Before the first shift, the house needs one card by the phone that someone who has never been inside can read without calling you. Write it once, post it, and test it. Do not rely on the caregiver remembering numbers you gave them on a phone call.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

Step 1: Write the card

Put these items on one sheet, in this order:

1. The full name of the person receiving care, and the home address exactly as it reads on the mailbox or the door.

2. Two family contacts in call order, with the hours each one usually answers.

3. The doctor's office number and its after-hours line. Copy both from the office's own paperwork, not from memory.

4. The pharmacy name and phone number. Medicine decisions stay with the family, the doctor, and the pharmacist, so the card lists who to call and nothing more.

5. The hospital the family uses and which entrance the caregiver should direct an ambulance or driver to.

6. The agency office line and its after-hours line, if an agency is placed. If the caregiver is hired directly, write the caregiver's own phone number and the backup person's number.

7. Where the main shutoffs are for water, gas, and power, and which light switch turns on the front walk.

Write here: Call order 1 ____________________ Call order 2 ____________________ Doctor after-hours ____________________ Pharmacy ____________________

Step 2: Set the call order in writing

Decide who is called first for an emergency and who is called first for everything else. Then ask the agency or the direct caregiver to repeat the order back to you and to write it into their own paperwork.

Listen for a clear answer: emergencies go to 911 first, then family, and non-emergencies go to family first. Listen for the gaps. A caregiver who says they will call family without naming which person, or who says they will wait and see how things go, has not answered the question. Write down the exact sentence they used.

Ask what happens when the first family number does not answer. A workable answer names the second number and a time to try again. A weak answer leaves the caregiver alone to decide.

Step 3: Post it and test it

Print two copies. Post one by the main phone and keep the second inside a cabinet door or on the refrigerator where the caregiver will look first. Mark the date you last updated it at the top, so the next person knows whether it is current.

Test the card once before the first shift. Ask someone who has never seen the house to read it and find the doctor's after-hours line. Time them. If they cannot find it in about a minute, the card is too crowded or the labels are unclear. Rewrite it.

Then test the phone the caregiver will carry or use. Call the numbers on the card from that phone and confirm that the family member answers and the agency line connects to a person, not a recording that goes nowhere.

Step 4: Keep the card current

The family owns every change. When a number changes, the family updates both copies the same day. A caregiver may point out that a number on the card no longer works, and that is a useful report, but the family makes the correction.

Write here: Date of last update ____________________ Who made the change ____________________ Where the second copy is posted ____________________

When the card is not working

Walk away from a caregiver or agency that refuses to put its after-hours line in writing, that says a card is unnecessary, or that will not call the family numbers printed on it during a trial period. A caregiver who will not follow a written call order in a small matter will not follow it in a large one.

For the wider hiring steps that sit around this card, see Start Here: Five Steps to Hiring.