Tell Us: How Would You Improve the ER?

emergency_room_591The New York Times published an article today called “Emergency Rooms Are No Place for the Elderly.” The article references a document called “Geriatric Emergency Department Guidelines” created by American College of Emergency Physicians, The American Geriatrics Society, Emergency Nurses Association and Society for Academic Emergency Medicine.

The organizations recommend changes in emergency rooms to better serve the elderly, including:

  • Geriatric-trained physicians and nurses on staff;
  • Education and training for staff “to ensure high-quality geriatric care”;
  • Instructions printed in large fonts.

I’d love to know: What changes would you make so that visits to the emergency room are easier for you and your caree? While the report focuses on accommodating elderly in the ER, let’s focus on all carees, regardless of age.

Tell us your recommendations to improve emergency rooms in our comments section, below.

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About Denise Brown

I began working with family caregivers in 1990 and launched CareGiving.com in 1996 to help and support them. Through my blog, I share words of comfort and offer coping strategies and tips. I also write opinion pieces about recent research, community programs and media coverage of caregiving issues. I've written several caregiving books, including "The Caregiving Years, Six Stages to a Meaningful Journey," "Take Comfort, Reflections of Hope for Caregivers" and "After Caregiving Ends, A Guide to Beginning Again." You can purchase my books and schedule a coaching call with me in our store.

6 thoughts on “Tell Us: How Would You Improve the ER?

  1. Avatar of LarryLarry

    Also consult with specialty care providers (Nephrology, endocrinology, etc.) to be sure their recommendations are right for the patient. (Urgent care doctor had prescribed to high a dose of antibiotics for my mother a dialysis patient but we knew better and got Nephrology involved ourselves.

    Reply
  2. Marion Deutsche Cohen

    Based on my own experience, here is my suggestion: When a caregiver and care receiver visit (the ER), and if you (meaning anyone tending to the patient) can tell that their situation is such that the caregiver will not be able much longer to continue to be a caregiver (because s/he can no longer provide the necessary care, or b/c s/he understandably no longer wants to), say something like “Do you want to keep doing this?” or even “Are planning to take him home?”

    — Yes, about 20 years ago (as described in my memoir, DIRTY DETAILS: THE DAYS AND NIGHTS OF A WELL SPOUSE — google it!), I was in that situation. I was a “reluctant caregiver” (as it’s termed on the New York Times thenewoldage blog), VERY reluctant, and understandably since I was being awakened something like 20 times a night, to attend to my first husband, who was almost completely paralyzed from M.S.). It wasn’t in the E.R., but during an actual hospital visit, that I told the doctors and nurses, “I’m not taking him home. And I want to talk with a social worker about it.” That resulted in nursing home placement, and it probably saved my life, and the lives of our four young children.

    I believe that I should not have had to take that initiative. I believe that the health care workers in the hospital, in charge of his care, could have easily seen how un-feasible my caregiving situation was, and taken the initiative themselves. I believe, as I said above, that it’s their responsibility to broach the subject, to say something like “Do you want to keep doing this? Are you planning to take him home?” Maybe I’m naive, but to this day (10 years into a new happy marriage) I don’t understand why they don’t do this.

    P.S. Anyone interested in my book Dirty Details might like to know that its sequel came out just this past fall. It’s called STILL THE END: MEMOIR OF A NURSING HOME WIFE. Again, google it!

    Reply
  3. Avatar of LisaDLisaD

    The last time my Dad was in the ER he was having a panic attack. Some of the nurses seem ill equipped to handle that and were less than patient. I think better training on how to deal with anxiety and mental health issues would be a good thing.

    Reply
  4. Avatar of MariaMaria

    Have staff trained to deal with people who have dementia/Alzheimer’s Disease. When I worked in a group home for people with dementia/Alzheimer’s Disease I have a resident in the ER and the nurse did NOT understand the disease and demanded that this resident remain in the room and would not listen to me when I told him I could not control his moves and that he didn’t understand what was happening.

    Reply
  5. Janet McCaskill

    On an average we make about 6 trips to the ER in a year. Depending on the ER I have found that many of them view the elderly as “on their way out” and as they age the care is less and less attentive. Putting into perspective that they are probably viewing the fact that my husband has permanent brain damage (from a neurologist who wouldn’t listen to my updates on his symptoms) I find that they view him as “terminal” when he really is not! A usual stay in the ER has been about 6-8 hrs even if they have admitted him to a room. That to me is unacceptable. On most ER visits I also have noticed that the nurses and docs always appear to be rushed to go to the next patient.
    One of the newest issues in the admission process is the status code called “Observation Status”. Everybody needs to be aware of what this term can actually mean in the scope of what Medicare will pay and not pay. First off if the patient is being admitted ascertain that the status is “IN-Patient” v/s Observation. When a doc admits a patient under Observation Status Medicare may not pay most of the hospital charges. On two occasions my husband was admitted and the doc never said that they were admitting him in Observation Status. After the first time and receiving a boatload of invoices for services I complained and was given the benefit of that action by having 95% if the charges removed. The second time that I was not informed I had our attorney make the call for me since I had inquired as to the status on admission and was not given the proper paperwork to inform us of this status. It is super important to inquire when they decide to admit!

    Reply

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