Tips to Prepare for Emergency Room Visits
Recently our client, Mary, went to the local ER with abdominal pain, nausea and vomiting. After 7 hours, Mary left the ER without knowing her diagnosis or understanding how to take the new medications prescribed or even when to follow up with the doctor.
This is not an unusual scenario. In our fast-paced health care system, many patients don’t understand their illnesses, their medications and treatments. And all too often, doctors don’t have the time to explain.
One of the riskiest points of care for anyone, particularly for elders, is emergency care. Elders are especially vulnerable because they often go to the ER alone, have multiple medical problems and many treating physicians. Typically, elders are not good “historians”, and do not provide detailed explanations of their medical problems, current symptoms and medications. And elders are often hesitant to speak up and ask questions.
According to a recent article in Health Affairs, when you are a patient who is actively and knowledgeably involved in your health care- an “engaged patient”- you are healthier, get better care and have lower health care costs.
So it is very important that you understand your health care needs, conditions and medications and know how to communicate with doctors, especially in emergency situations.
Certainly, you want to do all that you can to avoid an emergency room visit. So whenever possible, call your doctor for medical advice as soon as you have symptoms. In urgent situations, when an emergency room visit is indicated, ask your doctor to call ahead to the ER to provide information and help expedite decisions about your care.
In preparation for emergency situations, carefully develop a detailed support plan with your family/friends. As part of that plan, prepare emergency information documents to include:
- Doctors’ names, specialties and phone numbers.
- Emergency contact numbers for health-care proxy and next of kin.
- Personal Health Record (PHR), advance directives, health care power of attorney documents and POLST (Physicians Orders for Life Sustaining Treatment).
- List of prescription, over-the-counter medications and herbal supplements or vitamins, including dosages and frequency.
- Allergies, to medications, foods, contrast dye or latex.
Here are some tips to help prepare for emergency room visits:
- Never go alone to the ER. Have a schedule planned with family members or friends to go along with you should the need arise. And, your companion should stay with you at the bedside at all times during your emergency visit.
- At the ER, if you are able, provide a thorough history and detailed explanation of your current symptoms. Do not edit your history or minimize or exaggerate your symptoms; this can cause the doctor to misdiagnosis your problem.
- Ask questions. Speak up if you do not understand the explanations or directions.
- Ask for a written ER report including diagnosis, lab and test results. Request that a copy be sent to your primary care physician.
- If you encounter problems in the ER, ask to speak to the nurse supervisor. If the problem is not resolved, ask to speak to the patient advocate/ombudsman.
- Read your discharge instructions carefully while still in the ER and be sure to have any questions answered before your discharge.
- DO NOT leave the ER until you know the answers to the following questions:
- What is my diagnosis? What medications should I resume at home and which new ones should I take? What symptoms should prompt a visit back to the ER? What are the ER providers’ contact numbers in case I feel worse later? When should I follow up with my primary care doctor?
- If you are being admitted, ask about your admission status and billing implications. Are you admitted or are you on observation? The answer is important. Observation services could end up costing you a lot of money!