No one wants to go to the emergency department. But for older adults, it can be especially overwhelming.
“Older adults can really struggle with a change in their environment,” says UNC Health geriatrician David Lynch, MD. “If you’re sick or in pain, you’re already feeling vulnerable, and if there’s also some cognitive or functional impairment, the hospital environment can be a challenge.”
There are ways to support your loved one through the challenges of the emergency department. Dr. Lynch provides some tips.
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Take steps to avoid the emergency department in the first place.
Sometimes, people wait to seek care until there’s no option but an emergency department. If you have a loved one who is an older adult, encourage them to tell you when symptoms start. You may be able to get them help before it’s an emergency.
“When it’s the evening or weekend, your options are limited,” Dr. Lynch says. “Be as proactive as possible—if it’s Friday afternoon and you have a cough, don’t wait until evening when the emergency department might the be only option.”
On a weekday, they may be able to see their primary care provider in a more familiar environment or use virtual care from the comfort of home. Ask the doctor’s office what to do in urgent situations that may come up in the future.
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Have someone stay with the older adult at all times.
Sitting alone in an emergency department is difficult for anybody, but it can be particularly challenging for an older adult. If you’re taking an older adult to the emergency department, do your best to stay with them or arrange another person who can be there for the duration of the visit.
Be sure your loved one knows who they can call if they need emergency care (after calling 911, if necessary).
The support person can provide comfort and help the older adult navigate any instructions they receive.
“You can help by offering activities to do. Listen to music, watch a show, talk. It will help reduce the stress of the situation,” Dr. Lynch says.
If possible, delegate someone besides the support person to communicate updates to friends and family, Dr. Lynch says.
“If it’s a situation with lots of family members who need to be notified, have someone who is not with the patient do that, so the person in the emergency department can communicate once and then focus on looking after the person and interacting with the medical team,” Dr. Lynch says.
It’s also important to discuss who will make medical decisions if the person can’t do it themselves. That information, along with a person’s wishes in terms of medical interventions such as resuscitation, intubation or feeding tubes, should be documented.
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Bring a list of all medications.
Another thing to keep on the fridge so it can be grabbed quickly: a list of all the medications the person is taking, prescription and over-the-counter.
“If you’re going to a hospital within the same medical system, they should have a record, but this list is always good to have,” Dr. Lynch says. “That way you’re not trying to remember everything in a stressful environment.”
If the person uses a pill organizer, it can be helpful to bring that as well, so that it will be clear which medications they took that day. Depending on the circumstances, some medications may have to be paused, and it’s important for a provider to consider any drug interactions before starting something new.
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Follow up with their primary care provider.
Make sure the person’s primary care provider knows about the emergency visit and follow up with an in-person visit with them, generally within two weeks. That provider will have a broader view of your loved one’s full health history and may need to adjust prescribed medications or make recommendations depending on what happened. For example, if the person suffered a fall, the provider may be able to recommend a walker or a cane, along with occupational therapy.
A primary care provider can also help if you have concerns about new symptoms after a trip to the emergency department.
“If things don’t feel right, don’t wait,” Dr. Lynch says. “Get in and be seen earlier.”
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Ask for help during the recovery period.
When you’re in the emergency department or hospital, it’s understandable to just want to go home. But keep in mind that the days after a medical emergency and the transition back home can be another big adjustment.
“There may have been a change in independence or in performing their daily activities, especially if it was a more severe illness,” Dr. Lynch says. “Generally, for one day in bed in the hospital, there might be three days of recovery after for an older adult.”
Dr. Lynch says there’s an instinct to let the person rest completely after such an experience, but it’s important that they stay active to the extent possible—get them up and out of bed.
Caregivers might find the transition home overwhelming too, because the round-the-clock help of medical professionals in the hospital is over. This is when it’s important to depend on your community whenever possible, Dr. Lynch says.
“The more help you have those first few days at home, the better. If a family member or neighbor offers to help, say yes.”
Questions about aging and health? Talk to your doctor, or find one near you.