What to Do When Your Parent Is in the ER
It’s something we don’t like to think about, but – like taxes and flu shots – we can’t ignore. At some point, it’s likely that our older loved ones will take a trip to the emergency room. These visits, even for minor mishaps, can have major consequences.
Medical emergencies are considered “sentinel events” because they frequently indicate more serious health issues.
“Visits to the emergency department are sentinel events for anyone,” explains retired emergency physician Ben Hippen of Decorah, IA. “But elderly persons’ health can be more fragile than younger people's, so it’s a wake-up call to make necessary changes and keep a closer eye on your family member.”
Just what you wanted to hear, I know. But with a little advance work, we can be better prepared for a loved one’s ER visit and recovery.
How to Create a Medical History for Your Parent
Healthcare professionals agree that one of the most helpful things we can do to improve outcomes from a trip to the emergency room is gather critical information beforehand.
“This is extremely important because things happen very quickly in the emergency room,” explains Nicole Rochester, a physician expert on health care navigation, a patient and family caregiver advocate in Gambrills, MD. “A senior who’s not feeling well – and may have cognitive deficits secondary to dementia – will likely have difficulty providing an accurate and detailed medical history.”
Here’s the information you and your parents should gather now:
• Current medications, including names, dosages, frequency, and whenever possible, whether your parent is actually taking the medication as prescribed
• Allergies, including those to medication
• Medical conditions and surgical procedures
• Advance directive wishes
• Contact information for you or another decisionmaker with power of attorney
PRO TIP: If you’re not sure, ask your parents’ primary care physician to help you compile and update this information.
“The good news is that, if you plan ahead, this doesn't need to be too difficult. All of it can be maintained on one or a few sheets of paper, updated as needed,” Hippen says.
Having the information ready for the nurse at triage makes the intake process much more efficient, and allows healthcare professionals to begin delivering the best possible care sooner. “Without it, medical errors are more likely to occur,” Rochester adds.
PRO TIP: Store the medical history in an envelope near your parent’s front door or their bedside for easy access when you’re not around. Keep digital copies or photos on all family smartphones, too. Make a list of items that might be needed during an ER visit, like a sweater or shawl, address book, mobile device, glasses and hearing aids, a pad or notebook for taking notes, etc.
What to Ask the Emergency Room Team
Once your parent is in the care area, you have two jobs: to keep Mom or Dad as calm and comfortable as possible, and to gather information.
According to Rochester, studies also show we retain very little of what we’re told during doctor visits, so make sure to take copious notes during the visit. Ask questions that help you understand the care decisions being made. Don’t be sheepish about requesting a “translation” into plain language so you and your parent have a clearer picture of what’s going on.
PRO TIP: Bring a notebook or your smartphone. Go over what you wrote down with a nurse or doctor to make sure you have it right.
Once your parent is ready to go home or be admitted to the hospital (almost 20% of seniors are admitted after an ER visit), make sure you ask the nurse or doctor these questions:
1. What’s the diagnosis? Know what, specifically, was diagnosed. Add it to the medical history when you get home.
2. What’s the treatment? Understand what medications were given and procedures completed. Update the medical history with this information when you get home.
3. How will my parent’s primary care team be informed? Confirm who and how information about Mom or Dad’s ER visit will be shared with their primary care physician.
5. What we should expect or look for in the coming weeks? Ask what you and your parent should be watching for related to mobility, cognition, healing, etc., to know whether things are getting better or not.
These last two are especially important.
A 2017 study by researchers at Yale University found that older people who were treated and released from the emergency room without a hospital admission experienced a “clinically meaningful decline in functional status” in the 6 months following their discharge. In other words, study participants’ ability to live independently was diminished or lost.
Your parent is particularly vulnerable immediately after their trip to the ER. That’s why nurses and physicians are extremely concerned with your parent’s health after discharge from the emergency room.
“We put as much time and effort as we can into writing discharge instructions and explaining the post-visit plan – or in communicating that plan to the nurse who will discuss it with patient and family,” Hippen explains. “The post-discharge plan is as important to us as any other part of the ED visit, and we really want patients and families to understand that and, we hope, feel that way, too.”
• Create a complete set of medical information to help the ER team provide your parent with better care faster
• Get clear on what was done in the ED and what you need to do after discharge to make your parent less vulnerable during recovery
Nothing can take all the stress out of a visit to the emergency department. Use this advice to reduce hassles, accelerate intake and ease your uncertainty about the care your loved ones received and how to keep them healthier and safer after discharge.
Don’t disregard professional medical advice, or delay seeking it, because of what you read here. This information is not intended as a substitute for professional consultation, diagnosis or treatment; it is provided “as is” without any representations or warranties, express or implied. Always consult a healthcare provider if you have specific questions about any medical matter, and seek professional attention immediately if you think you or someone in your care may be suffering from a healthcare condition.