Going to the ER With Someone Who Has Alzheimer’s

WebMD Medical Reference in Collaboration with the Cecil G. Sheps Center at the University of North Carolina at Chapel Hill Logo for UNC Chapel Hill, Cecil G. Sheps Center

Emergency rooms are typically noisy, crowded places. They can be especially overwhelming for people with Alzheimer��s disease.

You never know when you might need to go to the ER, but it can be less stressful if you know what to expect and what to do.

Before You Go

When you bring your loved one to the ER, it can help to have the following with you:

  • Any devices they may need, such as hearing aids, eyeglasses, dentures, walking aids
  • Medicines they take or a list of them
  • Health insurance information
  • Contact information for their doctors
  • Contact information for other family members
  • Details of your wishes about care in writing
  • Power of attorney information

Hunger can make your loved one upset, so it’s a good idea to bring a snack, and you may also want to bring along a music player and noise-canceling headphones if you have them.

Don’t bring your loved one’s jewelry or wallet unless you hold onto it. If possible, don’t bring children, especially small children.

When You Get There

Unless your loved one has a life-threatening condition, they’ll have to spend time in the waiting room. Wait times are usually at least an hour. To make it less stressful for your loved one, ask if there’s a quiet place they can sit.

While you wait, you’ll need to keep an eye on your loved one and try to keep them as comfortable as possible. Offer them a snack if they get hungry so they don’t get impatient or upset. You should also make sure to find the closest bathroom and take them there often.

You’ll probably need to tell the staff why you’re there and let them know if your loved one’s mental state is different than usual. This will help them figure out if they’re delirious or if there’s another issue with their brain.

Clarify the goals of your visit. Tell the staff how far you want them to go when deciding on a treatment plan. For instance, if you want your loved one to come home as soon as possible and don’t want the staff to do a lot of tests, let them know.

It’s important to let your loved one know what is going on, unless it makes them upset or agitated. If this happens, don’t try to explain things. Just try to soothe them and keep them calm.

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If You’re Not There

If your loved one goes to the ER by ambulance or with someone else and you’re not able to go with them, call ahead and tell the staff your wishes for your loved one’s care.

Problems to Watch For

A visit to the ER can sometimes lead to certain medical issues, such as:

Urinary catheter: If your loved one is very ill, they might get a urinary catheter. The most common problems with these are urinary tract infections (UTIs). The chances of a UTI go up the longer they wear one. Condom catheters can also make it more likely for someone to get a skin ulcer or for the skin to lose its color. Your loved one should use a catheter for the shortest possible time.

Pressure ulcers: These happen when someone stays in the same position on a stretcher or wheelchair for a long time. The ulcers usually form under bony places, like under the heels or tailbone. To prevent them, help your loved one change positions often. It’s also important to keep their skin clean and not let it get too dry. If they can’t control their bladder, you’ll need to check them often to make sure they’re not wet.

Delirium: This is when someone suddenly becomes very confused. It happens often to older adults with Alzheimer’s disease who go to the ER and can be hard to diagnose because your loved one already has some confusion. It’s important to let the ER staff know what’s normal for them and what has changed.

WebMD Medical Reference in Collaboration with the Cecil G. Sheps Center at the University of North Carolina at Chapel Hill Reviewed by Jennifer Robinson, MD on August 11, 2018

Sources

SOURCES:

Indiana State Department of Health: “The Braden Scale: for Predicting Pressure Sore Risk.”

National Institute on Aging: “Going to the Hospital: Tips for Dementia Caregivers.”

Next Step in Care: “Emergency Room (ER) Visits: A Family Caregiver’s Guide.”

The Official Foundation of the American Geriatrics Society: “Ten Things to Look for in a Senior-Friendly Emergency Room.”

Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine: “Delirium in Older Emergency Department Patients: Recognition, Risk Factors, and Psychomotor Subtypes.” 

International Journal of Nursing Studies: “Facilitators and Barriers to Safe Emergency Department Transitions for Community Dwelling Older people with Dementia and their Caregivers: A Social Ecological Study.”

Internal and Emergency Medicine: “The Elderly in the Emergency Department: A Critical Review of Problems and Solutions.”

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