Follow
Share

OK, so mom's ALF called at 11 pm to say they were sending her to ER because her sugar was low (paramedic said was at 24). She is a type 1 diabetic. I arrive at the ER just as they as unloading her from ambulance. I go into the entrance asked to wait in waiting room while they settle her in. Fine right. Only have me wait about 10 to 15 minutes, the ER was very busy.
I go back and the nurse tells me her sugar is now 117, but she is not talking. Which I try to say that is normal for her with her dementia. I notice there is a list of test ordered on the wall for her (CT scan, ultrasound and chest xray). I ask the nurse if all that is ordered for her. He said that since she was unresponsive the doctor order to see why her sugar was low. I said this happens as a result of her not eating, can we not do the tests. He says he can send the doctor over.
10 more minutes. Dr. comes over and immediately goes into how no one was here and she was unresponsive and the test were to help figure out what was going on. I say OK, I am here. She has dementia and this is what mostly happened. He interrupts me say well she is unresponsive. I stop and says yes but I rushed here to answer questions and am here. I am ok with CT scan to make sure she did not have a stroke, but why the chest xray or ultrasound? Xray to make sure she does not have fluid on lungs. I said she is here for low sugar, not a cold or cough or chest pain. He they said well she was foaming at mouth and could have shallowed some fluid and that could be on her lungs. Really can't we treat the diabetes? Dr then says well you can refuse but if she gets pneumonia later that is on me. My response was, that was just rude of you. NO xray or ultrasound just CT scan and can we get her some snacks to see if I can get her to eat something to stabilize her sugar. His response, I guess she will eat it. Seriously, because I question you. No one asked he a history or wanted to hear anything I was saying.
I did get mom to talk to me, but she was very combative, which I know means her sugar is still low. Nurse finally brings snacks and checks her sugar and it is dropping again, now at 74. Dr. comes back to tell me what the nurse just told me and that mom has a UTI which could also be cause the problem so going to get her IV for sugar and antibiotics. Me being angry at this point, say I know about the UTI she was being treated at the ALF, if some one would bother to actually speak to me and ask me her history and what has being going I I would have told you. P*ssed off Dr. is like well this is why we run tests and she could not answer. Serioulsy I am her and no one is asking questions. He then says he would like to admit her to her this in control, but I don't have to if I don't want to. I am being a a**, I should just let them run up a huge bill and run every test because she can't answer them. Ask some thing and I will answer you. Jack A**es! Oh course she needs to be admitted, I am not trying to deny her care, just unessary tests.


CT scan done, no sign of any new damage. Another doctor comes over to tell me she is being admitted and then asks me is there any history they should know about. Finally what should have been done over an hour ago. He does ask me what type of diabetes, I say type 1 and he questions if I am right, because doesn't sound right. Really, what is wrong with this place this evening? His also ask why no chest xray, my answer because I don't feel it is nesscary to treat her condition.
He then trys to listen to her chest and mom throws a fit about him taking away her covers because she is cold. Another reason not to do extra test her response is combative, come on.
So, 3 am I leave as they admit her and hope the Dr's on the floor are more willing to listen.
Am I wrong or this horrible person for not just letting do whatever? Just feeling so annoyed

This question has been closed for answers. Ask a New Question.
Find Care & Housing
Honestly I do feel is was because of the UTI. The always check her suagr before giving her the insulin as she is on a sliding scale dose. The ALF actually bring her a snack every evening around 8 pm and they allow us to keep a small dorm refrigerator in her room with, juice ensure and snacks. Can't make her eat though. She has never had a big appetite, and I notice has not changed. Things gave been OK for the most part, then this UTI happened.
Helpful Answer (0)
Report

Tattoochick, I'm with you. But I am wondering why your mom's blood sugar goes low frequently. Maybe ask her doctor to reevaluate her insulin/ oral diabetic medication? Does she take long or short acting insulin? Are they not checking her blood sugar prior to giving her insulin or oral meds? Can you ask the staff to make sure she gets a snack before bedtime to prevent this drop? Just offering solutions.
Helpful Answer (0)
Report

Mom released from hospital this evening. Still on edge to see what happens. I am afraid now that the sore on her foot is now bandage the ALF will have a problem with that. They spoke with doctors and said OK, but I always seem to expect the worst now. Fingers crossed that there are no issues tomorrow when I visit her at the ALF.
Helpful Answer (2)
Report

This is the first time I have had this experience. I am trying to let it go today and chalk it up to a busy ER on a Holiday weekend. My anxiety level is a 10 out of 10 today, as my husband is back out work after a three day weekend and I am on my own to head to the hospital and see what is up. Fingers crossed she is discharged and can go back to ALF.
Helpful Answer (3)
Report

Tattoochick, I'm with you. Doctors need to listen to family members with an established history with their parents. You know her history and they should have let you in right away. I wonder if there's a way to make sure you're included from the get-go in the future?
Helpful Answer (1)
Report

