Updated April 30, 2014.
As a caregiver, or--let's be real now-- as a human being acquainted with our medical system, you know that a trip to the emergency room can be a very stressful event both for you and the person for whom you're providing care. No one wants to think about this kind of situation in advance (my mom would call it "borrowing trouble") but with a little planning, these sometimes inevitable events can be a little less stressful.
Tip #1: Be proactive
The most successful emergency room trip, of course, is one you've safely avoided. And the most successful way to safely avoid emergency room trips is by developing a meaningful relationship with your loved ones primary care provider and any important specialists.
For example, if you're taking care of your mom who has diabetes and trouble maintaining good blood sugar control, it's important that you know how to reach her endocrinologist after hours. Being able to contact the provider when you have a question or concern that can't wait until the next weekday morning might mean the difference between being able to address the problem at home and spending five hours waiting in the emergency room lounge.
Almost all health care providers have a service that takes calls and reaches out to the on-call provider who then ideally calls you back. Often this is as easy as dialing the office phone number after hours. If you don't know the procedure, ask the provider next time you and your loved one visit their office.
Tip #2: Be Choosy
If at all possible, go to the emergency room affiliated with the hospital where your loved one usually receives care. Going to the senior's “homebase” hospital where their medical records are kept increases the chances that all pre-existing conditions will be taken into account when the senior is being evaluated. If they are admitted, they may even be able to see their own primary doctor.
Please note that this is an issue only if an ambulance is not needed for safe transport. Under most circumstances, if you call 911, you will not be able to choose the destination hospital.
Tip # 3 Be Persistent
Patients in the ER are not seen in the order they arrive, the sickest patients are seen first. So you may have to wait while others who came after you get their turn. But the Emergency Medical Treatment and Active Labor ACT requires hospitals to screen and stabilize all patients to determine if there is a medical emergency. In other words, the ER staff must see your loved one, even if they are uninsured or aren't able to pay.
Tip #4: Bring a med list
.If for some reasons you don’t have a list of all the medications your loved one is taking, sweeping all the current prescription bottles into a plastic bag and bringing them with you is better than nothing The ER staff may roll their eyes, but they will have the information they need.
You've probably been through that "well...I take a blue pill at night, most of the time. I don't know the name of it, but I think it's for my heart. Or maybe my breathing? Oh, my blood pressure?" It's really not a fun game, and the ER staff doesn't want to play it either, and the list bypasses all that. Make sure the list includes over the counter medications and supplements as well.
Tip #5: Bring the paperwork you'll need and the comfort items you'll want
For example, you will need:
- Do Not Resuscitate order (if relevant)
- Healthcare proxy form
- List of current medical conditions
- List of prior surgeries
- Recent documentation of symptoms (for example, a list of recently recorded temperatures if the problem is related to a fever)
?Ideally, you have all this information together in one place. Many caregivers like to keep this a copy of this information in a plastic bag or plastic wide mouth water bottle (minus the water of course) in the refrigerator, so it's easy to locate in an emergency. How easy it is to locate depends on the tidiness of the refrigerator, I would imagine.
And you will want to bring:
- Quarters for vending machines (often the only snacks available late at night)
- Reading material
- Hand sanitizer
- Tissues
- Extra sweater or hoodie: emergency room waiting areas seem like they're nearly refrigeration units!
- Bucket or emesis basin (if nausea is an issue)
- Cell phone charger
Tip #6: Bring a friend
Hospital emergency rooms are loud, scary places chock full of people having perhaps one of the worst days of their lives. Your loved one needs someone to be there for them (that's you) but you need someone to be there for you as well. This person can go for coffee, stay with your loved one so you can get some fresh air or use the restroom, help you manage your stress and make any needed phone calls.
Hospital emergency rooms can be loud, confusing and intimidating places and they're not someplace you want to leave someone alone who is already feeling sick and vulnerable. If you bring along another family member who can be in the waiting room, you'll have someone to spell you so that you can take
Tip #7 Bring your A Game
The ER is a place where your patient advocacy skills can really be put to the test. Keep a pen and your caregiver's notebook handy so you can take notes and write down names of providers you've spoken with and the names and reasons for any diagnostic tests that need to be performed. If you feel like your concerns aren't being addressed, ask to speak to the attending physician, the patient advocate or the nurse manager on call. If the problem concerns pain, it can often be helpful to ask to speak to a member of the palliative care team.