Scenario: Your loved one had been hospitalized urgently and is non-communicative. You are being asked to make critical medical decisions

What to expect in the emergency situation

    • In the event of a life threatening situation, ER staff are going to take necessary steps to stabilize a patient’s condition
    • The medical team will be looking for a primary family member or loved one to communicate with and help make decisions. In North Carolina, this is the Order of Priority for decision making in a hospital setting;
              1. Patient
              2. Individuals identified in legal documents (Healthcare Powers of Attorney)
              3. Family and Friends
              4. Doctors (Last Resort)

What to do in the emergency health situation

If there is someone other than yourself who is the designated Healthcare Power of Attorney (HCPOA), contact them and establish communication between that individual and the hospital staff even if it is by phone.

        • Try to locate advanced directives. This may be a job a friend or family member can assist with while you remain in the ER.
        • Documents may be stored in the hospital system and accessible by staff or on line through the NC Secretary of State website.

      Identify someone who can support you and listen to what is being asked and communicated by hospital staff.

        • If necessary your support person can listen to information and decision points with you by phone.
        • Do NOT invite all of your family members to join you in the ER. One or two people who can bring calm to the situation will serve you and your loved one best.
        • If you are truly alone, there is likely a hospital chaplain or social worker who can be with you and assist in interpreting what is being said

     Ask questions until you fully comprehend the situation.

        • Understand the urgency of the situation and time available for decision making
        • Understand the risks, benefits and probability of various outcomes of any treatment or surgical procedures
        • Understand the risks, benefits and probability of various outcomes if NO treatment or surgery is pursued and the probability of various outcomes
        • If you are having difficulty communicating with the person delivering the information, ask for a nurse or someone else to assist in the situation

     As difficult as it may be, it is important to keep in mind what your loved one would want in this situation and follow their wishes

        • If you or other loved ones have not had discussions about advanced care and end of life, try to think of what you know about them and how they might view the various options and outcomes.
        • If possible discuss the options with other available family or loved ones who may have better knowledge of their desires and wishes

     Jot down notes.

        • It is unlikely that you are going to remember what is being said. This may be a good job for your support person.

 

Making decisions for someone you care about in a life threatening situation is challenging even for those who are medically trained. The best way to manage these situations is to have in depth conversations with your family and loved ones prior to emergencies. There are numerous programs, tools and professionals available to assist you and those closest to you through this process.  

 

When you end up in the emergency room with a parent or an older adult who is no longer able to make decisions, there are some important points to remember when working with the medical team.

  1. If there is someone other than yourself who is the designated Healthcare Power of Attorney (HCPOA), contact them and establish communication between the HPCOA yourself and the hospital staff even if it is by phone.
  2. Identify a calm, trusted family member or friend who can be with you for support and help listen to what is being asked and communicated by hospital staff.
  3. Ask questions until you fully understand the situation and the decisions that will need to be made along with their consequences.
  4. As difficult as it may be, it is important to keep in mind what your loved one would want in this situation and follow their wishes.
  5. Take notes and write down who you spoke with and what was communicated. This could be a good job for your support person.

 

Lastly, there are 2 things you can do to keep a focused mind in an emergency

  • Breath – 3 Deep slow breaths in and out
  • Focus – on what is being said to you by medical staff and the moment at hand. Do not attempt to play out every scenario to its end the myriad of what ifs.

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