Memory care ER visit.

This somehow surprises me but yet it doesn't.
I can see with shortages where this would happen.
One way around this might be to have mom evaluated for Hospice. If she is on Hospice there are no trips to the hospital and the facility would have called hospice for instructions. (or they may not have called and just recorded the fall and informed Hospice and family later. If there were no visible injuries there would have been less of a reason to call.)

This is why my husband and I have not had a vaca together in two years. My Dad was sent to ER IN HIS UNDERWEAR in the middle of winter before I was called. I can’t imagine being out of town that night. His new facility has been told no ambulance until we get there. My husband was an x-Ray tech for 30 years. He can evaluate much easier than any nurse or CNA. Most falls have been from the bed where there is a nice pad on the floor, over carpet. He bounces well.

This is a horrible situation for everyone involved but it is unfortunately quite common. With the nursing staffing shortages, particularly post covid, it is almost impossible to spare staff to accompany a resident to the ER. An LTC must have a min of 1 RN on site at all times and depending on staffing, that RN may be the only one in the facility especially on the night shift. They are usually low on LPN staffing also. And they are in dire need of CNAs to cover the issues (toileting, changing linens, etc) that come up during the night shift. I recently posted a situation that I observed with the CNAs in regard to the time it can take for them to answer a call light. Same situation, CNA A, CNA B and CNA C to cover 24 residents on the night shift. CNA A calls out with an hour's notice because the person who watches her children is a no show. That leaves 2 CNAs to cover 24 residents some of whom may be two person assist (you can't singly try to help them transition from bed to bathroom if they are a documented two person assist). There is no way that the facility can spare on of the two CNAs to travel with a resident to the ER.

What we tried to do was contact the family or the listed representative to advise them of the need to send the resident to ER after a fall or any other serious medical condition (of course, if it was life threatening the resident was going to ER immediately). We also tried to make and send with the ambulance crew a copy of the latest medical information from their chart (some of these charts were several inches thick so you could not make copies of the entire thing) and a copy of their current med list. The poor ER staff is caught in the middle if a family member didn't show up (and that happened sometimes). Is it enough? Not by a long shot but until you can convince the private entities, who own the profit facilities, to let some of the funds they are being paid drift down to the lower levels (CNAs, kitchen staff, laundry, housekeeping) it is going to be pretty hard to convince people to join the industry at that level. CNAs in most states still start at $15/hr (that comes to about $13.80 with min tax) and some states are lower than that. $15/hr will barely get you enough gas to get to work in NJ. We won't talk about outrageous rents, utilities, car insurance or childcare.

My close friend’s mom was sent to the ER alone from her beautiful “state of the art” MC facility after an unwitnessed fall. My friend had been on the phone with the hospital all night trying to get her released to a family member to take her back to the facility. The facility insisted she HAD to be transported back by ambulance.
I arrived there for an unrelated reason (ER visit after my first week caring for my mom in home hospice). My friend’s sister was there, I greeted her mom, (who now thought she lived there after being there night all waiting for the ambulance). And the staff member started giving ME the information. Total s**t show. I’m surprised everyone is so surprised.

So sorry. This must have been horrible for your mom. After 2 trips to ER for unwitnessed falls where my mom claimed to have hit her head but had no injuries I decided my new answer is NO. Next time I got a "she fell - do you want us to transport her" question, I asked 1) is she bleeding or appear to have a broken bone? 2) is she in discomfort? If no, I stick with my NO more ER trips stance and ask them to just monitor her instead.

The ER will do a million tests, leave the elder alone for extended periods of time, etc etc. It's horrible. My mom has a DNR but that doesn't keep her AL from wanting to send her out. I wonder if a patient is on hospice or even palliative care, if the push for ER trips is reduced or eliminated?

My mom has dementia and my MIL too. They can't give the staff any info that they ask for about what happened and their history etc. It's just horrible.

Best of luck.

We were closer to our preferred hospital than to my LO’s very nearby residential care facility, so on the rare occasions when she needed to be examined by a physician, we were called before she was sent, and we’d be at the hospital to meet her.

I mention this because of the advantage of a facility where POA can be more available when emergencies occur, and I realize that we were very lucky that this turned out as it did.

Was there a “second in command” in your mother’s situation, SGL0419?

