A visit to the emergency room can be a scary and stressful experience for everyone, but it’s even worse for people with dementia. Unfortunately, as people age, the likelihood of an emergency room visit increases. Understanding the unique challenges that dementia patients face in an emergency room and developing a care plan ahead of time can help ensure the best outcomes with as little stress as possible. Here are some of the reasons why emergency rooms are particularly difficult for people with dementia, and what caregivers can do to deal with it.
The ER Is Fast-Paced and Can Be Confusing
A busy emergency department — at any hospital — tends to be in a state of controlled chaos at all times, which makes it difficult to navigate, even for a patient without dementia. You may have to deal with conflicting instructions, doctors and nurses coming and going unexpectedly, and frequent transfers to different rooms or departments for tests and diagnostics. For a person with dementia, it can be far too much to deal with and cause even more confusion and fear.
ER Staff Are Prepared For Everything — Except Dementia
The heavy workload and high demands that emergency room staff face often mean staff members tend to work as if all their patients have high intellectual function. This obviously poses an obstacle for those with dementia, who suffer some level of impairment. With so much going on, emergency room staff are often unable to offer the specialized care that many dementia patients require. They may be quick to resort to medication to calm down a frightened or confused patient. Research has indicated that those with dementia are likely to stay in the hospital longer than those without dementia who are experiencing a similar clinical issue.
ER Patients Need To Advocate For Themselves
Although doctors and nurses are doing their best, they need to have a patient who can self-advocate. The busy nature of the emergency room often means staff won’t know if a problem is occurring until they’re told. It’s possible that things like meals and drinks may be missed, or the staff may not notice that the patient needs assistance with eating or other basic tasks.
Pain Control can be a Problem
Some studies have shown that people with dementia are likely to receive less pain medication than those without dementia. Insufficient pain treatment can cause unnecessary suffering and stress, and eventually lead to delirium, which exacerbates the patient’s confusion. Doctors and nurses may not be able to provide the specialized care that is necessary to treat dementia patients suffering from delirium, or they may even misdiagnose the condition.
When the ER Is the Only Option…
While the emergency room may not provide the best kind of environment for people with dementia, it’s still their best option for treatment and care in emergency situations. The risks dementia patients face can be minimized by having a care plan, as well as making sure someone is there to keep your loved one calm, and to serve as the advocate that a dementia patient needs.
Before an emergency occurs, create an easily accessible document file with copies of all the information you may need during a hospital visit. This includes legal paperwork, such as an advanced directive and power of attorney, as well as other necessary health care information, such as a list of medications. You may want to create several copies and keep one at your loved one’s home, as well as at the homes of any other family members who might respond to an emergency.
Be an Advocate, Even If You Have To Be Annoying
Once you get to the hospital, don’t be afraid to speak up. Start by making sure that every doctor, nurse, and technician who interacts with your loved one knows about their dementia. Don’t be afraid to tell them about things that your loved one likes or dislikes, or to make suggestions about the best way to go about your loved one’s treatment. Pay attention to details like how long it’s been since your loved one has last eaten or received pain medication during their stay. If it’s been too long, ask the staff about it.
Be Alert For Changes
Sometimes the stress of going to the emergency room and being in a new place can cause new problems for your loved one. They may have difficulty with routine tasks that they can otherwise handle at home. Keep an eye out for things like difficulty walking, using the bathroom, or eating and drinking. If you notice these changes, alert a doctor or nurse. Paying attention to these issues may prevent serious problems, such as a fall or aspiration pneumonia. You know your loved one better than anyone, so you’re in the best position to notice these things.
Focus On Preventive Care
Of course, one of the best ways to avoid any emergency room issues is to avoid the need to go to the emergency room in the first place. A strong preventive care program can help you do that. Maintain a strong relationship with your loved one’s primary care doctor and other care team members, and keep an eye out for subtle changes during daily activities that may hint at underlying pain or illness. You may be able to catch budding problems before an emergency room visit is necessary.
Although there is no way to completely remove the stress of an emergency room visit, having a solid plan and knowing what problems to watch out for can help you navigate the process more easily. Plan ahead to keep your loved one as comfortable and calm as possible. Make preventive care a priority, and do your best to keep your loved one healthy and safe, so they can avoid going to the emergency room and dealing with the related stress.
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