I hear so many horror stories about long waits in emergency rooms. Is there any point in even taking my elderly parents there? How can I be sure they are seen quickly?
It’s important to understand how emergency departments are run, the alternatives and some tips for preventing a health crisis. Here are some guidelines.
Visiting the emergency department
Medical professionals advise a visit to the emergency department when any acute change occurs. In the case of an elderly person, this might include trouble breathing, a decline in cognition, a bad fall or perhaps excessive bleeding when taking blood-thinning medications such as aspirin.
Rather than driving yourself or a loved one, you may wish to call 911. The emergency medical services will arrive quickly and assess and stabilize the patient. They’ll advise on whether a visit to the emergency department is required.
Take an advocate
Emergency-department staff suggest that patients take a close friend or family member with them. That person should have a list of the patient’s current medications and dosages, provide information to staff as to how the patient’s behaviour or condition compares to their normal state and generally act as an advocate for the patient, who may be confused, in pain and fearful. The advocate should also make notes about findings and recommendations.
When patients enter the emergency department, they are seen by a triage nurse. This nurse determines the urgency of their condition using a five-level assessment tool known as the Canadian Emergency Department Triage and Acuity Scale. For example, level 1 patients, who are in a critical unstable condition, such as cardiac arrest, must be seen immediately. Patients are therefore treated based on the acuity of their condition, not their arrival time or the fact that they arrived by ambulance.
Geriatric emergency nurses
A new innovation in many emergency departments is the geriatric emergency management (GEM) nurse. This is a practitioner who will make a full geriatric assessment, including of the patient’s physical condition, cognitive level and home support. GEM nurses can diagnose, order tests and prescribe, working in consultation with a physician and the emergency team. Their goal is to treat seniors and to discharge them with a care plan that will ensure better long-term health to prevent future crisis visits.
Keeping track
Be sure information is collected, updated and accessible, including medications, pharmacy name, family doctor’s name, medical history, valid health card (photo-ID health cards have expiry dates) and updated contact names and phone numbers. Attend medical appointments with your parent or family member, meet their doctors and learn about their medical conditions.
L. Carol Edwards RN, GCM, and President of Careable Inc. can be reached at carol@careable.com
