Steve has been falling a lot (poor vision and can't tolerate glasses/impaired depth perception due to advanced AD, etc.). So far, no real injuries. Last night was the first time he needed stitches in his forehead.
The ALF called me and I went over and concurred. They called an ambulance and two female ENT's came to pick us up. I explained that I can help keep him calm so they let me ride in the back with him (they don't usually want to but made an exception). It took about 5 hours in the ER, but he was examined, a CAT scan taken (negative), given a tetanus shot, shots to numb the area, it was cleaned and stitched. Before we left the ALF, they gave him his evening meds, which include Trazadone for sleeping; took him to the bathroom and changed him; gave me his paperwork (med records/DNR/Advance Directives). I know ER's are cold, so I took jackets for both of us.
When we were finished, another 2 female ENT's came in and cleaned and dressed him and took us back to the ALF. They were wonderful, so compassionate. Ditto on the ER staff. Steve was calm and cooperative the whole time (WOW).
Recently, I had been talking with another wife whose husband has been through this many times, and she filled me in on the basics. She said sometimes they glue the wound shut, but Steve's was deep, so they stitched it (dissolving stitches--no aftercare). An important point she told me was that when you come in by ambulance, you don't go to the general waiting room, but to the ER proper (we had to wait in the hall a short time, Sunday night is crazy around there).
I thought I'd post in case anyone wonders how a dementia patient is treated in the ER. I have to say, it went better than I would have expected.
I found out years ago, to go by ambulance to ER,get seen quicker, also they attend to falls quicker.I have to keep explaining to the staff that Sonny has advanced AZ. I suggested they put a special wristband on identifying AZ patients. Even when they are a in hospital patient unless the staff reads page one of report they don't know.I always insist it is written across the top of his history but it still gets missed. I have to keep reminding them.
Good point--especially for people with young-onset dementia. I was constantly telling the staff that he has AD and also not to yell, it upsets him. Both the EMT's and ER staff automatically shouted and he hates that. And of course when there has been a fall, the staff wants to converse with the patient to see if they are disoriented. Good luck on that, AD is permanent disorientation.
happy to hear it went better than expected Marilyn. its always a concern when an ER is needed. but this shows there are drs/nurses who do get dementia patients are a different breed and need special care. I remember too even after explaining alz, the workers always addressed my spouse for an answer and if he said yes to anything they wanted to proceed according to his response. it can be very difficult and that's why its important to have another caring person there with them who knows the ropes. hope he heals soon. divvi
I just posted up above, awwww poor Steve! Yes we always go by ambulance too, can't get him in a car. I am glad your experience was at least pleasant. We have a great experience too, slowly but surely they are learning how to handle dementia patients better. I hope he recovers quickly and has little pain ((hugs))
Marilyn, glad to know Steve is okay and the ER trip and experience went well for both of you. Rich has been in the ER once a year for the past 3 years and we've had a mixed response. The recent visit in June for the broken knee cap was similar to your experience. The nurse was very kind, knew how to engage Rich (with crazy NJ humor) and he was very compliant (thank god...not usually the case). She knew to ask if he would need a one on one when the doctors decided to admit him. She treated him with respect by addressing him but looking to me to verify the information or offer the correct response. I think the initial experience with her in the ER was the reason he remained so calm during his 3 day stay. The other 2 visits were terrible.
We've only gone by ambulance once. It is true they get more immediate care and less waiting time, but I find for Rich he is better (and less alarmed) when I tell him we're going for a ride, so I usually drive us there. Of course my secret weapon is his very large, imposing aide who always manages to get him seen before the others. He's very respectful and polite, but determined his client will get seen first whenever possible.
Oh no...sorry that happened, but I'm glad it was easier than anticipated!
I sincerely hope that since Jeff can no longer stand, his occasional tumbles out of his wheelchair will not have enough impact to require any stitches!
LFL, had to smile reading about your "secret weapon". Would be nice to have a very large, imposing man to tote around in my back pocket for such times!
Now it seems as if Steve has a concussion from the fall, as well as the myclonic jerks. They got him out of bed this a.m. but he couldn't walk, sit up straight in the chair, or eat. Quite a change. He does have a UTI (his first) so he's being treated with an antibiotic. We'll see what the next days bring--something tells me this may be a turning point.
I'm sorry to read of this and understand your concern. However, a UTI can cause havoc, too. Let's hope that all issues will have a happy resolution. Love from me to you.
Dear Marilyn, so sorry to hear of the concussion and change. I am hopeful and positive this is a minor setback and Steve will get back to baseline once the UTI is resolved and the concussion heals. You both are in my heart and I hope Steve has a speedy recovery.
Thinking of you both in this difficult time Marilyn. I will never forget how you sternly coached me during our horrible time, without that who knows where we would be. Hope dear Steve will be ok.
Marilyn I am so sorry for you both. It seems every emergency gives us a chance to educate staff. Eventually they will get it by our sheer numbers. On good thing about hospice is that they will evaluate the need for that dreaded trip to the ER.
So sorry you and Steve are having such a hard time. In some ways it was better once Joe couldn't fall anymore. The scary time when he thought he could walk or stand up, and he really couldn't involved some falling. And that is always scary. Joe never needed the ER. One of the times they literally caught him on the way down.