Mom fell 50x while living in Memory Care Assisted Living over a 3 year period. She was never sent to the ER after being checked out by the RN because she never hit her head and/or never had wounds or what appeared to be broken bones, nor was she crying out in pain. She had quite a bit of padding on her behind, hips and thighs to cushion the falls, I suppose 😂🤣. The MC would call me every single time she fell, and I could always ask them to call an ambulance, but what for?

A couple of times she did have to go to the ER by ambulance for pneumonia and illness, but I always met them at the hospital. If I couldn't make it, I would've called my son or daughter, or my husband would have met her at the ER. A few times dh and I were out of the country on vacation, or out of town for a wedding or whatever, but I had a backup plan in case of emergency. I didn't expect a caregiver to accompany her for the 4 hour minimum stay that always takes place in the ER. I don't think it's the facility's practice to do that...I know it wasn't at the Memory Care facility I worked at.

The ambulance attendants always see to it the resident gets back to the MC and to their room safely, and the hospital staff looks after the resident as a patient. It can be quite disorienting for the elder, however, especially with dementia going on.

My jaw is dangling open while reading the stories about LOs with dementia and memory loss being sent to the ER unaccompanied. wow. just...wow.

Yup, after a fall with wound, the very nice looking hellhole Mom was in during COVID sent her to the ER alone and without a medical or medication record or correct face sheet. Poor ER received a patient with dementia and delirium, gushing head wound, medicated up to her eyeballs with meds they didn’t know about, and no correct contact info for family. Facility also said that it was up to family to get her back to the facility.

If I had not gotten called by the terrified aid at 4:30am whispering that she wasn’t supposed to tell me, I’d not have known. As it was the DON when I called at 9 when she got in and when I still hadn’t heard anything didn’t know which hospital Mom was in or how she was. I called the ER, who by that time wanted their nurse’s hand back because Mom was clutching her hand in a death grip, and they invited me to come on down.

The ER did the best they could in that case, but Mom did not do well. She would have been better to have stayed in the ER than go back.

My mother fell at her MC, and needed MANY stitches to her head and face.

She was sent unaccompanied. My husband followed the ambulance. It was at the beginning of COVID, and I couldn’t be exposed.

My husband was told that he couldn’t come into the treatment room with my mother.

Luckily, my SIL (who is a police officer, and sometimes works there) stopped by in his uniform, made his way back and talked the nurses into letting my husband come back and advocate for my mother.

If we all were out of town, I don’t know what on earth they would do without a family advocate there. My mother has a 1 minute memory, and would definitely be a flight risk.

When we had first admitted Mom into MC, the salesperson told us that if Mom went to the hospital, someone from the facility would go with her. Nope. Didn’t happen.

When the day was over, what we didn’t know was that if a patient returns after 7pm, they wouldn’t be readmitted. It took begging and pleading not to have Mom sent back to the ER till the morning.

The whole thing was a mess, I’m sorry to say.

My stepmother fell, they sent her to the ER. We were advised the next day, we were not happy and raised a fuss with the GM, nothing came out of it.

Sorry that this happened to you.

It seems like if this is their policy then they should have informed family members of this.

I am sorry that this happened, especially since you were out of town and not available to be there with your mother.

Best wishes to you and your family.

Yikes... I had no idea they'd do that. Good to know.

Did you contact the licensing organization for facilities in your state to find out if this is allowed? Or an ombudsman? Sorry for the distress it caused you!

Yes, sorry to say, but they do send residents unattended to ER. My Mom fell 4x the first 4 months she was in AL. I went to the ER, which I am glad I did. Mom didn't like men and thet assigned her a male nurse. I had to request a female. I think more tests would have been run if I had not been there to say no. I was always contacted after she was sent out. I requested that she not be sent out until I was called first. If she did not hit her head, then don't send her out. "But she complains about pain" I said "wouldn't u after you fell. Give her time and just see if there is any swelling and she continues to complain." I was lucky I lived 5 min up the road and my DD in an RN who was capable of evaluating Mom. More so then the aides. After that talk, Mom was not sent out every time she fell.

I have never heard of a facility that sends its staff to an ER with EMS at all. Ever. As you can imagine they have no staff to spare for this. And staff, and indeed family, is of little use in ER as long as there is info or contact to GET info for the medical staff.
They do send with contact information (for you and for them).
Was there a head injury? Often residents, especially if a DNR is involved, are not sent if there is no apparent injury and the head had taken no injury.