With all of our national health problems and the extreme burdens on hospital emergency departments, when very old senior citizens visit they require special care. Their bodies, attention spans, and fearfulness cause extreme disorientation after a short time in an emergency facility. Disorientation occurs quickly. I’ve now observed this several times now with several parents. Why can’t more hospitals do what Holy Cross Hospital did by establishing a facility expressly set up for older patients?
Three weeks ago a 90-year-old family member of ours rode in an ambulance to the emergency department of our local hospital. The people were kind and the care was superb. But the experience of spending nearly seven hours with a 90-year-old on a gurney (with no chance of moving around because of the IV and monitors) was exhausting for her and for us. Mother’s problem was dehydration, but once she arrived, medical personnel needed to conduct a number of tests, despite the fact that she possessed a medical directive. Over and over she begged to get off the cart — her back hurt and her legs got weaker and weaker.
As the day went on, our parent, who is experiencing dementia, solved the problem tidily by taking herself back to the 1930’s — essentially checking out. This despite the fact that her illness, her stroke induced dementia, has now progressed to the point where she looses track of the present. Mother stayed safely in the past until she left the hospital the next day.
After her admission to the hospital for the night, we stayed with Mother into the late evening. But each time we got her settled and dozing, in came another hospital staff member with something to do. First a nurse came in to wrap her IV, and so we resettled her. Then the heart monitor arrived. Twenty minutes later they came to add an alarm to the bed, and then when they could not get it to work, an engineer arrived a half hour after than. After four tries at settling her down for the night, continuous disturbances ensured that we lost our opportunity. When we returned early the next morning Mother we found that mother had not slept. Another view of senior care hospitalization can be read in a post A Desperate Caregiving Moment at the Inside Aging Parent Care blog.
Interestingly, about twenty minutes after being released from the hospital, Mother rejoined us in the present. Her one comment, “Don’t ever take me back there.”
We were not surprised at the health setback that resulted from the emergency room visit and the night in the hospital, but the intensity of her setback surprised us. For almost two weeks following her 24 hour hospitalization Mother, was weaker, more distracted, and easily frightened. It took almost three weeks for her mobility to improve, though it never returned to where it had been before the visit to the hospital.
Watch this YouTube video clip about the special emergency facility for senior citizens opened at Holy Cross Hospital in Montgomery County, Maryland. Dr. Bill Thomas, a geriatrician on the faculty the University of Maryland Baltimore County’s Erickson School, consulted with the hospital.
What a terrific achievement. The new senior emergency facility was also described in this article in the Washington Post.
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I remember reading your posting about that hospital visit at http://www.desperatecaregivers.com. It was so moving to read about the changes in your father and, reading between the lines, how hard you worked to avoid them.
Sorry this happened with your mom. We had similar experience with Dad on his last visit to the emergency room. He basically dissociated when the medical personnel were in the room and then immediately came out of it when they left, asking us what we had learned and what was going on.
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