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Caregiving Resources

Information for family caregivers and those caring for aging or chronically ill adults

ER and hospital admissions

When to call 911? Caregivers' Action Network's advice is to call for help when:

  • Moving the person could cause further injury
  • The person is too heavy for you to lift or help
  • Traffic or distance would cause a life-threatening delay in getting to the hospital

What makes a delay life-threatening? We can't know for certain, but call 911 for advice if the person you are caring for:

  • Is unconscious
  • Has unexplained chest pain or pressure
  • Is having trouble breathing or is not breathing at all
  • Has no pulse
  • Is bleeding severely
  • Is vomiting blood or bleeding from the rectum
  • Has fallen and may have broken bones
  • Has had a seizure
  • Has a severe headache and/or slurred speech
  • Has pressure or severe pain in the abdomen that does not go away
  • Is unusually confused or disoriented

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 If an emergency puts you in the position of dealing with an ER, urgent care facility, or hospital on someone else's behalf, here's useful advice on how to get the best outcome for your loved one. Even after the event, these sources have tips for follow-up care, as well as for how to handle the next emergency. 

Plan ahead for medical emergencies

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While it's nearly impossible to plan for the unexpected, it is possible to be prepared for an ER visit, or for when it turns into a hospital stay. Having all the relevant details ready to hand allow ER staff to do a much better job of assessing and stabilizing a patient in crisis, and avoids potentially dangerous misunderstandings. Here are some handy checklists and suggestions for collecting the relevant medical information into an easy-to-grab resource.

Ideas on the other pages in this Guide - especially the section for Organizational Tools and Tech  - can also be really useful.

Thinking ahead to large-scale emergencies  - like wildfire, earthquake, flood, or multi-day power outage - takes these preparations to the next level. See our guide on Emergency Preparedness for how to do this.

If it is possible to choose which ER or hospital to use in an emergency, look at the performance ratings for the closest emergency facilities, especially the factors on seniors treated or admitted. If there's a choice of where to get treated, this information will help to select the best care.

Some ways to investigate are:

  • Ask the primary care doctor - what would they recommend? Where would they take their family members?
  • See if the hospital has specialized acute care units for older adults or certified geriatric emergency departments (GEDA) 
  • Is the hospital system "age-friendly" according to the Institute for Healthcare Improvement?
  • Check the hospital quality ratings from: Medicare, Joint Commission, and/or the Leapfrog Group.

It's a good idea to look at the reports on the same hospital in more than one of these sources, because they track or accredit different factors.

Preventing the most common causes for senior ER visits

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Some of the most common reasons why older adults end up in the ER or in the hospital could be avoided. See our Later Life Guide and Caring for Someone with Mobility Problems in this guide for more information on avoiding dehydration, injuries from falling, or car accidents. (Dehydration and lack of physical activity can contribute to urinary tract infections, pneumonia, or other infections, too.)

Inadequate pain control or medication side effects are other common issues - another reason to review all medications (including vitamins or over-the-counter preparations) with the healthcare team on a regular basis. For example, drugs to control high blood pressure can make older adults dizzy (and more likely to fall); knowing the side effects can help to take precautions.

People with chronic illness - heart diseases, diabetes, COPD (including bronchitis and emphysema), diseases of circulation or a higher risk for strokes) - are more likely to have multiple hospital visits. If you have a chronic illness, or are caring for someone who does, talk with the healthcare team about what to watch out for in a crisis.

Post-hospital syndrome and other aftereffects

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Researchers have found that when older adults spent time in a hospital, even for a short stay, it increases the chances for worse health to follow. So-called "post-hospital syndrome" can start a dangerously spiraling decline. Anesthesia for surgery has been suspected to cause delirium or further cognitive problems in older adults, for one thing. Even just the stress of constant noise, interruptions, immobility, unfamiliar food, and so on can lead to agitation, anxiety, or loss of functioning.

But people are admitted to a hospital because they need more intensive care than they could get at home. So how to keep the experience of being hospitalized from making their health worse? 

The solution seems to be like the story of Goldilocks: to stay in the hospital not too long, but as long as necessary to get well, and to make the hospital room seem like being home (as much as possible) while getting the right amount of medical care. 

See these links for more information on how to protect seniors' health during and after an ER or hospital stay.

Disclaimer

While PlaneTree Health Library strives to guide you to reliable, valid, up-to-date information, every person's situation is unique. Be sure to discuss information gathered from these resources with your health care providers to see if it is relevant to your individual situation. Health and medical information accessed through these websites is not intended to substitute for or to replace the advice or instruction of a health care professional. 

PlaneTree Health Library is not responsible for the content on web sites accessed from our site. Each originating organization has sole responsibility for its web pages. Our intention is to provide patients, their families, and caregivers with trustworthy information to help them make informed decisions.

About PlaneTree Health Library

PlaneTree Health Library's mission is to guide the public to trustworthy, accurate, and free health and medical information. In operation since 1989, it is a free, public, patient and consumer health library and 501(c)3 nonprofit organization. It does not accept advertisements; it has no commercial relationship with the sources of information on these webpages. Visit our online information guides linked from our main website at: www.planetree-sv.org

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