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A Family Caregiver’s Guide to the ER
Throughout its 15 years on TV, Michael was a big fan of “ER.” But when his mother, Shirley,
recently diagnosed with Alzheimer’s disease, fell in her bathroom, he didn’t know what to
do. Should he call 911? Should he take her to the Emergency Room on his own? Which
one? What should he bring to the ER? Once there, what should he expect?
ERs — or Emergency Departments, as some are called — are often chaotic places. To learn how
to get your family member the right care, “Emergency Room (ER) Visits: A Family Caregiver’s
Guide” is a good place to start. One of the 16 family caregiver tools in English and Spanish on the
United Hospital Fund’s Next Step in Care Web site (www.nextstepincare.org), this guide takes
you step by step through the ER process. “It tells you what to bring and what not to bring, and
explains the various staff members and their roles. Equally important, it offers advice about how to
avoid an unnecessary ER visit,” said Carol Levine, director of the Fund’s Families and Health Care
Project, which created the Web site and guides.
For people with dementia, probably the most common reason for an ER visit is an accident or
trauma, or a sudden complication of another chronic illness. Although it’s difficult to anticipate such
events, understanding some key points should help:
- If you call 911, be prepared to answer the operator’s questions about the patient’s condition.
- You can ask the ambulance’s Emergency Medical Technicians (EMTs) to take the patient to your
preferred hospital, but they may not be able to comply. If the emergency is life-threatening, they
will go to the nearest ER.
- In anticipation of an eventual crisis, assemble a Hospital Emergency Kit, which should at a
minimum include copies of your family member’s health insurance card and identification, an
up-to-date list of medications, personal health record, health care proxy, and advance directives.
The guide provides a complete list of items to include.
- In the ER, after (or sometimes before) registration, a triage nurse will decide whether your family
member needs immediate treatment or can wait.
- Make sure that everyone who talks to your family member understands his or her memory or
behavior problems. Explain that you are the family caregiver will help them get the information
they need. Don’t be put off by references to HIPAA (the federal privacy law). This law
should not be used to inhibit conversations between you and medical staff about your family
member’s care.
You will undoubtedly spend a lot of time waiting. Several people will ask questions, take your
family member’s medical history, order tests, wait for the results, and then decide what to do. While
you are waiting,
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Try to be patient, and keep your family member as calm as possible.
- Don’t leave your family member alone; explain why you are needed to the doctor or nurse.
- Ask for periodic updates from the nurse.
- When the ER visit is finally over, make sure you receive and understand follow-up instructions.
Remember Michael? He made the right decision and called 911. Shirley withstood the experience
well, and he learned that making preparations before a crisis is well worth the effort.
For more information, please visit www.nextstepincare.org.
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