Our 94-year-old relative was taken to th

The single most useful change today: stop nodding, start writing — and get one named person plus a night number before you walk out. At 94, the questions that matter most on day one are not "what's wrong" (the team knows), they're "what are we watching for, what would make it worse, who do I call at 2am, and what has to be true to go home."

(1) What you tried vs. what to do instead

Nodding feels respectful but it throws away everything. Three upgrades:

A. One question, then write the answer word-for-word. Even just: "Write it in my notepad, please." Numbers, times, and thresholds are the parts you will not remember at 11pm.

B. Ask these eight, in this order. Any one of them changes tomorrow's behaviour.

1. "In one sentence, why was she admitted?"
2. "What are you watching over the next 24–48 hours?"
3. "What would tell you she's getting worse — what specifically would you look for?"
4. "If that happens at 2am, who do I call, and what's the number?"
5. "Is there a named nurse or doctor for our family today?" *(get the name written)*
6. "Which of her regular medicines continue here, and which are on hold?" *(have them mark it on your medication list — don't work it out yourself)*
7. "What is eating, drinking and toileting like now — and is that changed from home?"
8. "What would have to be true for her to go home, and when do we review that?"

C. Ask for the thresholds, not the reassurance. "How much should she drink today?" / "How many wet nappies/pads?" / "If she eats nothing all day, do you want to know?" — these are checkable numbers, and the answers tell you whether home is still safe.

Screenshot scripts:

• "Could you write that down for me? I want to show it to the night nurse."
• "Which number do I use at night — the ward, or the switchboard?"
• "If I call you tomorrow with three questions, will you have five minutes?"
• "She's 94 and I don't want to be the person who missed a change. What should make me press the call button rather than wait?"

D. Divided shifts, since you're the one with the school week. Agree now with the sibling or nearby relative: one person is *the note* (asks the questions, keeps the medication list), the other is *the body* (sits with her, watches drink/pad count/toilet, notices change). One phone number between you, one shared notepad. Swap at visiting hours, not at night.

Notepad layout — five columns, one row per item: `time | what I asked | what they said (write it as they say it) | what I must do | who to ask next time`. Photos of every medicine bottle and the insurance card, in date order, taken once at home — that's your backup if the paper list gets lost.

(2) What to avoid tonight and tomorrow

• Do not adjust, split, skip, or double any medicine yourself — including her "usual" ones, including ones that look harmless. Ask, get it written on the list.
• Don't agree to a new medicine or a test without asking what it's for and what happens if you wait until tomorrow. "Can we think about it until the morning team?" is always a legitimate sentence.
• No powders, tonics, herbal mixes, or anything bought online to "help strength" — at 94 these most often add confusion or fall risk, not strength.
• Don't feed her "her usual" from memory — ask what the kitchen is doing. If she eats very little for a whole day, that's a fact to report, not a reason to force or to hide.
• Don't sit through a whole round without writing — you will be asked the same question at the night shift, and the answer will differ.
• Don't be the messenger for adult family conflicts. If siblings disagree about the care plan, ask for a family meeting with the senior registrar rather than relaying messages between them at the bedside.

(3) Red flags — press the call button, don't wait

You don't need to diagnose. You need to know *when to stop managing it yourself*. Press the call button or tell the nearest nurse immediately if you see:

• Hard to wake, or suddenly not making sense when she was clear earlier today
• New confusion, or hallucinating
• Struggling to breathe, breathing much faster or much slower than her own normal
• Chest pain, or pressure- A fall, or any hit to the head — even if she seems fine, especially on blood thinners. Say it in those words and tell them what she takes.
• Vomiting blood, coffee-ground vomit, black tarry stool, or blood in urine
• Unable to drink at all, or signs of dehydration: very dry mouth, no urine output since you arrived
• A swollen, painful, hot leg or calf
• Sudden confusion plus a rash, or a new rash with fever
• Pain that she cannot stop describing, or pain you cannot locateDecision tree — which door, tonight:

```
Is she hard to wake, not breathing normally, having chest pain,
or fitting now?
YES → press the call button / tell the nearest staff member NOW.
Do not walk out, do not go home, do not look it up.
NO ↓
Is she confused or drifting compared with earlier today,
vomiting, unable to drink, or in pain you cannot locate?
YES → tell the nurse during rounds, and ask:
"Do you want to see her now, or is watching it an hour okay?"
Put that answer and the time in the notepad.
NO ↓
Does she look like her usual self, eating/drinking a little?
YES → use visiting hours 10–20 to work the eight questions,
write every answer, get the night number and a name.
Go home, rest, come back rested. Fatigue helps nobody.
```

Tonight, before you sleep — about 20 minutes:

1. Photograph every medicine bottle + insurance card (5 min).
2. Write today's facts: when admitted, what she ate and drank, pads/wet count, temperature only if the ward already takes it (5 min).
3. Get one contact name + one night number, written (5 min).
4. Agree the division of labour with the sibling or relative (5 min).
5. Put the notepad and the charger by the door, so tomorrow-you only carries one thing (2 min).

What "success" looks like in 24 hours

Not a diagnosis, not a cure — this is the honest target:

• You can say, in one sentence, why she is in hospital and what is being watched.
• You have a written name and a written night number.
• Your medication list is marked up by the team, not by you.
• Someone on your team knows one thing to look for, and one number to call if they see it.
• One person in the family is designated to the notes, and one to her.

That is a complete first hospital day. If you want, I can turn the eight questions plus the notepad grid into a single printable one-page sheet for the bag — just say the word and I'll write it.