The Senior Emergency KitSM features several worksheets that family caregivers can complete with the help of a senior loved one. This toolkit can be kept in an easy-to-reach location, such as a nightstand, to allow easy access to information.
Checklist of Things to Have in Your File
Keep these documents about your senior loved one in your information management tool file:
- Contact Names and Numbers
- Life History Snapshot
- Medication Tracker
- Allergies and Conditions Worksheet
- Dementia-Related Behaviors Chart
- Doctor Visit Worksheet
- Health Care Proxy
- DNR (Do Not Resuscitate) Order
- Advance Directives such as Living Will and Durable Power of Attorney
- Insurance Policies
- Will and Testament
- Copy of Medicare/Medicaid Card
- Anatomical Gift/Organ Donation Card
- Valuables Designation List
The toolkit is part of the Home Instead Senior Care® network's Answering the Call® program designed to help family caregivers be ready for a call when a senior loved one needs emergency assistance.
Download individual senior emergency tracking kit components below…
Important Contacts
It's important that a family caregiver has easy access to the medical and business professionals that manage their senior's affairs in the event of an emergency. List on the worksheet all of those individuals with whom your senior does business.
Important Contact Information Worksheet (PDF 732k)
Life History Snapshot
Use this worksheet to record key details pertaining to each stage of your senior's life from childhood through older adulthood. Documenting this type of background information is particularly important for a loved one with Alzheimer's or other dementias to help cope with memory loss or manage difficult behaviors.
Life History Snapshot Worksheet (PDF 632k)
Medications and Dosages
Tracking medications is one of the most important exercises that a family caregiver can do to help keep an older adult safe from medication accidents. This worksheet is a valuable resource to keep all of a senior's medications and dosages up-to-date.
Medication Tracker Worksheet (PDF 331k)
Allergies and Conditions
Your loved ones and any emergency workers who may assist your senior in a medical crisis should be aware of allergies or conditions that a senior is suffering from, including:
- Foods
- Seasonal Allergies
- Medications
- Heart Problems
- Diabetes
- Arthritis
- Macular Degeneration
Allergies and Conditions Worksheet (PDF 247k)
Dementia-Related Behaviors Chart
Behaviors associated with Alzheimer's or other dementias may become more evident as the disease progresses. Use this chart to track the prevalence of these behaviors.
Dementia-Related Behaviors Chart (PDF 654k)
Doctor Visit Worksheet
Doctor visits can be confusing for older adults. Take this doctor visit worksheet to an appointment so you can write down questions, answers, and what you need to do next.
Doctor Visit Worksheet (PDF 592k)
Senior Emergency Wallet Card
Keep emergency information quickly available wherever your loved one goes. Information such as emergency contacts, medical data and a medical conditions list are easily available with this wallet card.
Emergency Wallet Card (PDF 210k)
Download the complete Senior Emergency Toolkit (PDF 3.9 mb)
Explore these pages to learn more about:
Get helpful tips and articles like these delivered to your email.
October 5, 2018 at 12:27 pm | Posted by Ellen
My 91 yr old mother uses a pill box, which I fill every week for her. I often find that she misses either the AM or PM dose. I'm wondering if their is a template that I could download, that had a column for the name of the med, AM/PM dose and days of the week. She could check off once she took the dose. She is blind in her left eye and has very limited sight in the right, many that I see have too much info on the sheet, this needs to be very basic. I suppose I could make one, but wondering if one already exists. Thank you
Share your thoughts or story
January 8, 2015 at 8:18 pm | Posted by Aileen Iowanes
In january 1999 i used to be taking care of my grandma i feed her an shower her and gave her madication help her and stay with her all the time and every time she sick i was take her to the hospital an stay with her and take care her and i really love her and take care her till i move to us in 2003.....
Share your thoughts or story
January 8, 2015 at 8:03 pm | Posted by Aileen Iowanes
I would like to be a caregiver becouse ilove it and i been done taking care off my mom and dad that why i really intrested to be a care giver....
Share your thoughts or story
June 28, 2014 at 10:11 am | Posted by Lynn V. Bovingdon
the comment that first came to mind was - check with others who may have had contact with the insurance you are considering. They can tell you if they have had a good or bad experience.
Share your thoughts or story
March 13, 2014 at 10:12 pm | Posted by Cyndi
I never thought about being a caregiver, until my best friends mother was dying of cancer, and she asked me to take care of her. I thought, wow, what a privilege to be asked such a important job. It turned out to be one of the most rewarding jobs I have ever had. Now I can not wait to have the privilege to experience that again. It is such a honor to be able to be in someones daily life and to be able to enrich their day, by just being their for them.
Share your thoughts or story
December 18, 2013 at 5:55 am | Posted by angela williams
thank you.
Share your thoughts or story
December 9, 2013 at 6:49 pm | Posted by JOSEPH AVILES
MAY GOD JEHOVA GOD OF ISRAEL, GOD THE SON JESUS CHRIST, GOD THE HOLY SPIRIT BLESS ALL AND EACH OF YOU. FOR EVER AND EVER ! YOU ALL ARE THE BEST OF THE BEST. THE INTERNATIONAL CARE-GIVER. LE CREAM DU CREAM. AMEN
Share your thoughts or story
October 21, 2013 at 10:44 am | Posted by ANN BOURQUE
I'm a the point in my life where I would like to be a companion for a lonely senior, helping with laundry, grociers, ready, taken them on an educational trip, e.t. museum, fine arts, antigue shop, many different things they may like as a I do. Maybe sit and read a good book, play a good board board. Help them with a shower or bath. I think I could make their somewhat quiet life to a much brighter life. I hope a get the chance to help someone who has help my parents when I was in school
Share your thoughts or story
January 6, 2015 at 3:04 pm | Posted by Debbie Perea
Ann, Where do you live? I am in Denver and could use some help with my husband who had a brain aneurysm 3 years ago. He goes to a day program which he does not like and I need to figure something else out. I recently realized that I need alot more help so have hired some in-home agencies to help. Please reply. Debbie Perea
Share your thoughts or story
August 19, 2013 at 7:26 pm | Posted by Esperanza
It feels great the satisfaction of helping others.
Share your thoughts or story
August 5, 2013 at 7:46 pm | Posted by Lois Eggleston
How do I get information and rating on a company that is offering me this kind of insurance? Thanks, Lois
Share your thoughts or story
July 11, 2013 at 3:27 pm | Posted by marie stfleur
help wanted LPN private duty/companion with 8 yrs exp. own transportation FT/PT or Perdeem. afternoon/evening shift
Share your thoughts or story