Judith Graham reports for KFF Health News on the plight of older adults in hospital emergency rooms. Hospitals often keep older adults in their ERs for extended periods before getting them admitted to the hospital. Hospitals could benefit financially from these delays, but patients can suffer.
The evidence shows that older adults often can wait more than a day to be admitted to the hospital, although their doctors have recommended a hospital admission long before. In the ER, patients often are not getting their care needs met. They are prevented from moving much, and they are usually not well fed or hydrated.
The problem is only getting worse, according to ER physicians. And, older adults appear to be kept in ERs longer than most other people. But, there’s little data to understand how common ER boarding is and which hospitals are the worse offenders. Hospitals do not need to report this data. It’s also not clear which hospitals do not have adequate space for patients.
Why are some people spending so much time in ERs? In some cases, hospitals are short-staffed. In other cases, people needing care that is highly profitable get preferential treatment and are moved out more quickly than those who need less profitable care. In still other cases, hospitals don’t have enough beds because they are unable to discharge patients for home health care or to a nursing facility as quickly as they should be able to.
In an ER, older adults can quickly see their conditions worsen. They lose muscle from sitting or lying all day. They may not be taking their medicines. They may become delirious.
Unnecessary stays in the ER can mean longer hospital stays and more health issues for older adults. Patients generally don’t get proper care in the ER, except to address an immediate crisis. They can fall, get hospital-acquired infections, bedsores and worse. They are more likely to die in the hospital if they spend the night in the ER needlessly.
What to do if you’re admitted to the ER? Don’t go alone. Make sure you have a family member or friend or caregiver with you to speak out on your behalf, ensure you are fed properly, and otherwise well cared for. Bring a list of your medicines and bring a bag with the medicines you take, if possible.
Also, protect yourself against delirium. Bring your hearing aids and glasses to avoid being disoriented and some food and drink. If you can get up and move around, do so.
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