Pearls of Wisdom from the ER
by Ginger McMurchie, Elder Care Management owner and Care Manager
Millions of elderly adults will cycle in and out of the emergency room this year. They will be seen because they have the flu, have fallen, or have had a more complex and life-threatening medical event. As Care Managers, we are called upon to advocate for our clients while they are in a clinical setting, making sure that physicians understand our client’s history, what medical conditions they have, what medications they are taking and who they were prior to being brought into the hospital. We are then able to reach back out to family and responsible parties and let them know what their loved one’s diagnosis and status are.
We offer you the following tips to help navigate what is often a tense and stressful time and hope that we can guide you to better outcomes for yourself and those you love.
First, understand that your emergency room visit will be judged on the acuity of the event that brought you there. If someone has suffered a potential stroke or heart attack, they will be seen immediately to determine next steps. A flu bug or potential broken ankle will likely move you to the back of the line. Bring a large dose of patience and ask for things to make you and your loved ones more comfortable like warm blankets and perhaps a drink of water if approved.
Please note that our advice is based on two people being present- the one who is ill and their family, friend, or advocate. We do not believe that anyone should go to the emergency room alone. This is particularly true for anyone with cognitive impairment or history of mental health issues. The atmosphere in the emergency room is stressful and can exacerbate behaviors and symptoms. Always have an advocate with you. If you are not able to be physically present and your loved one is agitated, ask the staff if they will provide a “sitter” to be with them- the sitter can prevent a fall or having an IV pulled out which in turn helps the hospital staff.
Carry with you lists of current medications and chronic medical conditions and allergies. These lists should be given to the first responders, if they are called, along with a POLST (Physician Ordered Life-Sustaining Treatment) or Advanced Health Care Directive. The first responders are required to follow those directives if they have been properly drawn up- a POLST will be the go-to document for the paramedics.
Be a good listener and ask what each test a technician or nurse is ordering. Ask how long it will be until results are back and make a note so you can remember the types of tests and times that they are due. You are going to be there for a while and it helps to know that you are likely waiting on test results to get back to the doctors. Be sure to get those results! You will be the one to convey the results to the Primary Care Physician on a follow-up visit.
A final tip: have a clear understanding of what the next steps are. If it is a non-life-threatening event you may be home in 4 to 16 hours. If you are moved to a hospital room and told you are being admitted- ask whether you are there under formal admission or observation. This may impact whether you will be eligible for a Skilled Nursing stay if one is recommended for further treatment.
Be patient with the ER staff. Know they have a challenging job- but push for answers that will help you and your loved one return home safely.