Yes I was being sarcastic.
Helpful Answer (0)
Report

Sorry, I misunderstood.
Helpful Answer (0)
Report

I think she was being sarcastic, saying that despite trying to explain to the dr that there is an established pattern for her mom, and that the daughter wanted to make sure they stabilized her mom's sugar first, the dr got into it with her and suggested that it would be Tattoochick's own fault if she ignored his suggestion for an xray and her mom ends up with bronchitis.
Helpful Answer (1)
Report

Tattoo, are you saying that having a chest x-ray would cause bronchitis? How does that work? I'm curious.
Helpful Answer (0)
Report

Tattoochick, in your place I would be tempted to google the ER dr and see how long he's been on staff. Many hospitals have those pages online now. Is this a teaching hospital? Some of the ER residents at our teaching hospital were really screwballs. At the hospital my husband works at now, they hire locum tenens drs to fill in gaps for permanent staff. Sometimes when you see they were just hired a few months ago or something, it's easier not to take it so personally.

Don't feel bad about this -- your mom is ok, that's the most important thing. Your questions were reasonable; the dr sounds like a jerk.
Helpful Answer (2)
Report

I guess I should have just listened to her old primary care doctor that said she was fine after her diabetic coma and left her to live on her own. Especially since she was refusing to give herself her insulin. He most have been right and all of this last year and a half  or was my imagination and I was micro managing all of the medical professionals. They always know what is best. LOL, right.
Helpful Answer (0)
Report

Anyway I guess I don't care anymore, I know nothing about her medical condition and just let them do what they think is best. Not micro mange and let them run every test in the world even though I know what is going on. A chest x ray will certainly tell them how to get her sugar levels to increase and in a week she gets bronchitis and dies I will live with that. Which really is my grip about the doctor not listening and then telling me I will have to live with what will certainly be her down fall. Whatever!
Helpful Answer (1)
Report

As for putting her into a NH, I have been fighting to keep her out of one for a year. She is only 71 basically healthy except for dementia and type 1 diabetic.(Which I know are serious) She has spent some time in a skilled nursing rehab (which here in Florida is just the other hall from the long term residents.) I have nothing against them, she was treated well and always answered my questions. It is like living in a hospital, though. Mom totally shuts down there, refuses meds, refuses food and just sinks into depression. She as been in those for one to two months stays and just never adjusts. They can not force her to take her meds or eat more an more then an ALF could, they can just giver the IV instead of calling an EMT. To permanently place her there would mean an even shorter life. At 71 that is crazy. At the ALF memory care she does activities gets out of bed and is out and about in her wheel chair. She seems to feel safe their. So I will do my best to keep her there until it truly is medically necassary for her to more to a Nursing Home.
Helpful Answer (0)
Report

The only difference is right they would not send her to ER but just take of with an I at NH. But seriously my issues is with them saying well all these test are because she was not answering questions as to what was wrong but I was in the waiting area the whole waiting to answer questions. Told the nurse in the ER waiting room that she would not be able to answer questions due to her dementia. She went back and told them, but I waited until some one came to get me. Not asked anything just told her sugar was low and here she is. I saw the test listed on the white board for her, stopped the nurse to ask what these where, he said they do that with everyone he sent doctor back to talk to me. Which doctor said well she couldn't answer questions but here I was. Seriously I was frustrated because these low sugars have been happening in her life for more then twenty years as a result of her not taking care of herself. I know what the issue was, I know she was being treated for UT I and that could cause problems. For everyone here to be saying the doctor known best is very disappointing. I have found very few doctors to know best enless they are willing to listen and take a full history. Trust me I have been to many ERs in the middle of the night with her over these years, this is a first for me.
Helpful Answer (0)
Report

I know I would hate to have to sit in the ER waiting room only to be low on the list due to triage, which I fully understand. Thus, I am so happy there are urgent care places just down the street. The wait time is so much shorter. And they can do x-rays and lab tests. And if it was deemed more serious with more tests being needed, the urgent care will call 911 to have you transported to the ER.
Helpful Answer (1)
Report

My personal theory is that's ER's make the experience as miserable as possible to keep people from using them for things they - the ER staff, deem unworthy.

For me? I will literally have to be bleeding profusely from some heinous injury before I'd ever be willing to step foot in one again. Ever.
Helpful Answer (1)
Report

I just want to add that "the reason" someone is in the ER does not always turn out to be the REAL reason.

A story:

Three weeks ago, my husband was feeling kind of "blah" and when I asked about specifics, he said that his urine was dark. It was already 6 PM and it was not one of our doc's late nights, so I suggested we go to the Urgent Care place around the corner. Get him on antibiotics quicker, right?

So we go, and yes, there is blood in his urine. The doctor said "Mr. S, if you were a normal person, I'd just give you antibiotics and send you home. But you're on blood thinners, so we need you to get a blood test tonight. Not tomorrow. You need to go to the ER. I'm sure it's nothing, but we need to make sure".

So, we could have ignored that advice, right? We could have filled the script for antibiotics and gone home and gone to bed. But if we had, my husband would likely be dead.

We got to the ER and they drew blood. His INR (the number that folks on Coumadin live and die by, which should be between 2 and 3) was 17. They sent him via ambulance to the hospital. There isn't much literature on folks whose INR is about 10. Because they have internal bleeding, brain hemorrhages and the like, and they die.

