By MercyAssistedCare.org Care Team. Independent educational content, not medical advice. Sources checked October 6, 2026.
Respite care is short-term care for the person you look after, so you can rest, handle your own appointments, or simply breathe. The National Institute on Aging describes it as care that can happen at home, in a health care facility, or at an adult day care center. The conversation with a respite provider goes much better when you walk in with your answers already written down. This page gives you a worksheet to do exactly that.
The Short Answer: Know Three Things Before You Call
- What the person needs help with. Daily tasks, medications, safety concerns, and anything that could go wrong while you are away.
- When you need the break. Hours, days, recurring or one-time, and how much notice you can give.
- What you want to ask the provider. Who will be there, what they are trained to do, and what happens in an emergency.
Being a caregiver can be a labor of love, but the NIA also notes it can be stressful. Asking for a break is a normal part of caregiving, not a sign you are failing.
Why Preparing Helps
A respite provider can only care for your loved one the way you do if they know how you do it. Written notes make the first call shorter and let you compare providers on the same questions. The NIA also suggests asking family members and friends to share caregiving tasks, so the same worksheet can help relatives who may fill in for a few hours.
Respite Planning Worksheet
Copy this into a notebook or a document. Fill in what you can; leave the rest blank and ask the provider.
Part 1: What Care Is Needed
- Personal care: bathing, dressing, grooming, toileting, eating, moving around. Which of these need hands-on help, and which need only a reminder?
- Meals: allergies, food restrictions, swallowing difficulties, preferred times.
- Mobility: walker, cane, wheelchair, transfers, stairs. Who helps, and how?
- Memory and behavior: confusion, wandering, sundowning, anxiety, or anything that calms or upsets the person.
- Communication: hearing aids, glasses, language preferences, how the person signals pain or discomfort.
- Routine: wake time, naps, favorite activities, bedtime habits.
Part 2: Medications and Health Notes
Medication details are the part most worth getting right. Bring a current list of everything the person takes: prescriptions, over-the-counter medicines, vitamins, and supplements. Our guide to building a shared caregiver medication list walks through what to include.
- Name, dose, time of day, and what each medicine is for, as shown on the label or by the prescriber.
- Who gives medications today, and whether the respite provider will be allowed to do so. Ask the provider directly what their policy is.
- Supplements and over-the-counter products, listed the same way. If you are unsure whether a supplement belongs on the list, our article on when to consider a natural supplement advises talking with a healthcare professional before starting any regimen. Listing a supplement here is not an endorsement of it.
- Allergies, diagnoses, and the names and phone numbers of doctors and pharmacy.
- Any warning signs that should prompt a call to the doctor or emergency services, as your doctor has described them.
Why this matters for safety: the CDC reports that more than one out of four older people falls each year, and fewer than half tell their doctor. The CDC also lists certain medicines, including tranquilizers, sedatives, and antidepressants, as ones that can increase fall risk, and says even some over-the-counter medicines can affect balance. Never stop or change a medicine on your own. If you are worried about dizziness, drowsiness, or unsteadiness, ask the prescriber or pharmacist to review the list.
Part 3: Home Safety and Falls
- Has the person fallen recently, or nearly fallen? Note when and where.
- Walking and balance: does the person need standby help to get up, use the bathroom, or walk at night?
- Home hazards the CDC names, such as broken steps, throw rugs, and clutter. Walk through the home and note what a substitute caregiver should know.
- Footwear and vision. The CDC lists foot pain or poor footwear and vision problems among the conditions that make a fall more likely.
Part 4: Your Schedule Constraints
- Why do you need respite? A medical appointment, work, rest, travel, or a family event.
- How many hours or days, and how often? One-time, weekly, or as needed.
- Preferred times of day, and what is a deal-breaker, such as overnight care.
- Who is your backup if the provider cancels?
- Where should care take place: at home, at a facility, or at an adult day program?
- Your budget and any coverage you plan to check. Ask the provider what they charge and what is included, and ask your insurer or benefits plan what it covers.
Part 5: Questions to Ask the Respite Provider
- Who will care for my family member, and what training do they have for our situation?
- Can I meet or speak with the person ahead of time, and can we do a short trial visit?
- How do you handle medications, and what do you need from me in writing?
- What is your plan for a fall, a medical emergency, or a behavior change?
- Who do you call, and how fast, if something goes wrong while I am away?
- How will you update me during and after the visit?
- What are your rates, minimum hours, cancellation terms, and what is not covered?
- Do you have a written care plan I can review?
Where to Look for Respite Options
The NIA points caregivers to the ARCH National Respite Locator for respite programs in your area, and to the National Adult Day Services Association for adult day centers. It can also help to ask the person's doctor or another health care professional what options exist near you, and to ask friends or neighbors who have used a service. Availability and cost vary by area, so ask each provider for current details.
If the person was recently discharged from a hospital, the hospital-to-home questions guide includes a prompt about community resources such as respite care.
Limits and When to Get Professional Advice
This worksheet helps you organize information. It cannot tell you what level of care your loved one needs, whether a medicine is right for them, or whether a provider is a good fit. Talk with the person's doctor or pharmacist about medications and fall risk, and with a social worker, care manager, or local agency on aging about options and eligibility. Call emergency services for any urgent medical concern. This article does not describe services offered by any specific provider and does not recommend one.
What to Do Next
- Fill in Parts 1 through 4 this week, even roughly.
- Update the medication list and bring a copy to the first conversation.
- Pick two or three providers and ask each the same Part 5 questions.
- Ask a relative or friend to review your notes, so someone else can step in if needed.
Sources
- National Institute on Aging, Caregiving (caregiving can be stressful). Checked October 6, 2026.
- National Institute on Aging, Services for Older Adults Living at Home (respite care definition, locators, in-home help, adult day care). Checked October 6, 2026.
- National Institute on Aging, Getting Started With Caregiving (sharing tasks with family and friends). Checked October 6, 2026.
- Centers for Disease Control and Prevention, Facts About Older Adult Falls (fall frequency, risk factors, medicines). Checked October 6, 2026.