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Dementia is confusing enough to live with without being in an over-stimulating environment like the ER.  The thing with the Emergency room is that the wait is long between interactions with staff as tests are done and the results are read.  As I said before Dementia is not a disease that helps someone wait patiently.  Waiting is hard for even the most patient of us but if you don’t know where you are or why you are there waiting is impossible.  You “just want to go home”, and will do your best to get there even if you shouldn’t be.  Remember wanting to go home means, “I don’t know where I belong”.  I cannot emphasize enough the need for a familiar face who knows you when you are in an unfamiliar place and cannot remember things.

My recent trip to the ER with my parents occurred after my Mom had an episode of weakness and almost passing out.   That is frightening enough to have to deal with but when someone passes out they don’t remember the events that occurred like those around them do.  Several times while waiting for test results Mom asked what we were waiting for and she felt fine so why did we have to wait.  Meanwhile my Dad and I were waiting and hoping for answers about why this episode occurred.  We finally did get answers but they were really not answers since nothing was found and they were planning to send Mom home.  That was fine with all of us except that after sitting on a stretcher for 4 hours in the Emergency room they expected to discharge my 80-year-old mom to home without even standing her up to see if the event would repeat itself.  Because I was there I asked, “Aren’t you going to get her up and see if she can walk okay?” Which was followed by the support staff coming in because, “The Physician’s Assistant wants her to walk before she is discharged!”  If I had not been there I have no doubt that she would not have been walked or even stood up at the side of the stretcher.  They would have discharged her without ever getting her up.  I am sure of this because I had residents returned by ambulance to a Personal Care Dementia Unit after falls or similar passing out episodes that sent them to the hospital for evaluation without ever being off the stretcher.  Sadly some of them were not able to walk and it created all kinds of issues to have them at the wrong level of care even temporarily.

Questions you should think about when in the ER with your loved one

  • Which procedures will be performed and how? What are the risks and benefits? What are the expected results?
  • What is the expected length of recovery? 
  • Is assessment or treatment available at an outpatient clinic? 
  • Is hospitalization required? How long ?
  • If anesthesia is used, how will this affect cognition? 
  • What are the visiting hours? Are extended hours available?

Make sure that all treating physicians and medical professionals are aware of the Dementia diagnosis.  If the person with dementia has difficulty communicating, offer suggestions to medical staff about what the person may want or need.

Hospitals are not friendly places for people with Dementia.  Make their stay as comfortable as possible by clearly communicating with the staff what works for them and what doesn’t.  None of us function well when we are sick or in pain but when you are sick or in pain with Dementia it is even more traumatic and debilitating.

Most importantly know what is next.  Do not leave the emergency room to go home without a follow-up plan. If you are sent home, make sure you have all instructions for follow-up care.

Your loved one with Dementia will be treated better and have a less traumatic experience if you follow these guidelines.

http://www.alz.org/documents/national/topicsheet_hospitaldischarge.pdf

Follow the link above to get  a free topic sheet with some good tips from the Alzheimer’s Association on how to navigate a hospital stay for your loved one.

Dementia in the Emergency Room -Part 2
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