A: Bringing your loved one with Alzheimer’s or another kind of dementia to the emergency room can be a stressful experience, both for the person and his caregiver. Here are 9 tips to follow to improve his experience there.
- Have a written list of his current medications ready and bring them along.
There’s enough guesswork in the ER when trying to evaluate someone with dementia. Eliminate the possibility of confusion or an unwanted change in medications by being prepared ahead of time with this documentation.
- Go with him or meet him there.
This may sound like an obvious suggestion, but it’s not always followed. Your presence will benefit both your dad and the staff there. You can reassure your dad in an unfamiliar environment, and help him communicate his needs and concerns. You can also be helpful to the staff by keeping your dad calm and explaining his usual level of functioning. For example, hospital staff might assume your dad is always fairly unresponsive because he has a diagnosis of dementia, but you might be able to explain that his current level of functioning is significantly different than his normal interactions.
- Stay with him.
If you are not able to remain at the hospital with your dad, ask someone else familiar to stay with him to reassure and keep him safe.
- Clearly communicate any tendencies to wander.
If your dad has any potential to wander, be sure to let the staff at the hospital know. Ask what their system of monitoring patients is, and request that he be watched constantly.
- Be gentle but persistent in advocating for him.
Advocating for a loved one is an important task, especially in a situation where your dad may be more confused than normal or the environment is stressful. The busy pace of an emergency room can be stressful to anyone, and much more so for the person with dementia. If you can tell he is experiencing pain despite his verbal answer denying discomfort, explain why you feel he is in pain and ask for this to be treated.
- Bring his insurance cards and any legal documents such as a power of attorney for healthcare or a living will.
If you bring these with you, it’s one less thing you need to worry about or remember to do later. It may also save you a trip home to pick them up.
- Bring a comforting picture or other item with you.
In the unfamiliar setting of a hospital , having something that he’s able to physically hold onto can be reassuring and calming for him. Consider a physical item such as a picture of a family member, a well-loved book or a favorite stuffed dog.
- Write things down for hospital staff.
You know your dad’s preferences, his abilities, his challenges, his limitations and specific ways to approach your dad that may be helpful for them to know. Choose the ten most important facts and write them out for the emergency room staff so that as the shift change occurs or distractions happen, staff have an easy way to reference important information about him and don’t have to rely on verbally communicating it to the next staff in the midst of a busy shift.
- Minimize hospital visits.
As much as possible (and only if it's medically appropriate), try to avoid emergency room visits. Hospitalization can lead to increased confusion and several medical interventions that a person with dementia can’t understand. This may trigger frustration and possibly agitation, which sometimes results in the staff using medications to calm your loved one. If possible, contact your dad’s physician and see if you can treat his needs by discussing treatment over the phone or by bringing him into the physician’s office. This often will result in less invasive treatment and a less traumatic experience for your dad.
Alzheimer’s Association. Hospitalization. Accessed June 26, 2012. www.alz.org/national/documents/topicsheet_hospitalization
Alzheimer’s Society. Care on a Hospital Ward. Accessed June 26, 2012. http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=118
Alzheimer’s Foundation of America. Education and Care: Emergency Room Visits. Accessed June 26, 2012. http://www.agis.com/Document/695/education-and-care---emergency-room-visits.aspx