Unfortunately, emergencies happen…particularly as we age.  Older adults visit the emergency department at higher rates than other age groups and those rates are also increasing more than for other age groups.  Good senior care management and patient advocacy ensures those emergencies are handled as well as possible to improve your short and long-term outcomes.

Here are just a few of the challenges and resulting problems for seniors and the healthcare professionals who care for them in the E.R.:

• Older patients often present with atypical symptoms and have multiple conditions.  They present with a higher level of emergency and more serious illness than younger counterparts.
• Emergency medical providers are rarely trained in geriatric-specific approaches.  Many report being less comfortable dealing with older patients.
• Impaired mental status occurs in approximately one quarter
  of all older patients presenting to the emergency department as a result of delirium or delirium (or both).
• Older adults are more likely to be misdiagnosed and therefore be discharged with unrecognized and untreated conditions.
• Older adults face increased risk of return visits to the E.R., hospitalization and death.

*Older Patients in the Emergency Department: A Review

For the patient arriving alone to the E.R., it can be a scary and disorienting experience.  The E.R. team assessing the patient may also have little information to go on, particularly if the patient cannot communicate or has cognitive impairment.  All of this paints a vivid picture of the value of having an advocate with you (or your aging relative) at the emergency room.  Here’s a brief outline of some of the things an Aging Wisely patient advocate may do when meeting a client at the hospital during such an emergency.  The care manager:

• Helps communicate vital information to emergency staff about the client’s medical history, nature of the emergency, current medications and treatment and background information.
• Ensures the patient is as comfortable as possible, from providing reassurance to asking for staff assistance and helping them to more effectively help the patient.  The care manager might do something to improve the experience as simple as getting an extra pillow or blanket or helping the client make a call to a loved one.
• Communicates to family members and others involved in the client’s life and care (calling to inform family members and keep them apprised, letting a home care provider know to cancel an upcoming shift, contacting the assisted living facility about the resident’s status and expected return).
• Asks the right questions: gets a handle about what is going on, tests being done, and treatment plans (will the patient be admitted, receive treatment in the E.R., be released?).  Facilitates communication to make sure the patient and/or family understands the situation and options clearly.
• Assists in planning next steps and coordinating a smooth transition (whether this is a hospital admission or return home) and setting up follow up appointments and care.
• Contributes to creating the best plan of care by anticipating potential pitfalls, understanding the “big picture” for the client and applying his/her professional expertise (i.e. knows the client’s history, what services might help, past reactions to treatments, and resources to support the patient).

Our Aging Wisely care managers have been there for many clients over the years as they faced such emergencies.  The professional support provides a great deal of peace of mind for family caregivers, especially those who live at a distance. 

Professional care management in the emergency room benefits the patient and family with:

• Peace of mind and reassurance during an unsettling time (reducing the anxiety of the situation);
• Professional expertise in navigating the medical system and clarifying information;
• Better outcomes by arming the medical team with an improved understanding of the patient and situation;
• Reduced risks through personalized management and coordinated follow-up;
• Less chance of further unnecessary emergencies.

We’ll be sharing some of our stories from E.R. care management in upcoming posts to illustrate the specific ways professional care management improves outcomes.  If you need help with emergency management or local oversight for an elder in the Tampa Bay area, you can contact us anytime at 727-447-5845.

We welcome your comments about emergency room situations you have experienced or questions about patient advocacy in the E.R. or beyond.