If Something Happens to You: The Carer's Emergency Plan

Every carer has a plan for the person they look after and almost none of us has one for ourselves. The question is simple and unpleasant: if you were taken into hospital tonight, who keeps the person you care for safe tomorrow, and how would they know what to do? For most people reading this, the honest answer is that somebody would find out in a panic, from your phone, in a hospital corridor.

Mine was flu, in the January before last. Two days of not being able to stand up properly, in a house forty minutes from my mother’s, and four phone calls before I found somebody who could go over that evening. My brother did not know which tablets were in which box or that the back door key is with the neighbour two doors down. He worked it out. It took him most of a day and one call to a pharmacy, and I spent that day feeling worse than the flu was making me feel, which is the part I remember.

None of this is about being organised. It is about the fact that the whole arrangement, in most families, runs through one person’s head and is written down nowhere. If you are still working out what that arrangement even consists of, what unpaid carers actually do is the inventory, and caring for a parent at home is the map of the job.

What actually goes on the page?

One side of paper, in plain sentences, written for somebody who has never done this. Not a care plan in the professional sense, and not a document with any legal force. Just the contents of your head, made findable.

• Who they are and what they need in a day. Getting up, washing, meals, tablets, toilet, bed, and the times each of those happens. Write it as a timetable, because a timetable can be followed by somebody who has never done it.
• What they cannot do alone, and what they will say they can. This is the line that prevents a fall on the first evening.
• The medicines, and where they are. What they are for, in ordinary words, and who the prescriber and the pharmacy are. Not doses, not instructions to change anything, because that belongs to the prescriber and the pharmacist. Managing someone else’s medication sets out how to keep the round intelligible to another person.
• The numbers. Their GP or family doctor, the surgery’s out of hours arrangement, the pharmacy, the district or community nurse, the social worker or care manager, any paid agency, and the two people you have named below.
• Access. Where the key is, who else has one, the alarm code, the dog, the neighbour who notices things.
• What matters to them, in three lines. What frightens them, what settles them, what they will not say out loud.
• What is normal for them, which is the single most useful thing you can leave behind. Somebody who does not know their baseline cannot tell that they have changed, and that is the whole basis of spotting when someone is getting worse.

Print two copies. One goes in the front of the care file, one goes to the person named as first cover, and a photograph of it lives on your phone. A plan that only exists on your laptop is a plan that exists nowhere.

Who do I name, and how do I ask them?

Name two people, and ask them properly rather than assuming. The one who could get there tonight, and the one who could hold it for a week.

The 24 hour person is usually geographical rather than emotional: a neighbour, an adult child nearby, the friend two streets away. Their job is to get in, keep somebody safe and ring the numbers. The one week person is a different problem, and for most families it is not a person at all, it is a service, which is why the next section exists.

Ask out loud. The conversation is short and awkward and takes about four minutes: this is what I do, this is the page, would you be willing to be the first call, and here is a copy. What you are asking for is not a promise to do the job. It is a promise to answer the phone and to open the page. People say yes to that far more often than carers expect, and the ones who say no have told you something valuable while there is still time to ask somebody else.

If the honest answer is that the sibling who should be on this page is not going to be, that is its own subject, and sharing care with siblings is more use than another conversation at Christmas.

What does the system do in an emergency, and how do I find it beforehand?

The mechanism is the same everywhere and so is the trap: emergency help exists, but it is reached through a body that has to already know who you are. Being on a record before the crisis is what turns days into hours.

The named routes:

• United Kingdom. Ask adult social services for a carer’s assessment in your own name. Section 10 of the Care Act 2014 requires the local authority to carry out one where somebody provides or intends to provide care for another adult and appears to have any level of need for support¹. Contingency and what happens if you cannot continue is exactly the sort of thing the assessment is supposed to look at, and it is the record that a duty officer can find at eight on a Saturday evening. The carer’s assessment covers how to ask.
• United States. The National Family Caregiver Support Program, under Title III Part E of the Older Americans Act, funds five categories of support through state grants delivered by Area Agencies on Aging, including information, access assistance, counselling and training, and respite care². There is no carer’s assessment in the British sense, so the practical step is to find your Area Agency on Aging now and put its number on the page.
• Australia. Carer Gateway is the national route, and its services include counselling, peer support, carer needs assessment and support planning, tailored support packages including planned respite, and emergency respite³. My Aged Care is the parallel entry point for the assessment of the person you care for⁴.
• Ireland. Support is arranged through the local health service, and the annual Carer’s Support Grant is paid automatically each June to people already on the carer payments and can be claimed by others who meet the conditions⁵. It is money rather than cover, but it is the money most often used to buy cover.
• Canada. Home care is provincial and territorial, so the route varies with where you live. What is federal is Employment Insurance caregiving benefits, which pay 55 percent of average insurable weekly earnings for a defined number of weeks and can be shared between eligible caregivers, concurrently or consecutively⁶. If the person stepping in for you would have to take unpaid time off work, that is the thing to look up before it is needed.