I'm so glad that I didn't argue with either the urgent care doc or the ER docs, who did a CAT scan to check for internal bleeds before they sent him off.
Helpful Answer (4)
Report

Tattoo; Just so you understand, I DON'T think that you are a bad daughter!

Is it possible that this is a signal that your mom DOES need NH care?
Helpful Answer (1)
Report

Nothing wrong with over testings, but I would question the over medicate.

Did the Assisted Living/Memory Care send along a medical history of your Mom? When my Dad went to the ER, the Memory Care nurse handed the EMT's all the paperwork.... so the EMT's and hospital had a list of Dad's medical history and what meds he take daily. Plus the hospital already had on file Dad's Medical Directive, who was his POA, etc. so thankfully this hospital wasn't on bypass because the ER was too full.
Helpful Answer (1)
Report

She is in an ALF memory care not nursing home. Told understand and fine with being at ER. I can just leave and go home because she will not answer them. And when I have left in the past they have given her wrong medication. I would gladly answer questions I'd they had asked any. No one did just wanted to tell me what they think. As we all should know dementia response in a Stressful situation can be crazy and non communication skills. So it would be wrong to say do what you want. I was just trying to give them a history to understand what was happening. I guess I am just wrong and we should let doctor's over test and over medicate without question.
Helpful Answer (0)
Report

Freqflyer some ALFs do not have 24hour nurses and some states restrict nursing care to really narrow guidelines of care. This includes adjusting insulin or sugar supiments on the fly , especially if the resident only has the long term insulin. If the resident is unable to self manage then EMS needs to be called. If Mom was not appropriatelty responsive to swallow, the ALF may not be in a position to start an IV and have a bag of sugar water, nor would they have those supplies. It is the price we all pay to ensure someone's safety if not in a NH
Helpful Answer (1)
Report

Tattoochick, nothing like getting the doctor, who might be great at what he/she does, but has no bedside manner. My sig other ran into one of those doctors a few years ago. Dr told sig other that he was elderly.... yeah right, 60 is elderly???

Hospital ER's are quickly changing. I do volunteer work at a local hospital and I am seeing more security changes. Last year when my Dad was brought into the ER after a fall, I was asked to wait in the ER waiting room after I was through with Registration.... say what? I had on my hospital badge as I had been doing volunteer work there for over 20 years, same with my Dad when he was younger. New rules.

I am the same as Barb above, I just sit back and let the doctors and nurses do what they think needs to be done... and I answer any questions and give information they might need. Yes, the test can be time consuming, but an updated baseline is always good to have. Dad didn't mind the tests.

It seems like once in a blue moon, we will run into an ER doctor who doesn't want to listen. In that case, I find the nurse assigned to the patient to be more receptive.
Helpful Answer (1)
Report

So, if she's in a NH and she frequently has low blood sugar, why aren't they able to manage it there?

I think with us, as a family, this is why we ended up with the "no transport" order. ERs are not good places for elderly dementia patients.

I am no longer trying to keep my mother alive. Anything that can't be managed by the RNs and Nurse Practitioners at the NH is going to take her.
Helpful Answer (6)
Report

It sounds like you were exhausted and trying to micromanage. I work in a hospital and see this a lot. Once she is brought to the ED the doctor will try to find the source of problems. All that was ordered is appropriate under best practices guidelines. If she does not have a living will or DNR, then this could be medical neglect. If you feel that her condition is terminal and you wish to refuse care on her behalf, you may need to get guardianship, but again you may be limited in refusing treatment( treat what you can treat) to intubation or CPR.
My mom used to go to the ER frequently for low sugars at bedtime. I just got to the point to let her get treated and went home to sleep until they called to discharge her.
Helpful Answer (2)
Report

I think it is part of the whole ER mindset to swoop in, order whatever test seems appropriate to quickly confirm or rule out conditions and save the day. ER is designed around acute care - heart attacks, strokes, traumatic accidents etc - and for that they need to act first and question later. When people like your mom come in with chronic conditions the ER often has no clue how to react, you were a stumbling block to their normal way of doing things, never mind that their normal was not appropriate for her.
Helpful Answer (2)
Report

I get what you are saying, but I know what the issues is. Unfortunitly this is nothing new, her low sugar has happen to many times to count over the years. This is even before the dementia issues, as she never took care of herself properly.

So, since I know why her suagr is low, lets take care of it instead of trying to figure out why. She should could have had an IV and antibotics an hour earlier if they would have listened to me and most likely been able to have been discharged.

Sometimes the family does know better and what is going on. Honestly, asking her history would lead to faster treatment instead of just running test because.
Helpful Answer (4)
Report

My mom is in a NH. We have a "no transport" order now, since mom is on palliative care. What they can't treat at the NH is not going to get dealt with.

When mom was healthier and ended up in the ER, my stance was "I'm not a doctor; do the tests and tell me what you think should be the treatment plan".
Helpful Answer (4)
Report

This question has been closed for answers. Ask a New Question.