EMERGENCY ROOMS AND THE ELDERLY
The American health care system is facing a lack of primary care providers and geriatrics specialists, despite the fact that there are an ever-increasing number of older adults. As “the number of older people seeking health care is expected to increase significantly over the next 40 years, doubling in the case of those older than 65, potentially tripling among those over 85, according to The New York Times, many of the country’s elderly individuals are likely to seek some type of health care in emergency rooms.
Unfortunately, emergency room staff are generally overwhelmed by the number of patients they must treat and usually are not trained, nor have the time, to coordinate complex outpatient care many elderly patients need. For example, emergency doctors and nursed do not provide follow-up care, such as calling a patient within a few days of discharge to ensure everything is ok. A social worker or an elder care advocate (if a hospital has one) may be brought in for follow-up assistance but that process often requires a fair amount of time to set up, taking the emergency room doctors and nurses caring for other patients. “Survival rates for patients in the throes of a stroke, heart attack or traumatic injury depend on the number of minutes needed to triage, diagnose and treat” and emergency rooms are designed to either admit or discharge patients as quickly as possible, not for continued care services, according to an article by Dr. Pauline W. Chen in The New York Times.
However, working with elderly patients presents its own set of challenges. Many older adults suffer from one or more chronic diseases and take multiple prescription medication that can have serious reactions or implications for emergency treatment. In fact, many older adults may forget to disclose all of their medications and ailments, either from shock or due to the effects of dementia or Alzheimer’s disease.
Should a trip to the emergency room become necessary, one method to help the process along is to have all of the relevant information readily available. Rather than just keeping all the documentation about medications as well as a do not resuscitate directive, contact information and legal documentation naming a designated a health care decision-maker should the injured individual become incapacitated, locked safe deposit box or stashed in an bureau drawer at home there’s an app for that. Seriously. The American Bar Association’s Commission on Law and Aging “has developed a smartphone app, My Health Care Wishes, that allows you to store your own advance directive or family members’ on your iPhone or Android phone. When you need them, the app lets you present such documents — and other health information and contacts — via email or Bluetooth,” according to The New York Times.
The New York Times also reports, “those digitally transmitted documents have the same legal authority as a signed and witnessed form on paper.” In addition to a free and upgraded-fee version of the My Health Care Wishes app, there are other methods for digitally storing advance directives, such as DocuBank, MyDirectives or even the cloud-based storage system, Dropbox.
Regardless of which method you choose, having your advance directive available when you need it is critically important and when the time has come when you or a family member is no longer able to live independently, please contact California Registry to discuss the personalized care options and learn about assisted living services and facilities throughout California.