Should We Even Go to Emergency?

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 Emergency

Medical professionals advise a visit to Emergency when any acute change occurs; in the case of the elderly, this might include trouble breathing, decline in cognition, a bad fall or perhaps excessive bleeding when taking blood-thinning medication such as aspirin.

Rather than driving your parent yourself, you may wish to call 911. The Emergency Medical Services will arrive quickly, assess and stabilize your parent, and advise whether an Emergency visit is required.

Making the Most of Your Visits

Emergency room staff strongly advise that patients bring an advocate, ideally a close friend or family member. That person should have a list of the patient’s current medications and dosage, provide information as requested by the staff as to how their behaviour or condition compares to their normal state, and generally act as an advocate for the patient, who is usually confused, in pain and fearful. The advocate should also make notes about findings and recommendations.

When all patients enter Emergency, they are seen by a triage nurse who determines the urgency of their condition using a 5-level assessment tool known as the Canadian Emergency Department Triage and Acuity Scale · PDF file. For example, Level 1 patients, in critical, unstable condition, such as cardiac arrest, must be seen immediately. Patients are therefore seen based on the acuity of their condition, not arrival time, nor the fact that they arrived by ambulance.

Geriatric Emergency Nurses

A new innovation in many Emergency departments is the Geriatric Emergency Management, or GEM, nurse. This is a practitioner who will make a full geriatric assessment, including physical condition, cognitive level and home support. GEM nurses can diagnose, order tests and prescribe, working in consultation with the physician and emergency team. Their goal is to treat seniors, and to discharge them with a care plan that will ensure better long-term health, that will prevent future Emergency visits.

Alternatives for Emergency Care

Urgent Care Centres are clinics designed for low-acuity emergency patients, usually with a referral relationship to major hospitals. Telehealth Ontario allows 24/7 telephone access to a registered nurse, who can help assess the seriousness of symptoms and suggest your options.Similar services exist for all Canadian provinces.

Being Prepared

 Be sure emergency 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 parents, meet their doctors and learn about their medical conditions.

Becoming a partner in your parents’ wellness will pay off when emergencies do arise.