Caregiving in the ER - Part 2
Charlotte Yeh, M.D.
Family caregivers are unprepared for emergency care needs for a variety of reasons. You can find our take on why they often fail to prepare themselves in our Four Common Mistakes of Family Caregivers in Part 1 of this two-part article. In Part 2 below, we provide specific tips and advice to help you and your organization support families who are faced with emergency care situations—before, during and after they visit the ER.
Preparing families ahead of time to lessen this stressful situation makes good business sense. It can help you deliver on your mission for improving patient care by tapping into community resources and providing useful information to families. It might also bring you dividends in terms of goodwill and return business. Plus, it's the right thing to do.
The Rising Tide
Family caregivers and family members needing emergency care are growing in number, and their combined impact is becoming evident to long term care professionals. According to the National Family Caregivers Association, the pool of family caregivers is dwindling. In 1990 there were 11 potential caregivers for each person needing care. In 2050 that ratio will be 4:1. With an estimated 10,000 baby boomers turning 65 every day for the next 17 years, Americans face a growing need for caregiving services. Much of that caregiving starts in the emergency room.
Recently, researchers at George Washington University found that the rate of visits to emergency rooms by older Americans (65-74) grew faster (34%) than that of any other age group between 1993 and 2003. In a sign of the importance of emergency care for older patients, the emergency room is also the entry point for about half the Medicare admissions to a hospital, according to the same study, titled “National Trends in Emergency Department Occupancy, 2001 to 2008: Effect of Inpatient Admissions Versus Emergency Department Practice Intensity,” published in the Annals of Emergency Medicine, 2012.
16 Tips for Helping Family Caregivers in Emergency Care Situations
To help you and your organization support families who are faced with emergency care situations, following are 16 simple, commonsense ideas. If you treat caregivers and their loved ones the way you would want your loved one treated, you can't go wrong.
1. Never forget that you are not the patient. The patient and their family are the ones who need your guidance and help. Your ability to listen calmly and create order out of chaos will be most welcome.
2. Demonstrate good communications skills with empathy and patience. While this health experience might be routine for you, it's not for the family and patient.
3. Be a good listener, and show patience. No matter how stressed and “outrageous” the patient or family can be, just listening and acknowledging their pain can go a long way.
4. Be sure you are fully familiar and aware of the local resources, and where support is available for specific issues, such as hearing or visual impairment. Help the family and patient apply for services.
5. Invest in tools like a website to help you communicate with families. You might also direct the family to a shared caregiving website to enable the family spokesperson to communicate regularly with family and friends, and help reduce the number of well-meaning but persistent calls and emails.
6. Implement a formal care assessment tool as part of a care plan for patients. A care needs assessment is an objective evaluation of a person's mental and physical health and independent living situation. Genworth developed a Care Assessment Tool worth exploring.
7. Develop education modules for families and caregivers. The hottest topics trending with caregivers and families include tips for making a home safe for an older family member, advice for making a transition from hospital to home, and help for overcoming family disagreements over caregiving.
8. Survey families and caregivers to generate ideas about improving your business.
9. Assist families and caregivers to obtain health care proxies, advance directives, advanced care plans and HIPAA proxies.
10. Consider implementing a patient apology program to use when things did not go as planned, or when a medical error occurs.
11. Provide 24/7 accessibility to your services because caregiving is a 24/7 experience.
12. Ask families and caregivers to share stories about their loved one. Invite them to bring in pictures and other mementos to help your staff fully appreciate and connect with the patient.
13. Demonstrate cultural sensitivity and facility with language and values to match your patient population.
14. Consider adding a caregiver respite program.
15. Sponsor a get-together for caregivers, provide tip sheets and designate a special place in your facility where caregivers can take a break. Consider hosting hands-on teaching sessions where caregivers can learn how to use infusion pumps, defibrillators, oxygen tanks, catheter care, and so on before going home with their loved one.
16. Make sure transportation services are available for patients and caregivers.
Preparation is important because care planning involves decisions about finances, legal issues, the needs and wishes of the care recipient, family cooperation, and a variety of issues specific to each family and their loved one who needs care. Read Part 1 of this article to get our take on the Four Common Mistakes of Family Caregivers.