One of the particularly stressful aspects of managing a loved one’s care during COVID-19 is managing a trip to the hospital Emergency Department (ED). Now that infection control concerns have caused hospitals to close their doors to most visitors and family members, an older person is often alone in the ED without someone to advocate for them.
In addition to causing great stress to the patient, this coronavirus protocol leaves a tremendous void in communication at a vital and stressful juncture in that person’s care. Without the support of an advocate, many older patients can fall through the cracks in the Emergency Department. In a worst case scenario, they may receive improper medication and treatment because they cannot accurately convey important information such as their medical history, the medications they are taking, and any allergies they might have. People living with dementia are particularly at risk.
“Under typical circumstances, one of the primary roles of our Aging Life Care Managers is to accompany clients to the ED and advocate for their needs. We have adapted during COVID-19 to perform this advocacy via telephone,” says Betsy Evatt, LCSW, CMC, Windward Director of Clinical Services.
Since its inception in 2004, Windward Life Care has had an experienced clinical team member on call 24/7 to respond to clients’ needs after hours. This includes helping them navigate Emergency Department visits at night, on weekends, and on holidays.
How can a family member advocating for a loved one effectively communicate with the Emergency Department staff to ensure the best care for their loved one? Lisa Thai, BSW On Call Care Manager at Windward Life Care, has these recommendations.
- Make sure to provide the paramedics copies of your loved one’s medical insurance cards, a list of current medications, copies of advanced directives, and a list of the patient’s physicians, including specialists. The paramedics will give these items to the ED staff. The patient will also need to provide a signed “Release of Information” form to the hospital personnel, giving the hospital permission to speak with you as the patient’s advocate.
- While the patient is on the way to the hospital, call the Emergency Department and ask to speak with the charge nurse. Provide the nurse with a contact number for a call back once your loved one has arrived.
- If an hour passes with no return call, call back and ask for the nurse assigned to your loved one. When you are connected to the nurse caring for your loved one, introduce yourself and explain your role is in the patient’s care.
- If your loved one has a cognitive or communication impairment you can follow the ambulance to the hospital and ask to be allowed to your loved one’s bedside. You may be allowed in. You should identify yourself as an essential caregiver if that is your role.
- Request a COVID-19 test and explain that it is needed to plan for care at discharge.
- If you are in touch with the hospital staff by phone, ask the nurse for a convenient time when you can call back to get updates. Enlist the nurse’s help for the best outcome for your loved one. Remember, you are helping each other.
- Request a call back from the doctor to provide a diagnosis or prognosis and describe the recommended plan of care at discharge.
- If the client is discharged home without being admitted, they may be prescribed new medications. Kindly request to have the medications delivered to the patient’s bedside before discharge. If they are willing to do this, you will not need to make a trip to the pharmacy the day of discharge.
- If your loved one is admitted the hospital, contact the receiving nurses station and ask to speak to the assigned nurse. Ask the nurse to put your contact information in the patient’s medical record.
- Find out who the discharge planner will be and their direct phone number. Then contact that person to coordinate the discharge home. The discharge planner’s role is to help you obtain the necessary services and equipment to ensure a safe transition home or, if needed, to skilled nursing. Review with the discharge planner your loved one’s current ability to walk and transfer (get in and out of bed or a chair). Ask for a physical therapy evaluation prior to discharge if there has been a decline in function.
- Ask the discharge planner to order new medical equipment that might be needed, such as a wheelchair, which can be delivered prior to the patient returning home.
- Finally, when planning for discharge from the hospital, ask for medications to go home with the patient. Again, this helps you from having to make a pharmacy visit on what is sure to be a busy day.
Sometimes specific knowledge about navigating the healthcare system can make a big difference in providing enhanced care. Remember, healthcare providers are under tremendous stress right now. You as the advocate can help them with the information they need to properly and efficiently care for your loved one. Communicating well with the hospital team during this important time of treatment will help your loved one get the care they need and give you the peace of mind that things will go as smoothly as possible.
Windward Life Care staff are the experts in aging well. If you have a loved one with healthcare challenges who needs an advocate, we will talk to you about your specific situation. Reach out to us at [email protected].