Caring for An Elderly Parent: 6 Lessons From the ER

I took my Dad to the emergency room yesterday. You would think I would know better. I made some rookie mistakes but at least it was a good reminder about what we need to prepare for when caring for an elderly parent.

 

My 90-year old father fell in his apartment Friday night. I happened to call him just after he fell and so I went over to check on him. He said he wasn’t hurt. Rookie mistake #1: I took his word for it. I went away for the weekend and asked my sister who calls him nightly to keep me updated. Her report: the fall made him nervous – which is out of character for him.

So yesterday, I cancelled a day trip for work so I could check on him. I needed to know he was okay and settled before I hopped on a plane — I am traveling for work all week. His balance was terrible so I wanted to see his doctor and find out 1. ) if there was an underlying cause for the increased lack of balance and 2.) what we could do to help him with his walking. I was thinking perhaps I could get him a referral for physical therapy. Rookie mistake #2: I didn’t call for an appointment early enough. Between 9:30 and 10 is the magic time for getting a same-day appointment.

Rookie mistake #3: When the receptionist at the doctor’s office told me to take him to urgent care, I listened. We went to urgent care and waited 45 minutes. (Define urgent, please.) When the doctor came in, I started to explain that my father had fallen a few days before, that his walking and balance are never great, but that they had worsened. The doctor didn’t let me finish. He threw up his hands and said, “There is nothing I can do for him. He may have had a stroke. Did he hit his head? I am calling an ambulance.”

Now, of course there was a possibility my father had suffered a stroke, but I highly doubted that to be the case. “Seriously?” I asked. “You won’t even look at him? My father, his primary care physician, and I are all on the same page – this man will never spend another night in the hospital as long as he lives.”

“There is nothing I can do here. You are describing a possible stroke. I am calling an ambulance. He needs to go to the ER.”

“Fine. I will take him to the ER but I will drive him.”

“You think you can handle that?” the doctor asked.

“I drove him here didn’t I? I was hoping to get him a referral for PT. You think they can do that in the ER?” The doctor walked out of the room clearly disgusted with me. On the way to the ER, I left a message for my father’s PCP letting him know I might need his help later when I wanted to discharge my father.

When we got to the ER, the staff was waiting for a stroke victim. In the exam room, they noticed a big, bad cut on his leg so I was glad we went; I might not have found out about that before I left for my work trip. I told three nurses and a doctor that no he didn’t hit his head, his baseline for walking was off balance, and that I was taking him home no matter what. They didn’t listen. And then they tested him for every thing under the sun – stroke, heart disease, diabetes, UTI (although why they didn’t do that for 5 hours is beyond me). The one mistake I didn’t make was that I was prepared. I had a sweater (those rooms are freezing), a water bottle, and my laptop. You must be prepared to work anywhere, anytime!

All of the test results came back negative – which is great news. So I took my father home. “Sorry, Dad. I should have known better. I help other women manage these situations and I didn’t do a very good job managing this.”

This morning, I called his primary care office. I explained, again, that I was hoping for a PT referral and that perhaps after the doctor looked at the hospital report he would agree with me. “Your father fell?! Is he hurt?! Did he hit his head? I will have a nurse call you.”

A nurse called. We started at the beginning. “Did he hit his head when he fell….”

“I’m thinking PT…”

“I will call you back,” she said.

The doctor called. “Hi Liz.”

“Hi Doctor. I think my father would benefit from PT. I’d like to do whatever we can to prevent future falls.”

“Excellent idea. I will have a nurse set that up for you.”

“Thank you. Have a nice day.”

Rookie mistake #4: Not using email to correspond directly with the doctor that actually listens. Ah well, it was a good refresher and I feel better traveling today knowing my father is okay. Here are the lessons from the ER that I relearned yesterday:

  1. Always follow up on falls in the elderly. They can be worse than they appear to be.
  2. If you need a same day doctor’s appointment, call early – preferably between 9:30 and 10 a.m. when people have already called to cancel and those slots haven’t been give away yet.
  3. Urgent care is not the place for a consultation.
  4. You must ADVOCATE for your elderly parent. You are the one who knows them best. Your voice must be heard. Your input must be considered.
  5. Sometimes, as working daughters, we can’t follow our ideal plan. Improvise. The ER might be a pain in the neck, but if you need to act same day to accommodate your busy life, just do it.
  6. Always be prepared. Never leave home without a sweater, water, a pile of work or a laptop and wifi hotspot, plus your parent’s insurance cards, medication list, advanced directives, and healthcare proxy form.

You might also like:

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Preventing Falls in the Elderly: A Caregiver’s Guide

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2 comments on “Caring for An Elderly Parent: 6 Lessons From the ER”

  1. Elizabeth - Happy Healthy Caregiver Reply

    I’ve made several of these mistakes before, especially #1. Can’t tell you how many times we could have prevented pneumonia or a hospital visit if we only went to visit the dr. earlier. Trust your instincts, caregivers. Sounds like you have a great relationship with your PCP. With mom having so many chronic issues and with getting her in to see the dr sometimes easier said than done, we opted for a ‘concierge doctor’. We paid a fee for this service but her dr. has way less patients and will respond in like 15 min to a call…anytime of day. His office was also great about allowing me to take their urine cups home and bringing samples in without having to bring mom in (which was always like a 1/2 day off work since it’s a process).

    • admin Reply

      Yes, I am so lucky to have a great relationship with the PCP. I had to push to get in his practice – so glad I didn’t take no for an answer.

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