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Why ER People Aren't Experts At Long Term Care: Dementia and Hospice

Armen Hareyan's picture
ER visits and Alzheimer's Disease

Begin to trust your own instincts when deciding to call the ER or Long Term Care because ER is for acute conditions and the in hospital units are more for chronic care.


"I'm increasingly losing faith in the healthcare system. I am not sure why I can't seem to learn the lesson that your needs are rarely met at the hospital. Maybe they are for the young, or for the wealthy, but time and time again I go against my better judgment and take my dad to the ER. His dementia is so bad it's hard for him to express his issues and the anxiety around it makes everything worse. In a panic I call 911 needing someone else to access the severity of his failing health and help make a judgement call only to actually get to the hospital and regret it entirely. I think it's time I change my expectation of what health services really looks like. I'm so exhausted of being repeatedly let down."

This writing was posted this morning by an Alzheimer's caregiver named Ashley at Support for Dementia & Alzheimer's Caregivers group on Facebook for discussion.

Other caregivers replied to her and said that when their parents were in hospice and they were able to call and talk with a nurse, hospice nurses prevented ER visits. They would send a nurse to their parents home and assess them at home.

It is hard to get good medical care in the ER unless you have a very clear emergency that the ER doctors and nurses can see with their own eyes. "I try to stay out of the ER unless someone has a broken bone or is having a heart attack. They don't know what to do with neurological, psychological or behavioral emergencies most of the time," wrote another group member Kathryn.

And it's true. When possible, it's not necessary to overburden the ER with concerns that can be addressed by a nurse or by a long term care specialist. Let ER people work with people who have broken legs or heard attacks: namely emergencies.

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ER Nurse's Response

I am a nurse and hate that this can be true (regarding ER care vs Long Term Care). The ER is really set up for acute conditions and the in hospital units are more for chronic care. The ER is meant to stabilize people quickly and move them to the next level of care. They are rarely experts at long term care issues.

Instead, hospice specializes in needed care. I have met hospice people and they are amazing. The care can even be provided in your own home. These people see death and end of life in this world daily and their attitudes are different. I have enjoyed meeting the nurses and volunteers who serve in hospices.

Therefore, if you are in a similar situation not knowing if you should run to ER or long term care ask your doctor to ask Hospice for an assessment. They will come where your parent is and I say they are another voice. Then you will have more information or what is available. Hospice servants are wonderful and will work with you and your doctor for the continued care of your Dad. Spiritual care is part of the dimension and it's good. You can also use their doctor. They will provided extra care, as help with bathing, supplies and a lot more.

ER and Alzheimer's

"I have never been in an ER that really 'gets' Dementia/Alzheimer. Which I don't understand because surely 80% of their patients are elderly," writes Ann in the same group. This is a valid question. How well are the ER people specialized in Alzheimer's care when many of their patients are elderly? Please let us know your opinion in the comments section below. If you liked this article and think it may help your friends, consider sharing or tweeting it to your followers.