Elderly mother uses the emergency room for doctor care. She's hardly ever gone to a doctor.

This post is from August.

Are you her MPOA. Are you asking for a physician referral and offering to take her to same? That's about the only thing I can think of.

I think I would handle this by calling the ambulance service & stating Mom's described medical 'emergency'. Ask their advice re a call out or refer to a clinic instead.

If a clinc is recommended, find the number for the local one & call & make the appointment.

Then offer to provide transport to the clinic.

If Mom insists on calling EMS again for the same issue, it's on her 100%. If she chooses to do this independantly - she is also responsible for the consequences. She calls. She gets transported (if she does). She does all the waiting around. Maybe she even makes her own way home independantly (taxi) if you have the nerves for that too.

Correction: I'm here DPOA, she arranged this five years ago.

It isn't a yes or no question ("should I refuse the next time?" )
Discuss with her primary care physician.
It really depends on the medical reason(s) / needs.
And, often MD medical provider appts are 2-5+ months out.

I would do what is needed based on medical recommendations, not on what your mother requests or insists upon.

If she won't get out of the car - there is your answer.
You do not mention dementia issues. This is important for us to know to more accurately respond.

You need to take control of this situation 'more' than it sounds like you are now. It is not only possibly a waste of your time and energy, it is possibly wasting time of often limited emergency room staff, and she is taking the space/place of a person who really needs to be there. If she 'won't get out of the car,' how do you determine that she actually would need medical care?

What happens when you do take her to the emergency room?
Do they tell you / her to follow up with your MD?
If they do, does she - or do you on her behalf.
I wonder if she 'wants to go' just to go for a ride or get a change of scenary?

Perhaps your mom (is ready for / ) should be in Hospice care - to eliminate these trips to the ER. They will handle her needs for comfort care only. She doesn't need to be diagnosed as terminal to be provided with Hospice care. Check into it.

Gena / Touch Matters

She can “insist” until the damn cows come home, but where are your cojones? Put a stop to this nonsense and do some “insisting” of your own! Who is driving this bus, anyway?

I wouldn’t ignore the symptoms. Just because we can’t see something that is wrong doesn’t mean that she doesn’t truly have a health condition.

I distinctly remember my mother saying to me early on a Saturday morning that she didn’t feel right. I took her to the ER and the decision was made by the hospitalist to take her off of BP meds. Her pressure was very low which is bad.

None of her doctors told us that Parkinson’s patients had lower BP. I was grateful to her hospitalist. The meds that she was prescribed before her Parkinson’s diagnosis were no longer needed and were actually causing mom harm.

A lot of people do this, not just the elderly. A lot of times private health insurance covers emergency room visits at 100%. Plus hospitals have to see all patients, whereas private practice doctors can refuse to see additional patients.

During one of my own visits to the ER, I asked that question out of curiosity. It wasn't for anyone in particular and I have my own doctors. The ER nurse that I asked said it is very common for people to use the emergency room as primary care.

My father loved going to the ER. They fuss over him and they check on him every 15 minutes. What is not to love? I logged more time in the ER than a medical resident. Finally I just started to refuse to take him because as you said, it was over nothing or something that could have waited until he could see his regular doctor. He knew this so if he had an issue he'd purposely wait until after the doctor's office was closed to call me for help. He called 911 a lot. One time I started getting calls from the hospital at 5am. They called every 15 minutes. After an hour I got up and took a shower because I knew my day was about to be ruined. Turned out they were just calling me to give him a ride home. He finally called a local friend who took him home. I lived 20 miles away so of course it made more sense to call me and make me drive all that way rather than call his friend who lived a mile from the hospital.

So, is there long standing mental illness going on here, or is it cognitive decline?

She does not have dementia. She used the ER all the time when she was younger, twice for Hemrrhoids. I will take her directy to an open clinic next time she does this. If she refuses, I'll just turn around an take her back home. I did make, yet another appointment, for her to actually see a doctor. I know she'll make me cancel it.

You want A.
She wants B.

If she is competent and cognitively intact, she can get herself to an ER. She doesn't need you.

If she DOES need you to get her somewhere, then you are in the driver's seat.

She can change her HCPOA to someone who will do her bidding if she likes.

That's the logical choice I would put to her.

I would refuse to take her to the ER. Does she HAVE a doctor? If not, get her one. Use a fib of some sort to get her to go. "Medicare/your insurance requires this."

My mom has taken an ambulance ride 3 times now to the ER, and the last time the EMT asked her "is this something your doctor could help you with, because.." It probably was but mom insisted on going and they can't refuse her.

That afternoon turned into night waiting for her to either be admitted or released, and I live in a major city. I don't have to tell you the types that start to trickle in when the sun goes down. It was a scary, weird, sad scene.

The first visit was needed but the last two probably could have been a doctor visit. I think she had it in her mind it would be faster and an automatic hospital stay which, sometimes to be honest I think she enjoys.

I told her next time she should call 911 and THEN call me. Or somebody will if she can't. "If it's dire, don't waste time, just call" I told her. They know how to break windows. Fortunately there's been no catastrophe, and, for some reason she seems to be more in the mood to prevent the visits now in the first place. Seeking attention is part of my mom's problem right now, but spending time in a COVID filled, people-who-have-been-in-accidents, people with airsick bags (I'm being nice here) waiting room, isn't my idea of a good time just because, "I'm ok, but I just don't feel well." She's had a minor stroke, so believe me we know to be alert, but "I think I'm getting a cold," isn't ambulance-worthy. And I hope it never is.

What have you got to lose by telling her “no, mom, I’m not taking you, call 911 if you feel it’s necessary” while also letting her know you’d be happy to take her to an urgent care place or schedule an appointment with a primary care place. I’ve mostly changed to seeing a nurse practitioner who works under an internist. She has far more time than the doctor and can do most everything the doctor can do. Maybe mom can get the attention she likes in a similar set up. The endless hours the ER takes are misery. I did that way too many times with my dad and learned to hate it

My mom would call 911 for a “stopped up nose”. She figured out that if she called 911 that there was no waiting in a waiting room. She was “escorted” straight in and did not have to wait!!! She had no patience waiting for any doctor.

Does your mother have dementia?

What is it about the ER that she likes?

What about Urgent Care Clinics? The ones I've been to have young, handsome doctors, which is a nice perk. :) No waiting, like an ER. Urgent Care doctors will refer you to a specialist if needed, hand you a written referral before you leave, no waiting. Medicare pays.

They check you out better than the Primary doctor does! An ER is for auto accidents, bleeding, broken bones, strokes or heart attacks. Too many sick people in close quarters makes me nervous...

Urgent Care is less crowded, with better personal attention. In and out quick, with Rx or printed referral. Refuse to take her to ER, just drive her to Urgent Care instead. Much less expensive and quicker! Bring her photo ID and Medicare card,