Senior & mobility-limited · Caregiving
Write it down before someone needs it.
When a primary caregiver cannot be there, a substitute needs to step in without guessing. This is the document that makes that possible: every medication, every schedule, every doctor, every piece of equipment, and every detail that seems obvious until someone else needs to know it.
Build yoursWhy this matters
A caregiver's knowledge lives in one head.
The primary caregiver knows that the morning medication goes with food. That the afternoon dose of the blood thinner is at 2:00, not whenever. That the nebulizer gets cleaned after every use and the filter gets replaced monthly. That Mom refuses to eat if the food is too hot, and that a specific tone of voice works better than another when she is confused.
All of this knowledge lives in the caregiver's head. When that caregiver is suddenly unavailable, whether from illness, injury, a storm that blocks the road, or their own emergency, none of it transfers automatically. A substitute caregiver, even a family member who visits regularly, does not know the daily details unless they are written down.
FEMA's Disaster Preparedness Guide for Caregivers identifies three essential steps: assessing needs, engaging a support network, and creating a plan. This document is the plan. The National Institute on Aging provides free downloadable caregiver worksheets at nia.nih.gov that cover medications, medical contacts, and important records. This guide explains what to include and why each section matters.
Medications
The medication section is the most critical.
A missed dose, a wrong dose, or a medication interaction can send an older adult to the hospital. A substitute caregiver needs this information immediately, not after a phone call to the pharmacy.
For each medication, record
- Name (brand and generic), dose, and form (tablet, capsule, liquid, patch, injection)
- When it is taken: exact time, with food or without, and what happens if it is missed
- Where it is stored: which shelf, which drawer, which bag. If refrigerated, note that
- What it is for: brief plain-language purpose ("blood pressure," "blood sugar," "blood thinner")
- Prescribing doctor and their phone number
- Pharmacy name, phone number, and prescription number for refills
- Known allergies and drug interactions listed prominently at the top of the section
See Medication Preparedness for the full guide on maintaining this list.
Daily routine
The schedule holds everything together.
For many older adults, especially those with cognitive decline, the daily routine is not a convenience. It is a framework that provides stability and reduces anxiety. Disrupting it can cause confusion, agitation, or refusal to cooperate. A substitute caregiver who follows the routine will have a much easier time than one who improvises.
Morning routine
Write the exact sequence: what time they wake up, what happens first (bathroom, then medication, then breakfast, or a different order). Note whether they need help getting out of bed, whether they use a walker to the bathroom, whether they need assistance with dressing.
Include breakfast preferences and any dietary restrictions. Note whether they take medications before, during, or after eating. A substitute who gets the order wrong may trigger nausea or a medication that needs to be taken on an empty stomach.
Through the day and evening
Document meal times and usual meals. Note nap times. Note when they typically use the bathroom (this matters for continence planning). Note their preferred activities: television, reading, sitting outside, a daily walk.
Evening routine is especially important: what time they eat dinner, when they take evening medications, the bedtime sequence (change clothes, bathroom, set up CPAP or oxygen, position pillows, turn on nightlight). For someone with dementia, a consistent bedtime routine reduces nighttime confusion significantly.
Medical equipment
How to turn it on. How to clean it. What it sounds like when something is wrong.
A CPAP machine, oxygen concentrator, nebulizer, blood glucose monitor, or home dialysis system is only useful if the person using it knows how it works. A substitute caregiver may never have seen the equipment before.
For each piece of medical equipment, document: what it does in plain language, where it is located, how to turn it on and off, what settings to use (write down the numbers on the display), how to clean or maintain it, what alarms sound like and what they mean, and the phone number of the equipment supplier for troubleshooting.
Photograph the control panel with the correct settings visible. A picture taped to the document is worth a paragraph of description when a substitute is standing in front of the machine at midnight.
See Backup Power for Medical Equipment for the power-outage plan for each device.
Behavioral notes
The things that seem too obvious to write down.
These are the details that a regular caregiver knows instinctively and a substitute will not. They are also the details most likely to cause problems if missing.
- Communication preferences: Does the person hear better on one side? Do they need you to face them when speaking? Do they respond better to a calm, low voice or a cheerful, animated one?
- Refusal triggers: What makes them refuse medication, food, or a bath? What approach works when they refuse? "She will take the pills if you put them in applesauce" is the kind of detail that saves an hour of frustration
- Confusion patterns: For a person with dementia, note the time of day when confusion is worst (often late afternoon, called sundowning), what calms them, what agitates them, and whether they are likely to try to leave the house
- Fall risk: Do they try to get up without help? Do they forget to use the walker? Is there a particular time of day when they are unsteady?
- Comfort objects and habits: A specific blanket, a radio station, a pet they talk to, a photograph they like to hold. These are not trivial during a disruption. They provide continuity when everything else has changed
- What they can do independently: A substitute may overhelp or underhelp. Note specifically what the person does for themselves and where they need assistance
Contacts and documents
Everyone the substitute might need to call.
Contact list
- Primary care physician (name, phone, after-hours line)
- Each specialist (name, what they treat, phone)
- Pharmacy (name, phone, location)
- Medical equipment supplier (name, phone, account number)
- Insurance company (name, phone, policy number, group number)
- Family emergency contacts in priority order
- Neighbor who has a key
- Home health agency (if applicable)
Document locations
- Advance directive / living will (where the original is kept)
- Healthcare power of attorney (who it names and their phone number)
- POLST/MOLST form, if one exists (these are pink or bright-colored and should be posted visibly for EMS)
- Insurance cards (where copies are kept)
- Medicare/Medicaid card
The NIA's "Getting Your Affairs in Order" checklist at nia.nih.gov covers the full set of documents every older adult should have accessible.
Build yours
One hour. One document. Three copies.
Set aside an hour. Sit down with a notebook or open a document on your computer. Work through the sections in this guide, one at a time. You will not get everything on the first pass, and that is fine. The important thing is to start.
Write the medication section first
This is the most critical section and the one most likely to prevent a hospital visit. Get it right. Double-check doses and times against the pill bottles.
Walk through one full day
Start from waking up. Write every step until bedtime. Note what you do automatically. Those automatic steps are exactly the ones a substitute will miss.
Add the behavioral notes
The things you know that nobody else does. The tricks that work. The triggers that cause problems. Write them as if you are telling a competent stranger how to get through the day.
Make three copies
One in the home (on the refrigerator or in the caregiver binder). One with the backup caregiver. One with a family member who does not live nearby. Update all three whenever medications or the routine changes.
Free printable: First Responder Note
A half-sheet summary of medical conditions, medications, allergies, and emergency contacts. Post on the refrigerator and place one in the go-bag.
Connected guides
Related sections worth knowing.
Senior & Mobility-Limited Hub
Back to the full section.
Backup Caregiver Plan
The broader framework for when your primary caregiver cannot be there. This document is the centerpiece of that plan.
Medication Preparedness
How to maintain the medication list that forms the core of this caregiver document.
Dementia Preparedness
Behavioral documentation, wandering prevention, and emergency communication for cognitive decline.
Backup Power for Medical Equipment
The equipment section of this document should reference the power-outage plan for each device.
Who Will Check on You?
The personal support network that includes the substitute caregiver this document is written for.