Crisis Care

Crisis Care


Advocate for Safety and Oversight


Emergency room visits can be scary.

These visits can be due to a variety of reasons: falls, chest pains, urinary tract infections, or even being dehydrated. If there are more than a few visits, there is certainly reason for concern.Sometimes your loved one might just need to be told that they are o.k. by an R.N.


Oversight of medications is a vital part of advocacy.

Many years helping families get care after their loved one had an E.R. visit or hospitalization showed me a big concern: medication administration. Elderly taking more than 5 or so meds can get confused and not take their prescriptions properly. New meds may not be interacting well. Many RN’s have told me it’s about education on an ongoing basis.

In assisted living there is an attempt to keep their clients safe and eliminate other risk factors when they return. It is important that the administrator knows the latest and is up to date on the current med list.

Hospital Discharge

If there is a hospitalization and then rehab, your loved one may need more support when discharged. Strongly consider extra support the first few days after discharge.

Extra Precautions for Safety When Discharged

    1. Stay with your loved one the first few nights.
    2. Put up hand rails, lower the bed, put the walker right by the bed if needed.
    3. Any dementia means that they may forget to do what needs to be done!
    4. Bedside commode eliminates walking to the bathroom and means fewer falls.
    5. Get a copy of the current med list and have it with you.

Pitfalls of Discharge Planning

Medicare Home Health is not staffed and ready to go. I’ve seen it happen way to many times. Ask the D.P. who will be doing rehab. Contact them and make sure they have the right people and are showing up the day after they come home!

Your loved one is not safe to go home. Again, way to often. DPs go over
home care and safety issues way to quickly. Independence and stubbornness make safety difficult as well. Don’t let them leave until you feel they will be safe!

The experience is overwhelming. Studies show that the trauma of being in rehab can bring on dementia and anxiety. Understand that they may forget a lot of what was said in rehab. Re-education about their care needs on an ongoing basis may be necessary.

Medication Madness. Medication administration is such a huge issue. Older adults go home without Home Health getting a current med list. G.P.s do not get an updated med list, let alone a new diagnosis. Get your own copy at Rehab. Make sure the prescriptions are filled and your loved one has enough for a few days!

Healthcare Doctors and practitioners are not on the same page. Make sure that all the doctors involved get notified about the changes. Make sure they all have a current med list.

The full picture has not been revealed. DP’s oftentimes don’t know the half of it. There can be so many other safety and dignity issues that do not get addressed. If you really want to know how your folks are doing, go stay a week with them!

Tough Diseases Deserve the Best Specialized Care


I have found in Assisted Living that there are administrators and care givers who have backgrounds in specific diseases. A physical therapist now owns a small board and care; an R.N. owns a small A.L. home. Anytime there are pros with the experience you’re looking for, its a huge plus.

There are specialists for Parkinson’s, Diabetes, C.O.P.D., and many others.

Not just Doctors, but non profits, care givers, and healthcare providers who are passionate about helping people with certain diseases.

When you factor in that many older adults have multiple diagnoses, it’s critical that the providers are specialists in their area of need. For example, the LOUD program for people with Parkinson’s can significantly help a patient’s speech, and the pain specialists at certain hospitals can help with certain chronic conditions.

Questions to ask when interviewing providers –


Is this your area of expertise?

Have you had other clients with this disease?  What was the outcome?

Ask the owner/administrator, “What would your care plan look like if you took care of my Dad?”

What kind of training does your staff have for treating this disease? Is it ongoing?

Are there any support groups, free medical equipment, or anything else specific to this disease I should know about?

Who will be acting as case manager? Who is my main contact to address concerns? Who will tell me about any new advancements?

What is my Mom’s Medicare benefit for rehab?

Would you be willing to do “in-service ” training for your staff from an expert?

More areas of concern to consider when in Crisis Care mode.


Re-educate about the new treatment plan.Hospitals have transitional care teams for patients who have reoccurring hospital visits. They send RN’s to the house to continue the education process. Knowing the process to understand how to take care of your loved one’s disease is critical and takes time. Make a plan so your loved one has the same! Emotional support can be just as important.
Both at home or in Assisted Living.Confer with the administrator at their Assisted Living about nighttime staffing.  Are they awake? Asleep but on call? What is the new care plan that will address their functional fitness and their emotional support in the evening.
Nighttime confusion and dementia.Falls at night after returning from the hospital or rehab are prevalent. Every precaution concerning safety in their environment must be looked at. As little, or no walking at night may be needed.Dementia, even not detected, can creep in. The experience and meds are enough to cause poor decisions.

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