Every year there are about 17 million visits to the Emergency Room by seniors. These visits carry a high price tag for the health care system and for the elderly patients who end up at the ER. Last week, my mother was one of those 17 million.
It all started at lunch when my mother choked on something she had eaten. It wouldn't be until many hours later that we found out what the culprit probably was. She was able to breathe, so there was no need for the Heimlich maneuver. She was, however, throwing up - in an attempt to dislodge whatever was caught further down her digestive tube - and unable to swallow anything. I was at Starbucks at the time and knew nothing about the situation until my sister phoned and alerted me. My dad was at home and he had done something to the phone and it wasn't ringing. So, I called a cab and when I pulled up at my parent's house, he was there and I told him about what was going on with Mom. We jumped in the car and took off for the Rehab Center.
When we arrived, Mom was still in the bathroom trying to throw up. I can't remember now who was with her. Whoever it was got her back into bed, I changed her top which had gotten wet, and tried to get her to drink a sip of 7-Up. She couldn't do it, so I went out to the front desk to let the nurse in charge know and found the speech therapist who came to see what was happening. Then, the center's doctor came in and next thing I knew he was recommending that she go to the ER because she still wasn't able to swallow and the center has no imaging equipment. My mom was not happy. She was unhappy that she was choking and also unhappy about going to the ER because too many visits there have ended up with her being admitted to the hospital. She has been in the hospital more than anyone should have to during the past few years and another stay there was not a possibility she wanted to entertain.
Luckily for her, the hospital she goes to has a senior's section in the Emergency Room. ER's for seniors are a new trend, one my mother is benefitting from. This was my third visit to the Senior ER with my mother and probably her 5th or 6th. Mom had been transported by ambulance because of her hip fracture and immediately taken to a room. My dad, my mom and I waited together. Mom was thirsty but not allowed to drink anything. Her pain medication was overdue and the nurse gave her morphine via IV. Then, in less than an hour, a dapper doctor wearing a bow tie came in and spent about ten minutes talking to my mom and checked to see if she could swallow yet. She couldn't, so he placed an order for an x-ray and the wheels began turning.
Then, it was a waiting game. My mom was in pain, had nothing to do, and was anxious about the test results. The hour or so before the test results came back seemed endless. The x-ray showed that whatever had been stuck in my mom's esophagus was now dislodged. The doctor came back in and talked to my mom and said, based on what she said she'd had for lunch, it was probably the carrots. "I don't even like carrots!" by mom said. The doctor urged her to be careful in future and to avoid carrots. Then, we had to wait for an ambulance to send her back to the rehab center. Now, that it was clear that her life was no longer in danger, it was a very long wait. Still, all things considered, my mom's trip to the ER ended better than some.
Elderly woman in hospital (Judy Baxter photo, flickr)
Visits to the ER are not risk free. This is doubly true for seniors. The risk of infection is one of the problems that seniors face after ER visits. Other risks - usually for more long term stays - include cognitive decline and, some experts are saying, even dementia. The bottom line is that hospitals are not a good place for the elderly, even when a hospital makes every effort to mitigate the impact on elderly patients. Elderly patients are also prone to hospital psychosis, which may be a factor in additional cognitive declines. I know this is true because I've seen the impact of hospital stays on both of my parents. And that's the Catch-22. You can't leave an ailing parent at home to die, but the more visits to the hospital they have; the greater their mental decline can be.
So, for all of these reasons, I was delighted to see that my mom was not admitted to the hospital last week. And keeping her out of the hospital is one of the reasons I'm here. Little things can have big consequences. The day after her visit to the ER, guess what was on my mother's supper tray? You guessed it, carrots. I reminded her not to eat them and sat with her to make sure that she didn't. Meanwhile, coaching her to eat more slowly is going, well, sloowly. I asked Mom why she eats so fast and she said because her teeth hurt when she eats. I remind her as often as I can, that having her teeth hurt is much better than a trip to the hospital. And that's why I made absolutely sure that the kitchen doesn't bring her any more "evil" carrots. (I apologize to all you carrot lovers and growers out there.)
Have you had any experiences when your aging parents or spouse worsened after a stay in the hospital?
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