When to call 911? Caregivers' Action Network's advice is to call for help when:
What makes a delay life-threatening? We can't know for certain, but call 911 for advice if the person you are caring for:
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.
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:
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.
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.
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.
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