2009-04-16 / Features

Be Prepared Before Aging Parents Need Medical Care

By Jimmy Mincin THE ALTOONA MIRROR

ALTOONA, Pa. (AP) - Taking an aging parent to the emergency room can be a trying time for any adult. But there are ways to ease the stress.

"It can be a very intense experience, so it's important to develop a contingency plan in case you ever have to take them (to the emergency room),'' said Dr. Jessica Shepherd, emergency room physician at Altoona Regional Health System, Altoona Hospital Campus.

"Caregivers feel very responsible, and a lot of times their folks are very fragile, and they can get sick very quickly. An elderly person can get a cough one day and be very sick the next.''

To begin with, it's important to know a parent's complete medical history, she said. That includes having a list of medications they are taking, their allergies and medical conditions; keeping track of recent hospitalizations and surgeries (especially those involving implanted devices, such as hip replacements or pacemakers); and having insurance information at the ready, while keeping it simple and limited to a single page.

"But of all things a caregiver can do, having a list of medications they are taking is most important,'' Shepherd said. "There are a lot of medications that interact adversely with other medications, or produce side effects. We need to know about that.''

Preparing a list of physician contacts that includes the reasons why parents see them can provide emergency room doctors with much-needed medical insight, she said, adding that when traveling, it's good to keep the doctor summary list with you, and a copy of an EKG (electrocardiogram), if it's abnormal.

"That way the terminology is doctor-to-doctor as opposed to layman-to-doctor - nothing gets lost in translation, and it makes the whole communication process so much quicker,'' she said.

When parents are confused, doctors will need to know what is normal behavior and what is not, she said, and may depend on caregivers to convey information to the parent.

"You've got to keep the conversation open to the parent, because sometimes dementia is involved,'' Shepherd said. "Children of elderly parents know best how to communicate with them, and they know the mental level that mom or dad is on - their mental capacity.''

And never forget that elderly patients tend to downplay their symptoms to doctors and nurses.

"Part of that is because they don't want to feel like a bother,'' she said. "They have more of a reluctance to seek care when they need it because they don't want to trouble anyone. They don't want to feel like they're imposing on you.''

Whatever they live independently or in a care facility, it's better to anticipate that elderly parents eventually will need emergency room admission, said Becky Mathers, assistant district administrator for the Bureau of Blindness and Visual Services in Altoona.

"It's important for older people to have a network of friends who support each other,'' she said. "One thing that's been helpful to my mother is she's developed a network of friends in the apartment complex she lives in.''

"When she fell a few years ago, it was one of her neighbors who told me she was in the hospital,'' Mathers said. "(T)hey were able to help her.''

A tough but important topic to discuss with parents is a living will.

"If a condition is life threatening, you need to know what the plan will be and what their wishes are,'' Mathers said.

The bureau's social workers are typically instructed to call 911 when their clients are in need of emergency medical attention.

"It's all about quick response,'' said Sherri Hack, a social worker for the bureau. "Sometimes, it's better to just call an ambulance, than to have someone who's very upset driving someone else to the hospital.

"It's also important to keep them calm and be supportive - to make the situation go as smoothly as possible,'' she added. The key thing is just to be as reassuring and supportive as possible. And if it's a situation that allows for it, stay with them. They need the support and familiarity.''

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