Emergency Room Visits – Many are Unnecessary

Emergency room visits for many older adults are unnecessary because they are not true medical emergencies.  Unnecessary emergency room visits add cost to the already overburdened health care system and drain money from savings and retirement accounts of older adults.  Yet, when older adults don’t feel quite right, 911 is the first number they call.

What are the most common causes of unnecessary emergency room visits?  Urinary tract infections are one of the reasons older adults end up in the emergency room.  Caregivers see their loved one experiencing mental confusion or strange behaviors and have no idea that the diagnoses can be as simple as a urinary tract infection.  Urinary tract infections are extremely common in individuals with memory loss, dementia or Alzheimer’s Disease and can be easily diagnosed and managed with a regular physician visit rather than going to the emergency room.

Other common reasons for unnecessary emergency room visits for older adults include:  dehydration and/or poor nutrition, bacterial pneumonia, high blood pressure, chest pain, asthma, poorly managed diabetes, congestive heart failure, COPD and dementia and associated behaviors.  In 2012, the Medicare co-pay for a hospital admission from the emergency room is $1156.  The co-pay for day 20+ in a skilled nursing home is $144.50 per day.  Older adults and their families are shocked to learn that Medicare doesn’t pay for all types of care including emergency room visits and rehabilitation.

Being admitted to a hospital emergency room and having subsequent treatment is extremely expensive for older adults in more ways than the obvious.  After an emergency room hospitalization or nursing home stay many older adults are less able to continue to live independently and to care for themselves.  Hospitalizations often result in significant cognitive and physical declines for many older adults who also experience delirium.  After a hospitalization many older adults find it necessary to move to assisted living; some remain in nursing homes for the remainder of their lives.

Rather than rushing to the emergency room, it is important for older adults to be proactive in their health care.  Medicare does not pay for care oversight and supervision that may prevent unnecessary hospitalizations and reduce greater out of pocket costs to consumers.  Many older adults are unaware of services that can save money and improve quality of life. This includes regular and ongoing medical appointments with physicians.  Care management and oversight helps older adults avoid emergency room visits and health emergencies and is a service offered by The Care Navigator.  Care management provides oversight and an advocate to ask questions of physicians and to coordinate follow ups for care, avoiding unnecessary emergency room visits.

Many family members miss common signs that loved ones would benefit from care oversight. In addition to the reasons listed above, these signs include weight loss, depression, poor hygiene and a number of other issues.  The Caring Generation educates caregivers about caring for older adult loved ones.

It’s time for older adults and their caregivers to become more educated about options to manage health issues.  This can only happen if education about available services occurs to eliminate hospital stays and the associated risks of not monitoring health conditions.  Informational videosabout care options and services are available.

Return from Emergency Room Visits are Unnecessary to The Care Navigator Blog.


About Pamela Wilson

PAMELA D. WILSON, MS, BS/BA, NCG, CSA helps caregivers and aging adults solve caregiving problems and manage caregiving needs through online programs, live support groups, and an extensive caregiving library that includes articles, podcasts, videos, and webinars.

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