The following reference material is provided for your convenience. These materials are not meant as a substitute to professional caregiver assistance or any other professional services.
_____Check your homes to see that heavy items are secured to the wall, cabinet doors are secured, and that the chance for glass and other objects to fall on someone is minimized.
_____Have a family member and/or caregivers attend a Red Cross or other training programs to learn first aid and CPR.
_____Learn how and where to shut off utilities.
Location of wrench: _____________________________________________
Location of: main water valve _____________________________________
Location of gas valve: ___________________________________________
Location of main circuit breaker: ___________________________________
Location of other utilities: ________________________________________
_____Draw a picture of how your house is laid out and show the location of: . Exit windows and doors , Utility cut-offs , First Aid kit, Emergency supplies, Emergency phone numbers, Food, clothing, tools, Flashlights with extra batteries, fire extinguisher, portable radio, sanitation supplies, medication, extra set of clothes, shoes and gloves,. Be sure everyone in your home is familiar with the list. Show it to caregivers and anyone that may be in your home during an emergency.
_____Set up a places to meet around house:
Outside: ___________________________________________
Inside: ____________________________________________
_____Set up alternate meeting locations when family is not at home (e.g. home, Red Cross shelter, neighbors, relatives, park, school, church):
____________________________________________________
_____List name and telephone number of a person that is not a family member to call to report location and condition:
ELECTRICAL
• Don't place cords under furniture or rugs.
• Replace worn cords.
• Don't overload extension cords.
• Don't use multiple outlet adapters on electrical outlets.
• Secure loose rugs, runners and mats to the floor with double-sided adhesive or rubber matting.
• Tack down carpet edges.
• Repair, replace or remove torn or worn carpets.
• One phone should be close at hand in event of an accident and a person cannot stand or walk to the phone.
• Post emergency numbers near or on the phone.
• At least one phone must be connected directly...cordless phones do not work during a power failure.
• Family members may want to consider carrying a pager (beeper) for immediate access if needed.
• Consider get a home alert system that can notify emergency services if you are unable to access the phone.
• One smoke & carbon dioxide detector is recommended on each level of the home.
• Change batteries two time a year when daylight saving times occurs
• Develop a plan to exit the home in case of fire.
• Keep pathways to all exits clear at all times.
• Make sure a key is nearby deadbolt locked doors, if possible replace all deadbolts lock with thumb lock that unlock without a key..
• Don't leave cooking items unattended.
• Never leave space heaters, wood stoves or fireplaces unattended while in use.
• Be sure any window bars are releasable from the interior of the home.
• Put frequently used things on shelves that are easy to reach.
• To reach high items, only use a sturdy step stool.
• Place heavy items flat on lower levels to avoid the possibility of items falling and causing an injury. Plan ahead. Move the object closer to something sturdy to hold on to.,
• Consider adding grab bars to the walls or using a tub seat to assist with bathing.
• Non-skid tub mats and a hand held shower can also be useful.
• Avoid sitting on low furniture. Chairs with arms make it easier to get up.
• Throw rugs pose a tripping hazard. They should be tacked down or removed.
• Using hand rails to go up and down stairs is easier and safer.
• Add hand rails to all stairs, if possible.
• Clutter such as shoes, electrical cords and magazines are a safety hazard. Keep pathways clear.
• Good lighting can reduce the chance of falling.
• Add bright tape strips to the edge of each stair.
• Always keep a charged flashlight near your bed for emergencies.
• A night light in the bathroom can also make night
• Set hot water at a temperature of 110-120 degrees.
• Install an anti scalding device on shower to prevent burns.
• Keep stove and area around stove free towels, paper towels, napkins, curtains and anything flammable.
• Keep a fire extinguisher in kitchen and have knowledge of how to use it.
An Advance Directive is a document in which a person either states choices for medical treatment or designates who should make treatment choices if the person should lose their decision-making capabilities. One document can cover both situations.
Advance Directive forms are readily available from many sources, including a physician or your attorney. Two adults who are not related to you must witness the document.
A Living Will is a legal document that allows you to state, in advance, your wishes regarding the use of life-sustaining procedures should you have a terminal condition.
A Durable Power of Attorney is included in a written document, such as Advance Directives or a Living Will, assigning to another person the right to make decisions on your behalf if you become unable to do so.
A Durable Power of Attorney, stating your agent for decision-making, must be notarized.
These documents should be reviewed every few years and can be changed if you want. It can also be cancelled by telling two adult witnesses of this decision. All old copies must be destroyed.
Your family members, clergy and physician should be made aware of your Advance Directives, or the contents of your Living Will and Durable Power of Attorney. Hospitals and other health care providers, including home health agency representatives must also be made aware of your Advance Directives. Your designated agent should have the original copy of the document and copies should be made available to all health care providers.
You can also obtain more information from your attorney or, if you are over age 60, Legal Services for the Elderly by calling your local Area Agency On Aging or Elderly Services, found in the Government section of your white pages.
Date of my Advance Directives or Living Will:___________________
My Advance Directives documents are located:__________________
My Durable Power of Attorney:______________________________
Copies have been provided to:_______________________________