Home Instead Senior Care, Birmingham

Senior Emergency Kit Worksheets and Checklists

Tuesday, January 10, 2012

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 
  • Medication Tracker Allergies and Conditions Worksheet 
  • 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 


Download the whole toolkit here!



 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. To us it's personal