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Long-Term Care: Emergencies and Non-Emergencies

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Emergency departments (EDs) are often the first stage of a hospital stay for older people. Most people still call them ERs for emergency room, but the formal term is ED. Whatever the title, they are usually busy, chaotic, and difficult environments for anyone, but particularly for an older person. Yet all too often they are the default solution for a problem instead of a well-considered decision.

Emergency departments

EDs are meant for real emergencies — difficulty breathing, choking, loss of consciousness, severe pain — not for problems that can be treated at home or at an urgent care center and followed up with a doctor visit in the next day or two.

Of course, no one wants to make a mistake by discounting the seriousness of a medical complaint, but calling the doctor's office or a nurse hotline to get a professional opinion about the urgency of the complaint can help you avoid unnecessary trips to the ED.

If the person answering the phone at the doctor's office doesn't ask questions or offer any suggestions but just says, “Take your mother to the emergency room,” it is likely a bad sign about the care being provided.

Some hospitals have created special EDs for older adults who are not sick enough to be admitted to the hospital but are not ready to go home. These special units are quieter, staffed by nurses and others used to working with older adults, and more comfortable than the typical ED.

Patients can stay in these settings while tests are run, medications are given, they're observed for side effects, and until someone can provide a safe ride home. Ask whether your local hospital has this kind of special ED.

Urgent care centers

An alternative to an ED visit is an urgent care center. Urgent care centers are appropriate for situations that are not clearly emergencies but that require immediate attention; for example, a twisted ankle, rash, or bad cold. Staff (often ED-trained doctors) can evaluate the problem, take X-rays, and prescribe medications.

If they feel that an ED visit is required, they can call an ambulance. If you do go to an urgent care center, make sure to inform the regular doctor about what happened and what was recommended.

Urgent care centers can be a very convenient and useful option. The number of urgent care centers in many parts of the country have been increasing. They are often less expensive than an ED and may be located nearer to you. The waiting time is also usually shorter than in an ED, and these centers take most insurance plans.

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