Going to the Emergency Department

Most older people need emergency medical care at some time. The most common reasons include heart attacks, heart failure, strokes, and injuries. Almost half of older people seen in an emergency department are admitted to the hospital. Older people may be taken to the emergency department by a family member or friend or in an ambulance. They may leave from their home or from a long-term care facility.

Knowing when to go to an emergency department can be difficult. When emergency care is not needed, going to an emergency department can be more harmful than helpful. In the United States, emergency departments are often crowded and uncomfortable, with little privacy and loud noises. Staff members sometimes have little time to ease people's anxieties. People sometimes wait several hours before seeing a doctor.

People should know what problems their health insurance plan considers an emergency. Some plans require people to call their insurance company or primary care doctor before they go to the emergency department, except for serious injuries (such as a hip fracture) or life-threatening situations (such as chest pain or a stroke).

Before going to an emergency department, older people should call their primary care doctor regardless of whether their health insurance plan requires such a call. The doctor can often determine whether such a visit is needed. The doctor may meet the person in the emergency department or call there to advise staff members about the person. If the primary care doctor is not available, calling the emergency department before going can help. Staff members there ask about symptoms and can help determine whether coming in is necessary. They can explain what to bring and what to do after arrival.

People should ask a family member or friend to accompany them to the emergency department. Having another person who can help fill out the forms and provide support makes the experience less overwhelming.

When people go to the emergency department, they should bring any medical information they have at home. This information may include a list of drugs they are taking, a copy of the most recent medical summary, or records of hospital stays. Otherwise, the information must be obtained from the primary care doctor or, for residents of a long-term care facility, from that facility. Family members can help by asking whether the emergency department has received the information.

In the emergency department, a staff member asks the person, if able, to describe the problem. The person is asked to fill out registration and health insurance forms and to sign a form consenting to treatment. If the person cannot fill out the forms, staff members try to locate someone, such as a close family member, to help. Then a nurse evaluates the seriousness of the problem. The more serious the problem, the more quickly a person is seen by a doctor.