A Family Caregiver’s Guide to the ERby Carol Levine

Throughout its 15 years on TV, Michael was a big fan of “ER.” But when his 80-year-old mother, Shirley, fell in her bathroom, he didn’t know what to do. Should he call 911? Should he take her to the Emergency Room on his own? Which one? What should he bring to the ER? Once there, what should he expect?

ERs--or Emergency Departments, as some are called--are often chaotic places. To learn how to get your family member the right care, “Emergency Room (ER) Visits: A Family Caregiver’s Guide” is a good place to start. Available at It tells you what to bring and what not to bring, and explains the various staff members and their roles.

Before you face an emergency, assemble a Hospital Emergency Kit, which should (at a minimum) include copies of your family member’s health insurance card and identification, an up-to-date list of medications, personal health record, health care proxy, and advance directives. The guide provides a complete list of items to include.

For older adults, the most common reasons for an ER visit are an accidentor a sudden complication of a chronic illness like difficulty breathing. Although these events are sudden and frightening, try to remember thesekey points:

  • If you call 911, be prepared to answer the operator’s questions about the patient’s condition.
  • You can ask the ambulance’s Emergency Medical Technicians (EMTs) to take the patient to your preferred hospital, but they may not be able to comply. If the emergency is life-threatening, they will go to the nearest ER.
  • In the ER, after (or sometimes before) registration, a triage nurse will decide whether your family member needs immediate treatment or can wait.
  • Explain that you are the family caregiver and will help staff get the information they need. Don’t be put off by references to HIPAA (the federal privacy law). This law should not be used to inhibit conversations between you and medical staff about your family member’s care.
  • Your family member is probably not going to be able to relate what happened or recall all the ER staff’s explanations and instructions. It is very important that you or another family member be there to ask questions and take notes.
  • You will undoubtedly spend a lot of time waiting. Several people will ask the same questions, take your family member’s medical history, order tests, wait for the results, and then suggest a plan. While you are waiting, try to be patient, and keep your family member as calm as possible.
  • Don’t leave your family member alone; explain to the doctor or nurse why you are needed.
  • Ask the nurse for periodic updates.
  • And when the ER visit is finally over, make sure you receive and understand follow-up instructions.

Remember Michael? He made the right decision and called 911. His mother was treated and recovered, and he learned that making preparations before a crisis is well worth the effort.

Carol Levine is director of the Families and Health Care Project at the United Hospital Fund. This article is adapted from “Emergency Room (ER) Visits: A Family Caregiver’s Guide,” one of a series of free guides available in English, Spanish, Chinese, and Russian at