Today’s guest post is from Roger Sims, the resident medical supplies expert at locostmedical.com.
No one wants to go to the Emergency Room. Frequently crowded, ER visits also require waiting for treatment and have a reputation for impersonal care. ER visits place you at the luck of the draw for the medical care provider you’ll get.
Yet almost everyone ends up in the ER at some point. Over the last ten years, ER visits for the elderly have increased by 34%. Even though ER visits are for emergencies, your aging loved one can prepare for the visit, just as they can manage their medications or keep track of their other medical supplies.
Have the Conversation
The conversation over health issues is always a difficult one for children and their adult parents. At some point, however, you should sit down and cover all issues. Consider discussing what care they want to receive in both emergency and non-emergency situations. You might want to raise the issue of an advance directive or living will. These will raise the likelihood that the person’s desires will be carried out.
During your conversation, you should also explore their medical history. When you go with them to primary care medical appointments, explore whether they will give the doctor permission to release information to you.
You should consider having your aging loved one compile a list of all medications and treatments they receive. They should keep a copy, and, ideally, you will have one also.
Prepare an Emergency Room Kit
In a closeable envelope, your loved one can prepare an ER kit and keep it near the door so it will travel with them to the hospital. The kit should include the following items:
- A summary of their medical history, including hospitalization, incontinence concerns, or other medical equipment they might use.
- A list of allergies—if your loved one has no allergies, the record should say “No known ”
- A list of current and past medications.
- Originals and copies of Medicare and health insurance card.
- Copies of any advance directive or medical power of attorney.
- A list of people to contact in case of emergency.
- A change of clothing—at least of underwear.
- A blanket.
- An appropriate small snack.
- A book.
- A family photo for comfort.
- A devotional, as appropriate.
All these items should fit in a small carry-on bag. If your loved one lives in a facility, regardless of the level of care, make sure the staff is aware of the kit’s existence and location.
Over one-quarter of American elderly people fall each year. Over 7,500 older adults are treated daily in emergency rooms for falls.
Part of preparing for an ER visit is working to avoid the need. The elderly who work on balance tend to fall less. Being aware of vision limitations may suggest moving things in their home. Determine if any medications might cause dizziness, interactions, or other side effects which might increase the likelihood of a fall. Increase the lighting in the home and check the rails on any stairs.
You might want to consider bringing up a medical alert system, especially for those living independently. Assuming your loved one is amenable, select a system, and then work with them to ensure they understand its use.
You may have to establish some compromises or guidelines with alert systems. Many elderly don’t want to wear them; they feel it limits their independence. Persuade them to have the pendants available in multiple rooms, or wear it when they go outside. If the mail is delivered to a box at the end of a driveway, talk to them about carrying the pendant there—or at least a cordless phone handset.
Fall patients admitted to the hospital to the emergency room are more likely to be discharged to long-term care facilities (frequently for rehabilitation) than other kinds of patients. Since falls are the most common cause of injury for the elderly, being prepared for the ER because of falls may mean being prepared for hospitalization and long-term care.
Your loved one should consider what they might want to have in both hospital and long-term care. These items should include clothes, toiletries, shoes, and other personal items.
Work with your loved one to self-diagnose when an ER trip might be necessary. Make sure they are prepared to make the call personally or tell the staff at their facility that it’s time. Some signs to watch for include:
- Sudden dizziness, fainting, or shortness of breath.
- Difficulty speaking or sudden confusion or change in mental state.
- Changes in vision.
- Uncontrolled bleeding or sudden, severe pain.
- Vomiting or coughing up blood.
- Severe diarrhea or vomiting.
- Severe or unusual abdominal pain.
- Thoughts of suicide.
Open discussion of health and other issues with your loved one should help prepare them for any trip to the ER.
Your loved one may still be driving, or you may be in the habit of driving them to appointments. If they are still driving, practice the trip with them to the nearest ER—you will also get a chance to judge their driving.
If it’s a true emergency, however, calling 911 is probably the best option. Make sure your loved one knows to call 911. People transported to the emergency room by ambulance are likely to be seen more quickly than people who drive (or are driven) in.
Prepare for Waiting
People wait for much of their time in the ER. Patients wait for triage and initial examination. They wait for diagnostic tests. They wait for admission. It’s likely that the waiting will either be on a gurney or an impersonal plastic chair.
The ER kit contains some items to help your loved one pass the time reasonably comfortably. The blanket will help keep them warm—some ERs are chilly. The book and/or devotional will both keep the mind occupied and provide spiritual strength. While food may be provided to patients during meal times, meals are not provided to accompanying caregivers. Therefore, prepare your loved one for your occasionally slipping out to care for yourself.
Preparing your aging relative for an emergency room visit is also preparing yourself. While we can’t know when the emergency will occur, we can be reasonably sure that it will occur. Being prepared can help ensure the best care for your loved one.
Roger Sims is the resident medical supplies expert at locostmedical.com, a company that carries products for home caregiving needs.