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After all of the tests and waiting and treatments are completed, it is time to decide what the next steps are for your Mom or Dad. Here are some possible scenarios.

Scenario 1: The doctor wants your father to stay in the hospital

Ø      The first question is … Why?

  • If it is for a blood test or x-ray that is needed tomorrow, can it be arranged and completed on an outpatient basis?
  • If it is because he should not be alone for the first 24 hours, can your dad go home with you or can you stay with him?
  • Does he live in an assisted living facility where you can arrange some nursing care and monitoring?
  • Can he be sent home with in-home supports you can arrange, such as private home health aides?

Ø      The second question is … Will he be admitted or placed in an observation bed?

  • Keeping your father in the hospital does not necessarily mean that he is going to be admitted!
  • If the doctor is planning to place your father in an observation bed that means that:

–        MEDICARE WILL NOT PAY FOR ANY OF THE HOSPITAL BILLS INCURRED ONCE THE ER TREATMENT IS COMPLETED, AND

–        IF YOUR FATHER HAS TO BE TRANSFERRED TO A SKILLED NURSING FACILITY FROM THE HOSPITAL FOR REHABILITATION WITHOUT BEING ADMITTED, MEDICARE WILL NOT PAY FOR ANY OF THE BILLS FROM THE REHAB FACILITY.

  • If the doctor is planning to admit your father to the hospital, that means that Medicare will most likely pay for his hospital bills, as long as it is a medically necessary admission.

Scenario 2: The doctor wants to discharge your mother

Ø      Where will your mother go?

  • If she lives alone in an apartment or house

–        Does she need someone to be with her for a day, a week, or longer?

–        Does she have stairs to get to her bedroom or bathroom that are now an obstacle?

  • If she lives in an assisted living facility, do you need to contact them for added services and supports to be in place before she returns home?

–        Can they have these supports available to her immediately upon her return, or does it take some time for them to arrange theses?

 Before your parent leaves the ER

Regardless of where your parent will be going, there are several issues you need to discuss with the doctor before your parent leaves the ER.

Need assistance? Wondering what the right thing to do is? Give us a call!

In good health,

The Health Champion Team

No one usually plans to go to the Emergency Room, but if you are one of 48.9 million adults caring for a parent or other senior in your life, consider this:

Adults over the age of 85 will have more than 6 ER visits before end of life. The typical reason for a visit is a fall. You may get the call from your loved one, or a neighbor may call to let you know that an “ambulance” has been called; or, it may be the assisted living staff that notifies you.

Are you prepared to be the best advocate you can be for your loved one? Not unlike the time in our lives when we prepared our “overnight” bag in preparation for the baby’s arrival, taking the time to organize and arm yourself with the following information about your parent(s), will effectively minimize the chaos that occurs when a loved one goes to the emergency room.

Here is Health Champion’s Emergency Room Checklist that will help you prepare for the inevitable time when you are called to join your loved one. Your Emergency Room kit should include:

♦ List of current medications, dosage and prescribing physician. It also helps to have the name and number of the local pharmacy your parent uses.
♦ Medication and food allergies.
♦ Current medical diagnoses and treatments and names of physicians involved in the care.
♦History of recent falls, if any. Does your parent need assistance to walk? Can they get up from a chair unaided?
♦ Brief history of prior medical issues (for example, is there a prior history of stroke, heart attack?).
♦ Any implantable devices? For example, does Mom or Dad have a pacemaker in place? Or, had a knee or hip replacement?
♦Copy of advanced directives and/or living will.
♦ Copy of power of attorney, if it is in place.
♦ Insurance information and copy of card(s) – Medicare, Medigap plan, Medicare Advantage plan and Medicare Part D, if applicable.
♦ Pad and writing implement to keep track of the event. It may be helpful to note the arrival time, name of the emergency room physician in charge of your parent’s case, names of the nursing staff involved in the care and any lab or diagnostic tests that are done.
♦ A small blanket or bed throw – not all Emergency Rooms are plush with comfort supplies and the ER can be cold.
♦ Snacks for the caregiver – you can expect to be in the emergency room between 4-6 hours. Depending on the time of day, the cafeteria may not be open and having some quick healthy snacks (granola bar, raisins etc.) may be better than the vending machine options.
♦ Take your book, kindle or ipad – there is a lot of downtime in the emergency room.

Last but not least, be prepared for a discussion about discharge planning. Depending on the outcome of the emergency room examination, mom or dad may not be immediately returning home. Are you prepared to have them go home with you? Be admitted to the hospital? Be admitted to a rehab facility? Next week’s blog will address things you should consider for each scenario.

There are times when you know it’s an emergency and you’re off to the ER. You don’t fool around with chest pains, for instance (no taking chances that it’s just indigestion). Ditto for broken bones and deep cuts.

But what about those other times? You know them: the sense that something’s  wrong, but you’re not sure how bad it really is. it always seems to happen over a weekend or during the evening, when the doctor’s office is closed. Waiting doesn’t feel right, but neither does rushing to the emergency room.

Call your doctor. Most physicians have an answering service for this purpose. Offer the following:

  • Your full name; that you’re a current patient, in active treatment.
  • The best way to reach you (provide both cell number and land line).
  • The reason for your call, emphasizing that, while it doesn’t seem like an emergency, it’s a matter of serious concern that can’t wait for office hours. Don’t be too explicit, as most folks who take messages have little clinical experience. Use phrases, such as:
    • My new medication is making me ill
    • I am experiencing several new symptoms
    • My pain has increased over the last (number of) hours and I need to discuss a different approach
  • Find out who’s on call. Ask the service to contact the doctor on your behalf rather than waiting for him/her to call in for messages. Note the time of your call and ask to be called back after the service relays your concerns. This will give you a time frame and help relieve anxiety.

Don’t ever hesitate to seek help.  Even over a weekend. Even when you’re not sure whether or not it’s an emergency.