Arriving at the hospital with an elderly loved one in crisis is frightening and often confusing. The first priority of the care team will be assessing and stabilizing their patient but at some point the family may be asked for information to help fill in the blanks. What medications does the patient take? Who is the patient’s doctor? Questions about medical history. It’s all so confusing. Having access to a list of medications taken by the patient is crucial, so make time to sit down before a crisis happens and make a list. For those that have a free membership on The Oldish, check under the Toolkit on the top menu bar and you’ll find the Medication Checklist that we developed with ER physicians.
Once they’re able, someone from the care team – often the physician – will come and talk to the family. The family is emotional, confused, not processing information well and the physician is often speaking what seems like a foreign language. Not surprisingly, there are disconnects in communication.
A recent study carried out in Canada by a team led by Dr. Daren Heyland, professor of medicine at Queen’s University in Kingston, Ontario, found that critically ill patients will often wish to be made comfortable but are charted for more aggressive treatments such as CPR should the need arise. “We are not really providing patient-centred care if we’re over-treating them at the end of life,” notes Dr. Heyland. In fact the study, published in the Journal of Palliative Medicine, noted that families are least satisfied with their inclusion in the process of decision making and control regarding the patient’s care.
It helps to know the wishes of the patient, who may be uncommunicative at this point and unable to express his or her wishes for treatment. For those who have prepared in advance, a Power of Attorney for Personal Care will be able to ‘speak’ even if the patient can’t. Follow this link to find out more about what this legal document covers. People who have taken the time to prepare such a document for themselves many not have communicated their wishes to family members which is another critical piece in the care puzzle. Follow this link to hear more about how to have these conversations with family members.
The Emergency Room is not anyone’s favourite place and, with emotions often riding high, knowing that there is information and that there is a plan in place can remove a lot of the stress. Allowing family to focus on being with each other and being there for the patient may be the best gift a family can give one another.