A trip to the hospital with a loved one who has a memory disorder can be extremely stressful. Planning ahead is critical and will help make things go more smoothly.

First, it is a good idea to have the person with the memory disorder signed up with either Safe Return through the Alzheimer's Association or the MedicAlert Bracelet through the Alzheimer's Foundation of America. People who are lost are often taken to the emergency room.

Be aware that emergency room staff often has little training in Alzheimer's disease so help them understand your loved one by preparing in advance.

Pack an emergency bag

An emergency bag will greatly reduce stress and confusion that can accompany a visit to the hospital, especially an unplanned trip to the emergency room. Include:

• A sheet of paper listing your loved one's name, nickname, address, insurance companies (including policy numbers and pre-authorization phone numbers), Medicare and Medi-Cal card numbers.
• A list of important phone numbers such as doctors, key family members, helpful friends and minister.
• A list of all current medicines and dosage instructions. Keep updated.
• A list of medicine and food allergies.
• Copies of important papers such as Durable Power of Attorney, Health Care Power of Attorney, Living Will.
• Extra adult briefs if the person wears them - the ER may not have them.
• A change of clothes and a plastic bag for soiled clothing.
• A card that says, "Please understand - my companion has a memory disorder. Let me help with specific questions." Avoid talking about your relative's memory changes in front of him or like he isn't there. This can be upsetting.
• Moist handy wipes.
• Reassuring and familiar objects or photographs, favorite music.
• Paper and pen so you can jot down what you are told by hospital staff.
• Pain medicine such as Advil, Tylenol or aspirin. This is for you, the caregiver. An ER trip will take longer than you think, and the stress can bring on a headache.
• A sealed snack for you and your loved one.
• A small amount of cash.
• If you have a cell phone, put a note on the Emergency Bag that reminds you to take the phone with you.

• Have someone stay with your relative at all times if possible, even during medical tests. It will help your loved one stay calm.
• Ask staff to avoid using physical restraints. This can be upsetting and confusing and cause more problems than it solves.
• Remind your relative to drink fluids. Offer fluids regularly and make sure your relative makes regular trips to the bathroom.
• A strange place, combined with illness and surgery will make a person with dementia more confused and likely to need more help with personal care.

To reduce agitation:

Remove street clothes from sight.
• Post reminders or cues if this comforts your relative.
• Turn off the television, the telephone ringer and intercom.
• Talk in a calm voice and offer reassurance. Repeat answers to questions.
• Give a comforting touch or distract your loved one with offers of snacks.
• Listen to soothing music or try comforting rituals.
• Slow down. Try not to rush your loved one.

These tips are adapted from a brochure entitled "Hospitalization Happens: A Guide to Hospital Visits for Your Loved Ones with Memory Disorders" distributed by the Alzheimer's Disease Education and Research Center. They also have a booklet for hospital staff called, "Acute Hospitalization & Alzheimer's Disease: A Special Kind of Care." Their web site is www.alzheimers.org.