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Every time my mom falls, sneezes, vomits, coughs, or stumbles, her memory care facility packs her off in an ambulance and calls me to go retrieve her. Nine times out of ten, it's a minor illness or injury that you wouldn't even see a doctor for and it always seems to be at night. They never admit her, nor do they ever prescribe meds. During the whole time she's in the ER, she demands to pee every 10 minutes, flirts with any male caregivers, and tells her life story to any sympathetic ear - including, of course, how horrible her children are. I love my mom, but I hate sitting in the ER for hours in the middle of the night, watching this fiasco and knowing I have to go to work the next morning. I'm 55 years old with real health issues of my own and this is taking a toll. My brother refuses to go and my sister makes excuses why she can't, so it almost always falls on me. I'm due for a knee replacement very soon and I don't know what's going to happen when I can't drive and Mom makes her monthly visit to the ER.

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What would happen if you didnt show up, if no one did?

Have you looked into palliative care?
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lablover64 Mar 2019
I'm not sure what the hospital would do if no one came to get her. I know the memory care facility would call me every 15 minutes - they've done that before for other issues. I'm not sure she qualifies for palliative care and, if she did, the only facility near me that provides it is 25 miles away.
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My dad got into a too frequent ER habit for a while. It was exhausting. Finally his doctor told him the ER was his enemy, that he was much more liable to catch an illness there than to have something fixed. That helped it become far less. I know you’re dealing with a facility, maybe time for a care conference where you come to some new criteria for these ER trips. State your concerns that it’s too often, and for unneeded causes. If it stills happens too much there’s nothing saying you’re required to go hospital sit everytime. You can call and check on her, find out if it’s for something you deem serious enough to warrant you going
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lablover64 Mar 2019
My sister actually started doing that. She will wait about 20 minutes after she gets the call from the facility that Mom is headed to the ER and then call and give the ER her phone number, asking them to call with any questions about her history, report test results and notify when she is going to be released. She says it has cut her parking expenses and wait time for the year in half. The hospital garage routinely gets us for $10-15 every time we have to go up there and sit for hours. It adds up to over $300 a year and we've been doing this for about 5 years.
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I had a similar experience with my LO in MC, except they called 911 and had her taken to the ER. They called me and of course, I had to meet them there. (Didn't have to, but, I am RP and Healthcare POA.) For some reason it was ALWAYS in the middle of the night, except for once on a Saturday morning. I was livid, because they were getting her out of her bed in the middle of the night for something that she had since she arrived there 4 years ago! (A lump on her side that had been documented years earlier by MRI and was fine.) To me, they came up with nonexistent or minor issues. I never could figure out why. She would get scared at the ER and getting needles and catheters for no reason! And, the ER doctors kept asking me why the MC was doing this. She had end stage dementia. Several of the ER doctors asked me if I had considered Hospice. She was already on Palliative Care! So, I talked to my LO's doctor and he thought she was ready for Hospice. We had her evaluated and she's been on Hospice for about 6 months. She gets so much care and attention from the Hospice staff (there is a nurse or personal care attendant in the MC with her at least 5 days per week!) and she's not having to go for ER visits in the middle of the night anymore. She can go, if she needs to, but, the MC staff are instructed to call their doctor or nurse before transporting her. And to my knowledge there have not been any problems.

