Q: My parents are older, but independent. I hear a lot about preparing to care for aging parents, but it doesn't seem to apply to me. Do I really need to worry about this?

A: If you have an older parent or loved one, you can never be too prepared for the caregiving challenges that may lie ahead. The fact is, as we age, our situation can change instantly - especially if a crisis hits, like a fall or a sudden illness. What you don't want is to be caught unaware when the time comes to make an important decision about your parent's health or safety. The key is to be proactive.

There are many things that you can do to start preparing now for future caregiving needs. As a first step, consider the myriad of legal and financial documents that need to be in place for an older person. From a medical perspective, this means talking about power of attorney, living wills, and do not resuscitate orders. It sounds scary, but in an emergency situation, these are the things you will need in a pinch - and by then it will be too late to start pulling them together. Once you find a trusted attorney to help you with these documents, it is also a good time to talk about other legal considerations, like beneficiaries, wills, estate planning, and more. Again, the more you can do ahead of time, the less you will need to scramble later on.

This is also a good time to begin shopping around for long-term care insurance, which is important for everyone as they get older. It's a good idea to comparison shop, and ask a lot of questions. What you want to find out is: how long the waiting period is - i.e., how long till benefits kick in; what specific benefits are included - they vary; how will the benefits be paid out - in a lump sum or as reimbursements, weekly or annually, etc.; and how will inflation impact the policy over time?

Something else you can do in advance is look at your loved one's surroundings, and make sure that they effectively accommodate the needs of an older person. Many elderly are victims of accidents in their own homes, and most of them can be avoided with a few common sense steps. I call this "elderproofing" the home, and it's an essential part of ensuring that our loved ones will be able to remain independent in their own homes for as long as possible. Start by eliminating any potential hazards in the home. Get rid of throw rugs, add grab bars and non-slip strips in the bathroom, put appliances and dishes within easy reach, and remove clutter. Check the lighting to make sure it allows for clear visibility. Make sure smoke detectors are in working condition. Program your loved one's phone with emergency numbers.

The need to provide care for someone can happen very slowly, or very suddenly. It's a good idea to start thinking about caregiving sooner, not later.

Q: What if I get the call that my loved one is in the hospital?

A: No one is ever fully prepared for this situation. Yet the decisions you make in a moment of crisis can have a significant impact on the level of care your parent receives, both in the hospital and after discharge. The key is to educate yourself in advance - before you even get the call. Start by choosing the hospital, if you can. Ideally, get your parent or loved one to a hospital that already has his or her patient records, or can access them relatively quickly. Once there, it's important to triple check admissions information. Make sure every detail is accurate, and that you have all necessary legal documents in hand or easily accessible - such as living wills, Do Not Resuscitate orders (DNRs), Health Care Durable Power of Attorney, and Medicare/Medicaid cards. These are things you can - and should - prepare even before a crisis hits.

After your loved one has been admitted, remember that it's up to you to advocate for them, so be proactive and don't be afraid to ask questions. Keep notes of doctor and nurse interaction, and ask the charge nurse for an overview of all activity. Find the social worker assigned to the floor to address everything from diet to laundry. Find out about any potential surgery situations and be present in the treatment rooms whenever possible.

Many people are disappointed in the lack of information and support they receive from their doctors in an emergency situation. The doctors are incredibly busy - so you need to be prepared with any questions you have ahead of time in order to really get the most of your time with them. I like to write down questions in advance and put them on an index card with my name and contact information, as well as the patient's name and room number, so the doctor doesn't feel hassled.

Something else to remember when going to the hospital is that you can't assume that everything is coordinated and everyone is communicating. Many different people will be handling your loved one's chart and things can sometimes be overlooked. Make sure you're aware of the people in the hospital who can help make sure this doesn't happen. For example, there is typically a social worker assigned to every floor, and it's their job to oversee everything from your loved one's diet to their laundry needs - as well as to make sure the chart follows the patient from place to place. There is also a charge nurse who should be able to provide an overview of all activity, so you can get up to speed on what has happened when you're not there. You should can check the chart yourself periodically to make sure the information on it is correct. 

Finally, many people overlook the important last step of planning for discharge care before their loved one leaves the hospital. When leaving the hospital for home or a facility, your loved one may experience "transfer trauma," and feel scared or disoriented. Make sure you meet and talk to the hospital's discharge planner, who can help you plan in advance to ease the transition. Ask questions like: who will arrange for transportation? What time of day will your parent be discharged? Will any prescriptions need to be filled? Will any follow up or home care be required?

In an emergency situation, knowledge is power. Arm yourself with as much information as you can in advance, so you're not without answers at critical times. Good luck!