Two honest caveats. The first is that emergency respite in most systems is slower than the word emergency implies, and the second is about the evidence. NICE guideline NG150 on supporting adult carers recommends that practitioners regularly discuss the value of a break and that breaks suit the carer in duration, timing, frequency and type⁷, but its own evidence review says there was a lack of evidence on effectiveness to support a recommendation about the circumstances in which breaks should or should not be offered⁷. The Cochrane review of respite care for people with dementia and their carers found four trials, rated the quality of evidence as very low, and concluded that current evidence does not demonstrate any benefits or adverse effects, while noting that this may reflect the lack of high quality research rather than an actual lack of benefit⁸. Arrange it anyway. Just do not expect the system to treat it as urgent because you do. Respite care explained covers the forms it takes.

What happens to decisions while you are out of action?

Care can continue without you. Decisions often cannot. This is the part carers discover in the worst week of their lives.

If the person you care for has capacity, they decide, and your absence is a logistics problem rather than a legal one. If they do not, somebody has to hold the authority, and that has to be arranged in advance while they can still choose who it is. In England and Wales that is a lasting power of attorney, made and registered before it is needed⁹, sitting on top of the Mental Capacity Act 2005, which presumes capacity, treats it as decision specific, says a person is not to be treated as unable to decide merely because the decision seems unwise, and requires that anything done for someone who lacks capacity is in their best interests¹⁰. Ireland’s Assisted Decision-Making (Capacity) Act 2015 works on the same principles through tiers of decision support¹¹. In the United States, Canada and Australia the instruments are state, provincial and territory ones with different names and the same purpose.

Do it before you need it, and do it while both of you can still discuss it calmly. Power of attorney and decisions is the full version, and it is one of the few pieces of paperwork on this site that gets harder every month it is left.

Why so few carers have any of this

Because a plan for your own collapse requires admitting that it is possible, and because most carers are not registered anywhere for anybody to plan around. In a Carers UK survey published in February 2025, drawing on fieldwork from June to August 2024, 77 percent of carers had not had a carer’s assessment in the previous year, and 65 percent had felt overwhelmed because they had not been able to take a break¹².

That second figure is the one that connects this page to the rest of the site. A carer with no cover takes no breaks, and a carer who takes no breaks is the person most likely to need the emergency plan. Carer burnout and your own health is where that leads, and carers skip their own appointments is the mechanism by which the person who was going to be fine turns out not to be.

Do the small version this week. One page, two names, three phone calls, and one sentence to your own doctor telling them that you are a carer and asking for it to be recorded. It takes an evening. My brother worked it out in a day, and he should not have had to.

The line that overrides all of this

If you are the one who is ill, be ill. Ring your own doctor, or the urgent line where you live, and tell them plainly that somebody depends on you at home, because it changes the conversation about discharging you.

And if the person you care for changes while you are not there, the same rules apply as ever, whoever is holding the phone. Ring their own clinician the same day if they are more confused than yesterday, have fallen, have stopped eating or drinking, are unusually drowsy, have a fever, or have new or worsening pain. Their own clinician first, because they hold the notes and the baseline. If that is not reachable, that is NHS 111 in the United Kingdom, the out of hours GP service in Ireland, an urgent care center in the United States, healthdirect on 1800 022 222 in Australia, and the provincial health line on 811 in most of Canada.

Use the emergency number if breathing changes suddenly, there is chest pain, one side goes weak, speech changes, they cannot be roused, or there is bleeding that will not stop: 999 or 112 in the United Kingdom and Ireland, 911 in the United States and Canada, 000 in Australia. Put those numbers on the page too. The person covering for you will not know them.