End-of-Life Care and the Emergency Room

When you think about a hospital emergency room, the first thing you might picture are ambulances racing up to deliver a patient who is facing death, while emergency room doctors and nurses work frantically to keep them alive.

However, ER staff are also seeing an increase in visits from elderly patients seeking treatment for unmanaged symptoms from a serious, chronic, or terminal illness. Hospice and palliative care are the perfect partners to manage this care in the home, preventing return visits to the ER.

End-of-Life Care and the Emergency Room

ER doctors are specialists. It is their job to bring order to chaos. They are faced with serious, unplanned injuries and illnesses and need to be able to quickly diagnose the problem and take immediate action to get the patient the care they need. This is where ER physicians and their staff shine as true healthcare heroes.

That said, the ER is typically not the best place for patients who are on a less emergent end of life path. Determining life expectancy is difficult – even when you are working with a patient over time. So it is natural that ER doctors shy away from prognostication when they are only seeing a small snapshot of the patient’s condition. Because of this, doctors are often reluctant to have end-of-life discussions with patients in an ER setting.

However, some patients do not have a strong relationship with a primary care physician, so it is up to the ER physician to give them best possible information about what they can expect in the weeks and months ahead.

How Hospice & Palliative Care Support ER Physicians

Crossroads Hospice & Palliative Care partners with ER staff to provide education and options for patients who are approaching end of life. Rather than transferring patients upstairs to an inpatient room for an extended stay, it is often possible to send patients home with the support of hospice or palliative care.

When receiving a referral from the ER, the Crossroads team sends someone out the same day to assess the patient and determine if they meet the criteria for hospice care – including whether they are expected to die within six months or less if their illness continues on a typical path.

If the patient does meet hospice criteria, the hospice team springs into action making sure all the equipment, supplies, and medication the patient will need is waiting for them when they return home. The team then begins making visits to support the patient’s physical, mental, emotional, and spiritual needs.

If a patient does not meet hospice criteria, then palliative care can be a good fit to follow the patient and help them address what is needed for long-term symptom management. The palliative team of a nurse practitioner and social worker visits the patient in their home to provide care and support and works with the patient’s regular physicians to ensure their plan of care is being met.

This added support in the home goes a long way to preventing hospital readmissions for symptoms like edema, shortness of breath, and pain, which can be addressed without the need for a late-night run to the ER.

The goal of the ER team and the hospice and palliative teams is to give patients the best care and best quality of life possible. To learn more about the services Crossroads provides, please call 1-888-564-3405. 

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