resuscitate (DNR) order, it is customary to place a copy outside of the fridge in plain view of emergency responders; for those who want a less public storage place, paramedics also know to look for such documents in the freezer.  Yes, the freezer. If first responders cannot find a copy of a DNR or Advance Directive, they are legally obliged to try to resuscitate an unresponsive patient.

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