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HEART Insight:
doi: 10.1097/01.HEARTI.0000407807.43573.2a
Features: Heart-to-Heart

In Case of Emergency

MacReady, Norra

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What Do You Do When the Caregiver Needs Care?

As a public speaker, Jamie Huysman sees it all the time-people in the audience nodding their heads in agreement whenever he talks about the need for caregivers to create an emergency care plan. Who's going to assume their responsibilities if they suddenly become ill or injured? Who's going to take care of Mom, Dad or Grandma?

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As a caregiver, you may catch the flu, need surgery, or be hospitalized due to an accident. Many things can happen to prevent you from performing your daily caregiving responsibilities, so it's important to be prepared in case the unthinkable happens.

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Caregivers juggle dozens of activities each day but rarely consider creating a backup plan. Whether it's a wife caring for her chronically ill husband, a son caring for his aging parents or parents caring for a disabled child, there's no “Plan B” for emergency situations. Compare it to taking a vacation. Would you book a flight without reserving a hotel room, stopping your mail delivery and informing family and friends when you plan on visiting? Without advance planning, caregivers and their loved ones can find themselves out in the cold.

Huysman, a psychologist, licensed clinical social worker and managing partner at Partners in Health & Entertainment Management in Miami, says the problem starts with perception.

“Even though you're not being paid as a caregiver, you need to think of yourself in a professional context,” he says, explaining that caregiving is a job. “See yourself as a family first responder or independent care professional. First responders like police officers, firefighters and emergency medical technicians create emergency care plans. Why shouldn't caregivers?”

The first step in developing an emergency plan is to tap into local resources that can provide immediate caregiving assistance when needed. Identify and understand community-based services that are available to you, whether they're short- or long-term, cost-based or free. You can find community services in your area by visiting Many of them offer a wide range of free or low-cost services to seniors in most states. You may also want to check with the local chapter of the association that's affiliated with your loved one's disease.

Joining a support group can also be helpful, Huysman says, because it will expand your support network and possibly offer a ready source of temporary caregivers. Likewise, check out religious organizations that may be able to refer experienced volunteers during emergencies.

Huysman says it's critical for caregivers to develop an emergency plan when they're healthy and can think clearly, not when they're sick or injured and unable to make important decisions.

He compares the process to opening a bank account. When you need to make withdrawals, “the account isn't empty,” says Huysman, a coauthor of Take Your Oxygen First: Protecting Your Health and Happiness While Caring for a Loved One with Memory Loss (LaChance Publishing, 2009). “You have a lot in reserve because your plan is ready.”

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Along with your plan, put together an emergency kit. If a temporary caregiver is needed, will he know what medicines to administer to your sick spouse? Will she know which doctor to contact if your mother needs medical attention? Will he know which family member to call if a medical authorization is needed for your grandfather?

There are many documents you need to create and copy, then store in one file in a safe, easy-to-reach location, such as a nightstand drawer. These documents include a list of key contacts, ranging from family members to physicians, and a list of medications—dosages and frequencies—to prevent medication accidents. Also include a copy of the patient's Medicare or Medicaid card in the same file. Make sure your loved one and other family members are aware of the file's location.

For free worksheets, a medication tracker form and complete list of important emergency documents, log on to

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Before you invite any caregiver into your home, make sure you receive solid references from reputable sources. Ideally, Huysman says, caregivers need to be thoroughly screened and bonded. Asking strangers to care for your loved one can sometimes escalate your problems. For example, they may be inexperienced at dispensing medication, giving your loved one the wrong drug or dose at the wrong time. They may prepare inappropriate meals–those loaded with salt—to someone with congestive heart failure. Worse yet, they may have a criminal background, which places both you and your loved one at risk.

Many agencies nationwide offer caregiving services in emergency situations (see “911 for Caregivers”). Check out those that service your area, and then narrow down your options to one or two. Some important questions to ask include:

Are you licensed? “Twenty-six states [require] some type of licensing,” says Emma Dickison, president of Home Helpers, a national home healthcare agency based in Cincinnati. For example, she says Illinois requires agencies to be licensed, but Ohio does not. To find out if your state has a licensing requirement, conduct an Internet search, using keywords like “Florida home care license” or “Texas caregiver license.”

Are you insured and bonded? Make sure the agency performs a background check on caregivers, ensuring they do not have criminal backgrounds.

How many hours of training has the caregiver received that's specific to home care? Ask if the caregiver is trained in needed areas, such as dressing, bathing or medication administration.

Once you find an agency you're comfortable with, test them out for at least half a day when there is no emergency, she says, adding that the agency should provide a care plan and follow-up report. When you return home, evaluate the caregiver's performance. Was the care plan completed? Did she properly administer medication? Did he prepare a healthy and nutritious meal for your loved one? Was your house clean or were dirty dishes stacked in the sink? Would your loved one want this person to return if you became sick?

Most agencies and community-based organizations are also knowledgeable about government programs that offer financial assistance when a primary caregiver becomes sick or injured. As an example, Dickison points to Aid and Attendance (, a federal program for veterans and surviving spouses who require assistance with personal care.

“The No. 1 mistake is that people are not prepared,” says Dickison. “They don't know where to go when that emergency happens. We all think we're invincible so we don't put an appropriate plan in place.”

Make sure you're prepared for an emergency so if something bad happens, you're ready—and you and your loved one will receive the care you both need.

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These resources can help when you find yourself unable to care for a loved one.

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Comfort Keepers

Provides in-home care for adults nationwide who need help with the activities of daily living.

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Home Instead Senior Care

A national network that assists people with daily living activities.

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A national caregiver agency that provides immediate home care for people of all ages.

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ResCare HomeCare

Provides family caregivers nationwide temporary relief from caring for individuals with various home care needs.

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Right At Home, Inc.

A national network offering in-home care and assistance to seniors and disabled adults.

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Visiting Angels

A national network of nonmedical homecare agencies providing respite and companion care.

© 2011 American Heart Association, Inc.