PracticePeace Asked August 2018

How do you deal with regular unnecessary demands to be taken to the hospital?

My father moved into our home at the end of June 2018, just a bit over a month ago. He was very unhappy with his previous living arrangements and felt he was not getting the support he needs. Dad is 87 years old and has stage four Parkinson’s Disease. He uses a walker, sometimes a wheelchair if he is having a very bad day. He is also dealing with anxiety, sometimes quite overwhelming for him on an almost daily basis. He is on levodopa/carbidopa 5 times a day with a CR tablet at night. He is also on 50 mg of quitanapine and lorazepam 2 mg 2 times a day as required to ease the anxiety. He has wanted to be taken to the ER at least once a week. We took him the first time but his symptoms seem to disappear as soon as a decision is made to go, so of course, once we get there the doctor has nothing to address. Twice now, when I try to figure out what “I feel crappy” means, nausea? headache? pain?, he says he doesn’t know, if I ask what he would like the ER doctor to help with, he tells me to “read my POA” or “they can just kill me”. I ask him if he would like some acetaminophen or lorazepam when he obviously anxious. He gets angry with me when we tell him that the ER doctor needs to know more than “I feel crappy” so he/she knows how to help, and that the ER doctor won’t kill him. I’m not sure how to deal with this sort of behaviour to help ease his physical and mental pain. Any advice would be so welcome.

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I am not sure how "with it" your father is. My mom is pretty spry still, but we have almost monthly or bi monthly "emergency" situations. The first three times she ended up going and quickly learned that it cost her money to ride in an ambulance, she now insists she MUST go, but I must drive her since she cannot afford an ambulance ride. Like your father, once we get going she is immediately better. She is on a very mild anti anxiety med and her doctor won't prescribe anything stronger because she is elderly? Whatever that means. I am always afraid to say no to taking her, but sitting in and ER for three hours when I have a handicapped son at home who also needs my attention is irritating when there never turns out to be a problem. Mom's biggest problem is her crying wolf for so many years that it is hard to tell now if she is actually sick.

Helpful Answer (9)

I think You need to look into some cannabis.

Helpful Answer (7)

Dementia goes along with Parkinson's. Has he been evaluated for it?

Helpful Answer (6)

Ativan wasn't cutting it with my mom either for her agitation and anxiety. Xanax (Alprazolam) is doing a much better job and she's much more calm and relaxed now.

Just a thought.

Helpful Answer (6)

Thank you for the suggestion. I’ll raise it with the doctor.

(0)

I can empathise with this. My Father is now in care facility but same as yours at home. Convinced he had a dis ease that could not be found. Wanting to go to emergency at hospital. Wanting me to call doc cause he is " ill".
Mad with me when I said more information required. His doctor was sure it was linked to anxiety and attention seeking to get me to his home cause he was scared. This does not happen now as he sees medical staff in care facility.
Maybe the nurse coming in will be best solution. Good Luck. Know its not easy and you cannot win

Helpful Answer (6)

You & only you decide whether a hospital visit is necessary ...my mother can ask everyday to go because her back hurts or whatever...she had back problems all her life which she refused to fix anything when she was younger & healthier. I don’t feel a hospital visit is always best with all germs around & can pick up anything w compromised immune system. Unless it’s emergency like bleeding everywhere or fell & can’t get up...you get picture?

Helpful Answer (6)

You’re welcome, “Double P”. 😁. When my husband came home from 4 months in rehab, we had a visiting nurse, one RN and one LPN who alternated weeks. Since Hubby has heart issues, I was over the Moon to have them come. When their 3 months were up, we all cried! It was all arranged by the rehab hospital through his Medicare, so his GP’s office could also approve it for you. The world runs on paperwork so you and they will have to fill out forms. They’re usually provided by the VNA. Ours even ordered incontinence supplies for us. Boy I still miss them! Let us know how it works out. Between my mom and my husband, I was at the ER so much I got to know all the staff One time the doctor looked at me and said “Don’t I know you?” We had a good laugh over that one!

Helpful Answer (5)

He may qualify for Hospice if so he/you would have a Nurse that would come to the house to see him once a week. You would also have a CNA that would see him a few times a week. This might make him feel that there are more people tending to him and they are coming to him. Along with that you can call Hospice 24/7 with any questions or concerns and if needed they will send a nurse out.
If this is not an option you want to take at this time keep it in mind for later.
It is possible that he is stressed about the move. Do not know if it was a local move or a long distance move but any change can cause anxiety. If he moved away from friends and an area he knew well this may be causing more stress.

Helpful Answer (5)

Or if he doesn’t qualify for hospice or he is not ready for that. Ask the Dr to order home care. Services include nursing, Physical and occupational therapy, home health aid, and medical social worker.

(2)

I knew my mom was ready for a facility when she called 911 three times in one week, once because she had an accident in her bed. When she was hospitalized for a raging urinary tract infection, her behavior was so off the wall, they evaluated her and determined she could no longer live alone.

I’m wondering if it wouldn’t help to have a visiting nurse come by once a week or so. She could do a cursory exam of Dad and pronounce him “fine”. He could share his “feeling crappy” with her instead of you and the ER. He may need to be tested for a UTI although there are usually no symptoms.

Was Dad previously in a facility? If so, he was not happy with the care and not enough attention? He’s had a change of scenery and caregivers but maybe not of attitude. His protestations may be a bid for attention and this is why you should have him evaluated for dementia. My father-in-law had PD and after about 5 years also had dementia. It shouldn’t be difficult to get him to the doctor as he knows it will be all about him there.

Helpful Answer (4)

Thank you for your suggestion. It sounds like a great idea. I’ll speak to Dad’s GP about having a nurse come by weekly. It may help him to feel safer knowing there’s a professional there for him, more often than his doctors can be, and he wouldn’t need to go anywhere either, which is definitely a lot easier for him.

(2)

I feel your pain! Before my wife had a major stroke at the end of October 2017, she had gone to the ER in excess of 65 times between Jan. 01, 2017 and October 30th 2017. Of these visits, she was admitted 3 times and kept for observation 3 times.

She has been in a NH since with several hospital stays of up to 5 weeks. About 2 weeks ago, she started asking the facility to send her to the ER. She is now asking daily, and cries and raises a fit because they can find no reason to send her. It's a part of her bipolar disorder and a desire to be the center of attention.

I am so glad that it is up to the facility to decide whether or not she needs to go to the ER and not on me. I am in no hurry fro her to come home but I do see her daily, usually about 5 hours.

Helpful Answer (4)

I can imagine how stressful that was for you! I try to be as aware of my Dad’s “situation “ as possible, with it changing so often. I would feel so awful if I thought a trip tp ER was “unnecessary “ and turned out to be wrong. The saddest thing about it, I think, is knowing that to my Dad, the emergency is real and in saying no, he thinks I don’t care.

(0)

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How do you deal with regular unnecessary demands to be taken to the hospital?

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