If your LO doesn't qualify for Hospice, I'd explore Palliative Care and then make sure those who are implementing it understand what it means and that the facility understands it too. I've read that some companies offer Hospice and Palliative Care in the same agency.
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My mom always got sent to the ER either before lunch or dinner. She is now only sent if SNF staff can’t handle situation.
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Oh my gosh, I have started looking into assisted living for my mom. I did pose question about hospital visits to them. They said a nurse is on staff and she would only be taken to the hospital in a true emergency. You have me wondering about this now. Should I question possibilities of ER trips further because I have to say, I have always taken mom in a true emergency but there have been times when I had to talk her out of going because I think some older people get frightened, bored or whatever and see the ER and doctor appointments as outings! Gives them something to talk about. Then my mom will complain about the bill she gets. Constant struggle where we strive to find balance in our lives, isn't it?
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lablover64 Mar 2019
I was told the same thing when my mom entered the facility. "We have nurses here to take care of minor illness and injury." The nurse is usually the one who packs her off to the ER for a UTI. At our last plan of care meeting, I brought this up, asking them to please make her comfortable for the night and call me and I will have her seen the next day at her doc's office. Also, Mom used to be on Coumadin, so every time she fell it was always a matter of "did she hit her head." She learned pretty quickly that if no one saw her fall and she said she hit her head, she would be going to the ER. Her former doc took her off the Coumadin because he felt her falls posed more risk on the Coumadin than her chance of stroke without it but she still wants the attention and excitement of an ER visit, so she always says she hit her head.
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For the facility, it's probably a liability issue. Since if they didn't send them to the ER and something did happen, they would be afraid of a lawsuit. Have you talked to them about this? Maybe if you signed something relieving them of all and any liability they would stop.
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I get how it's probably a facility rule to send resident to the ER if they fall or if they have unexplained injuries and they aren't verbal, but, to get a person out of bed, who's sleeping with exaggerated or minor things to be transported 25 miles to an ER in the middle of the night borders on absurd. (One was a slow growing growth on her side. It had been there for years and never changed size. It had been checked with an MRI years early. And her personal doctor was scheduled to visit her the following morning in the MC. She wasn't sick or complaining of any pain and was always released with no findings by the ER doctor. ) So, this kind of thing was really the only complaint that I had with the MC. I never did figure it out, why or anything else. I'm just relieved that it's resolved for now. I do wonder if they did that kind of thing with other residents. The ER doctors told me that they see it done quite a bit. Man.......
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When my father lived on his own he discovered the excitement of the trip to the ER. For two years I must have been in the ER at least once a week....over literally NOTHING. There is no such thing as a quick trip to the ER. After work it was a minimum of 4 hours and weekend trips 6 hours. I have logged my time in the ER than most medical residents. It took two years then I hit my limit. My father never went in for anything serious, mostly routine stuff that happened after business hours. I started weaning myself off of this crazy ride. I might take him to the ER if I was in the area but I would drop him off at the door and tell him to get a cab home. He started calling 911 so often that the police would take him there and back.

Once he went to AL I thought it would die down a bit. I was wrong. Now they know to just call medical transport to bring him back. Costing him $75 a pop. I had to cut off his ER trips involving me. I stopped running to the hospital. If they move him to rehab I will go get clothing for him and bring it. Rehab is his version of Club Med.
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lablover64 Mar 2019
I wonder if we tried that with Mom, it would discourage her from any more ER trips? I swear she looks out her window, sees the crappiest weather and decides to get even with us by snatching us out of our warm houses and making us drive into the city in the middle of the stormiest nights. I thought the $250 charge per ambulance trip might slow her down, but her trustee and I pay those bills and she doesn't really see them. Maybe we should start telling her to have the hospital call her a cab or medical transport to take her back to the facility. Seems heartless, but it might get the point across.
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Mom went to the ER in 4 months for falls. The Nurse was not even jnvolved a Medtech would send her. One time I agreed with, they didn't see her fall and wasn't sure if she had hit her head. They kept saying she complained of pain. Of course she complained of pain. Don't you have some pain when you fall. I asked them to give her time, not to send her out right away unless a head injury. All they need to do is check on her. So the ER visits stopped. When she went to a NH, they were not so quick to send her out for ever fall. Only if she hit her head. Of course there are more nurses an doctors in a NH.
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My dad is in memory care and has only been to the ER once since he's been there. He spent a few days in the short-stay wing with pneumonia. His facility automatically arranged transport to the hospital, and then asked my what I wanted to do to transport him back. I am local but opted to have the facility arrange an agency to bring him back with a van.

My mom lives alone now and mis-manages alcoholic beverages and medications and has turned into a drama queen. She has called 911 four times in the last year and has been in the ER, short-stay wing, behavioral health center, etc. I have learned to stay away from the hospital as much as possible because they are quick to pawn her drama off onto me as quickly as possible to get rid of her.

NIGHTMARE.
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Memory care does this so they won't be held liable if something bad should happen.
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