No one loves going to a hospital emergency department. It’s often noisy, chaotic and crowded. Long waits are common; information about what’s going on may not be forthcoming or clear.
And yet older adults and their caregivers sometimes have to make that trip. It’s best to plan for it, doctors and patient advocates say. Caregivers who learn to navigate the emergency department (ED) can make a big difference in their loved one’s care, they say.
Too often, “people are unprepared,” says Carol Levine, a senior fellow at the United Hospital Fund, a nonprofit organization that focuses on improving health care for New Yorkers, and former director of its Families and Health Care Project. “You just don't want to think about what would happen if we had to go to the emergency room.”
Once there, “the emergency department can be a scary place for anyone,” but especially for older adults with any problems seeing, hearing, walking or thinking, says Martine Sanon, M.D., an associate professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai, New York. Those with effective caregivers are fortunate, she says: They have a “an extra set of eyes and ears [and an] advocate to keep things moving in the right direction.”
So how do you become that advocate? Here are some tips for each step of the way.
Before an emergency
Next Step in Care, a website Levine helped create, says that every caregiver should set up a hospital emergency kit, with health histories, doctors’ names, medication records, copies of insurance cards and essential legal documents, such as those that name health care proxies.
Registered nurse and patient advocate Barbara Abruzzo, of New York City, says she did exactly that when she was a caregiver for her mother many years ago. When she showed up with all that information in the emergency department, she says, doctors and nurses were often pleasantly surprised: “It was so helpful to them and to the patient.”
Abruzzo and Levine also urge caregivers to research nearby emergency departments. You may learn, they say, that some are better than others for certain emergencies, such as stroke response or trauma care. Also, some facilities offer enough special supports for older adults to be certified as geriatric emergency departments by the American College of Emergency Physicians. Some emergency departments haven’t gone through the certification process but do have age-friendly features, such as geriatric social workers and nurse practitioners on duty, says Todd James, M.D., a geriatrician and professor of medicine at the University of California San Francisco. It's wise to check ahead to see whether the facility accepts Medicare to avoid paying any unnecessary costs.