Preparing ahead of time

• Prepare contacts. Make a written list of contacts, including the primary caregiver and other family members or friends who help with care, who should be notified in an emergency. Keep a copy with you in case you get a call about the patient's condition and can't come to his side yourself; share copies with other caregivers and facilities he frequents, such as an adult day care center or church program. Note which people have legal permission to be present when physicians and other staff discuss his medical issues.

• Prepare records. Anyone who accompanies the patient in the emergency room should bring along a copy of his medical records and relevant legal documents. These include:

• A clear summary of his medical condition (including the Alzheimer's disease and any other health problems)

• A list of all the medications, vitamins, and supplements he takes, including dosages

• A list of any allergies

• Contact information for his primary care physician and any specialists he sees

• Insurance and Medicare, Medicaid, or HMO enrollment card(s)

• Relevant legal documents, such as a health care proxy, advance health care directive or living will, power of attorney, and do-not-recuscitate order.

• Prepare for medical access. A companion who has the patient's verbal permission to stay by his side should have no problem gaining access. But you can't count on a verbal okay in a crisis or if he's already in mid- to late-stage Alzheimer's. If he's confused or agitated or unable to grant permission, the hospital staff may require that you present a legal document (such as a health care proxy) that allows you to stay with him -- another important reason to obtain this authority soon after his diagnosis. It's best not to count solely the patient's spouse for this role, as she or he may be too upset in a crisis (or, in the event of a car accident, for example, also indisposed).

Hospital policies vary. Make sure you let staff know the patient has Alzheimer's disease and that you are a caregiver (or a son or daughter there in that capacity).