Explaining the Emergency Room to a Dementia Patient

One or the other of us has been to the ER with our elder ten times in the past six years. Four of those times have been in the last eight months. It doesn’t help that the ER tends to be understaffed or that none of us was born with patience. If you add dementia to the impatient, things can get pretty hectic. Here are a few of the things that might happen:

“Here, take this.” Um, no? It was a wad of (used) toilet paper that should have been dropped into the bedpan. This is not a quirk; it is very possible especially if the patient has never used a bedpan before (that she can remember). It could be anything but thus far that has been the worst.

“Why can’t I go home?” This question will be on automatic repeat the entire time you’re there. How long the intervals are depends on the patient’s short term memory span and what the staff at the emergency room is doing. Answer calmly if possible. For the patient it is the first time the question has been asked.

“Can’t we just make an appointment?” Pointing out that the word “emergency” implies the answer is no will not be helpful. Trust me, sarcasm is lost. Like going home this may be on automatic repeat.

Both of these questions can have several diplomatic answers. In our elder’s case, more often than not she’s got an IV line in. Pointing out that they have to remove it may help. Of course that could result in the patient trying to remove it, so balance that with caution and knowledge of the patient. You can mention that you are waiting for test results as well.

Boredom: This is a big issue. Some ERs have televisions in the little cubicles. Some don’t. Bring a variety of things that you know will amuse the patient. One of the caregivers brought his iPad with him and she got to watch movies while she waited. It was an inspired idea on his part.

Needles: I don’t know about anyone else but our elder gets frantic where needles are involved. At first I thought she was acting but that is not the case. She flinches, tightens her muscles and otherwise makes it harder both for her and the person taking her blood. Did I mention that she has a powerful grip? Holding the patient’s hand may help them but beware the bruising.

Yes, he’s a nurse: In our elder’s day men became doctors not nurses. It doesn’t matter that times have changed and the strength needed for the tasks have increased. It’s hard for our elder to believe a man can be a nurse. Be prepared for awkward questions, and do know that they are probably not the first the male nurse has had to answer.

There is one other thing you can do in these situations and that’s redirect. For going home, you may bring up plans for the next family get together. For the appointment, maybe mention another appointment down the road, either the patient’s or your own. It can make a difference.