As indicated in my introduction post I am caring for my wife of 53 years at home. She was diagnosed with dementia (likely Alzheimer's) in last 2019. For the past few months I have been working on a contingency plan that would spring into action should I pre-decease my wife, or become incapacitated, either temporarily or permanently, and thus unable to care for her anymore. I used several resources, and advice from other caregivers and our financial planner to develop the content. Since the content has many details that need to be kept private I will only share the title page and table of contents below in the hope that it might inspire and assist others in developing such a plan for their own circumstances.
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Emergency Planning Workbook
For
XXXX’s Care

What follows is an effort to provide information to help those working to care for Xxxx should I (Xxxx) pre-decease her, become incapacitated, or in some way am no longer able to care for her, either temporarily or permanently.

First priority is to make sure Xxxx is safe and has someone with her, whether that means in our home, in someone else’s home, or admitted to a hospital (from there transfer to a memory care facility would be the next step). [NOTE: Memory care facilities typically require a doctor’s medical assessment within 30-days prior to admission, so direct admission to a memory care facility will not likely be possible.] If I am alive, but incapable of caring for her, I want to be involved with determining steps to provide care for her. However, if I am unable to advise, for whatever reason, then contact my sister Xxxx (my Primary POA agent and Xxxx Contingent POA Agent), Xxxx, and, if necessary, the Police Dept.

Prepared by: Xxxx
Last update: 8/4/23 10:57 PM

Table of Contents

Care Recipient ………………………………………………….….…p. 3
Health History……………………………………………….…….….p. 4
Medicine Schedule (note to see p. 31)…………….….....p. 4
Medical Equipment……………………………………….…….….p. 5
Emergency Response Information…………………………..p. 5
Food Likes/Dislikes………………………………………….………pps. 6-7
Daily Routine
Morning…………………………………………………….…..pps. 8-9
Afternoon/Evening………………………………………...pps. 10-11
Weekend.……………………………………………………...p. 12
Important Documents (List/Locations)..…….……..…....p. 13
Support Network Contact Information
Relatives…………………………………………..…...….…..p. 14
Caregivers………………………………………………………p. 15
Financial/Legal Service Providers….……………….p. 16
Friends………………………………...…………..……….....p. 17
Medical (Hospital/Doctor)………………….…………..……...p. 18
Dental (Dentist).………………..……………..…………..……....p. 18
Insurance (Xxxx)………………………………….……..………..…pps. 19-20
Insurance (Xxxx)……………………….……………………..….....pps. 21-22
Financial/Income Sources………………….….………….....….p. 23
Pre-Arranged Services………………….……………….………..p. 24
Utilities/Security…………………………………………….…..…..pps. 25-26
Streaming/Support/Ordering Services…………….………pps. 27-29
Suggested Memory Care Facilities………………………....p. 30
Medication Schedule………………………….…………………..p. 31