Simple ways family caregivers can help EMS, firefighters, and other first responders provide safer, faster care.
When you call 911, you know the person you care for. You know what is normal, what has changed, what medications they take, and what usually helps.
First responders do not.
They are entering an unfamiliar home and quickly trying to understand what happened and what care is needed.
A prepared family caregiver can help responders work more quickly while also helping the person receiving care feel safer.
At a Glance
When first responders arrive
- Designate only one person to talk with first responders.
- Take a breath and try to stay calm.
- Give them room to work. Step away when they are working, and they have the information they need.
- Listen and answer questions briefly.
- Tell them what changed from the person’s normal condition.
- Mention dementia, hearing loss, communication problems, or mobility limitations.
- Have an updated medication list and important medical information ready.
- Let the care receiver answer questions when they can.
Make the Home Easier to Enter and Work In
Emergency scenes can become crowded quickly.
- Unlock the door.
- Turn on lights.
- Clear a path to the person.
- Turn off the television.
- Move pets to another room.
- Move clutter or furniture blocking access.
- Ask unnecessary visitors to step away.
Immediately provide the lead officer of EMS a copy of a signed and witnessed Medical Power of Attorney, Directive to Physicians and Surrogate (living will) or OODNR.
In Texas: How First Responders Handle Medical Directives
- Pre-Hospital Limitations: Emergency medical technicians (EMTs) and paramedics do not have the time, authority, or legal capability to review or verify a Medical Power of Attorney or determine a patient’s legal incapacity in the field.
- Duty to Preserve Life: When immediate verification is impossible or doubt exists regarding the validity of a document, EMS protocols mandate defaulting to full lifesaving measures (CPR and stabilization) to protect the patient and avoid liability.
- What They Can Honor: To stop pre-hospital life-sustaining treatment, first responders need a signed Texas Out-of-Hospital DNR or an official Directive to Physicians backed by a physician’s signature
Family or Guardian Override: Under Texas Health and Safety Code 166.089, responding professionals must disregard the OOH-DNR if a qualified relative, legal guardian, or the patient themselves revokes or requests resuscitation at the scene.
- When MPOA Takes Effect: A Medical Power of Attorney only kicks in once the patient arrives at a medical facility (like an emergency room) and attending physicians formally determine that the patient is unable to make or communicate healthcare decisions.
Please note that individual communities and teams often rely on their policies and training to make decisions.
Texas Directive to Physicians and Surrogates
Texas Medical Power of Attorney
Texas OOH-DNR (Out of Hospital Do Not Resuscitate)
For other states, enter your state and the terms above. Many states use the term “proxy.”
Report Why 911 Was Called – Start With What Has Changed
One of the most useful things you can tell a first responder is:
“This is different from normal.”
Then briefly explain how.
For example:
“He normally walks with his walker and answers simple questions. This morning he suddenly could not stand and his speech became difficult to understand.”
Or:
“She has dementia and is usually confused about the date, but she normally recognizes me. Today she does not.”
This helps responders tell the difference between an ongoing condition and a possible new medical problem.
Give the short version first. You can provide more details as the assessment continues.
Explain the Person’s Normal Abilities
First responders may ask about the person’s baseline—what is normal for them.
Be ready to describe changes in:
- Walking or transferring
- Speech
- Memory
- Alertness
- Hearing or vision
- Pain
- Behavior
- Ability to follow directions
- Continence
- Use of oxygen or medical equipment
A person who normally walks but suddenly cannot stand needs a different evaluation from someone unable to walk for years.
The same is true for confusion, speech problems, weakness, or changes in behavior.
Tell Responders About Dementia Early
If the person has dementia, say so early.
Dementia can affect memory, communication, pain reporting, cooperation, and understanding of what is happening.
You might say:
“He has dementia and his short-term memory is poor. I usually provide most of his medical history.”
Also tell responders what the person can do.
For example:
“He understands simple directions. Please speak slowly and give him time to answer.”
That is more helpful than simply saying, “He has dementia.”
Let the Person Participate
Whenever possible, allow the person receiving care to answer questions and make choices.
Caregivers often know the most accurate information, but answering every question for someone can unintentionally take away their voice and even their dignity.
Give the person time to respond when they can.
Then add information if needed: “That’s correct. The pain actually started yesterday afternoon.”
With dementia or communication problems, you may need to speak more often for the person. The goal is to include them as much as their abilities safely allow.
Help Responders Communicate
Tell responders about hearing, speech, vision, or understanding problems.
Simple information can help:
“Her hearing is poor. Please face her when you speak.”
“He does better with one direction at a time.”
Have these available when needed:
- Hearing aids
- Glasses
- Dentures
- Communication devices
- Interpreter information
Also tell responders if speech or behavior sounds different from usual.
Keep Important Medical Information Ready
Do not depend on memory during an emergency.
Keep an updated emergency information sheet in an easy-to-find place.
Include:
- Full name and date of birth
- Major diagnoses
- Allergies
- Current medications and doses
- Important surgeries or hospitalizations
- Primary care physician
- Specialists
- Emergency contacts
- Advance directives
- Medical Power of Attorney
- DNR documentation, if applicable
- Insurance information
Keep an updated medication list where it can quickly be found or taken to the hospital.
Copies can be stored in an emergency folder and ER Go Bag.
Explain Mobility and Fall Risks
Tell responders how the person normally moves.
Mention:
- Walker, cane, wheelchair, or lift
- Transfer assistance
- Weakness on one side
- Recent surgery or fractures
- Problems bearing weight
- History of falls
Do not try to lift the person just to help. First responders have equipment and training for moving people safely.
Your most useful role may be explaining what is normal and then stepping aside.
Be Ready for a Trip to the ER
If responders recommend transport, decisions may happen quickly. A prepared Go Bag can save time and stress. See our blog with directions on how to prepare an ER Go Bag.
Keep these items easy to grab:
- Identification
- Insurance card
- Medication list
- Advance directives
- Glasses
- Hearing aids
- Phone and charger
- Needed mobility equipment
- A few comfort items
For someone with dementia, include a short description of their normal memory, communication, mobility, and behavior.
After the Emergency
When things have settled, ask:
What worked? What was hard to find? What information did responders need?
Then update your plan.
You may need:
- A better medication list
- An updated emergency folder
- New emergency contacts
- A backup caregiver
- Copies of legal documents
- A plan for pets
- A packed ER Go Bag
Each emergency can show you how to prepare better for the next one.
Plan for an Emergency When You Are Not Available
Emergency planning should not depend on one caregiver being present.
Ask yourself:
What happens if I am the person having the emergency?
Could another family member, neighbor, or backup caregiver quickly find:
- Medication information?
- Medical records?
- Emergency contacts?
- Legal documents?
- Instructions for safe transfers?
- Information about dementia or communication needs?
- Names of doctors and the preferred hospital?
Written information can speak for you when you cannot.
Remember
First responders bring emergency training and experience.
You bring important knowledge about the person.
Working together can help responders understand what is happening, protect the care receiver’s dignity and independence, and make a stressful emergency easier to manage.
Written by Zanda Hilger, reviewed and edited by Mark L, EMT/Firefighter and former caregiver of his wife with terminal cancer and Tina L, a caregiver of her husband with terminal cancer.
We hope this information is helpful to you in the important work you do as a family caregiver.
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