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Friday, July 12

Emergency Rooms & Alzheimer's Patients

EMERGENCY BAG CHECKLIST: People with Alzheimer's need to be prepared for an emergency. Simple planning now will make future hospital trips a lot less stressful. Ease visits by preparing today for emergencies, as well as routine stays. Check out these tips.


Going to the Emergency Room

A trip to the emergency room (ER) can tire and frighten a person with Alzheimer's. Here are some ways to cope:
  1. Ask a friend or family member to go with you or meet you in the ER. He or she can stay with the person while you answer questions.
  2. Be ready to explain the symptoms and events leading up to the ER visit—possibly more than once to different staff members.
  3. Tell ER staff that the person has Alzheimer's disease. Explain how best to talk with the person.
  4. Be patient. It could be a long wait if the reason for your visit is not life-threatening.
  5. Comfort the person. Stay calm and positive.
  6. If the person must stay overnight in the hospital, try to have a friend or family member stay with him or her.
Do not leave the emergency room without a plan. If you are sent home, make sure you understand all instructions for follow-up care.

What to Pack

An emergency bag with the following items, packed ahead of time, can make a visit to the ER go more smoothly:
  • Health insurance cards
  • Lists of current medical conditions, medicines being taken, and allergies
  • Health care providers' names and phone numbers
  • Copies of health care advance directives
  • "Personal information sheet" stating the person's preferred name and language; contact information for key family members and friends; need for glasses, dentures, or hearing aids; behaviors of concern; how the person communicates needs and expresses emotions; and living situation
  • Snacks and bottles of water
  • Incontinence briefs if usually worn, moist wipes, and plastic bags
  • Comforting objects or music player with earphones

Before a Planned Hospital Stay

Keep in mind that hospitals are not typically well designed for patients with dementia. Preparation can make all the difference. Here are some tips.
  1. Build a care team of family, friends, and/or professional caregivers to support the person during the hospital stay. Do not try to do it all alone.
  2. Ask the doctor if the procedure can be done during an outpatient visit. If not, ask if tests can be done before admission to the hospital to shorten the hospital stay.
  3. General anesthesia can have side effects, so see if local anesthesia is an option.
  4. Ask if regular medications can be continued during the hospital stay.
  5. Ask for a private room, with a reclining chair or bed, if insurance will cover it. It will be calmer than a shared room.
  6. Shortly before leaving home, tell the person with Alzheimer's that the two of you are going to spend a short time in the hospital.

During the Hospital Stay

While the person with Alzheimer's is in the hospital:
  • Ask doctors to limit questions to the person, who may not be able to answer accurately. Instead, talk with the doctor in private, outside the person's room.
  • Help hospital staff understand the person's normal functioning and behavior. Ask them to avoid using physical restraints or medications to control behaviors.
  • Tell the doctor immediately if the person seems suddenly worse or different. Medical problems such as fever, infection, medication side effects, and dehydration can cause delirium, a state of extreme confusion and disorientation.
  • Ask friends and family to make calls, or use email or online tools to keep others informed about the person's progress.


MORE INFORMATION:
  • For more information, see the NIA booklet "Hospitalization Happens," www.nia.nih.gov/alzheimers/publication/hospitalization-happens.
  • The Alzheimer's Disease Education and Referral (ADEAR) Center is a service of the National Institute on Aging, part of the National Institutes of Health. The Center offers information and publications for families, caregivers, and professionals about Alzheimer's disease and age-related cognitive changes.

Comment or Share:

  1. While I agree with the majority of these tips above (many of them are very generic and apply to anyone), I could add at least a dozen more. Having been the live-in caregiver for my Mother who had Alzheimer's and my Father who had other health issues, we spent far too MANY stressful days at the ER and/or hospital.

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    1. You are welcome to add tips in this comments section. It will only help.

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  2. These are all good tips, but it doesn't help if the hospital and/or ER staff are not educated in dementia care and challenges. My observation (my mother had severe Alzheimer's and I cared for her for four years) is that people with Alzheimer's should NEVER be left alone in an institutionalized setting, as it will increase their fear and agitation within hours. Staff should be made aware immediately that the patient has Alzheimer's (or dementia) and there should be some insistence that the patient take priority because of their condition - while mental illness is not seen as a priority, it SHOULD BE, because long waits are extremely difficult for people with dementia. Also, I insisted that my mother be placed in a quiet area, because people with Alzheimer's are very sensitive to loud noises and bright lights; staff should also be made aware of this. Finally, the article notes "Ask if regular medications can be continued..." I would say INSIST that regular medications be continued and REFUSE any anti-psychotics. I know of one man who was taken off his anxiety medication for no valid reason (e.g. contra-indications), and this just caused incredible suffering. Anti-psychotics are not recommended for people with dementia, as they add to the brain fog and cause falls. No drugs, more hugs. Stay with the person throughout, and INSIST on your rights to better care. I'm so discouraged by the way our seniors are treated in ERs, and I think this article touches on a lot of good points, but we need the hospital staff to be more sensitive, more aware, and more compassionate. This is out of our hands, but I do my best to educate as I go along.

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