Getting Lost In The System

Originally posted

And I don’t mean figuratively, I mean literally.  I heard two stories this past week of two elderly individuals who are both quite compromised with dementia.  One lives in a retirement residence and the other lives in her own home with care support.

In both instances, they had a fall and their caregiver called 911.  The ambulance did not allow their caregiver (PSW) to attend with them.  They were bundled off with their health card and a phone number on a piece of paper.  The ambulance told the caregiver in each case, that they were going to hospital A.

Now fast forward to the family member who called the emergency department of hospital A only to find out that the person in question never reached that hospital.

Worried and anxious they started calling other emergency departments.  Several of the hospitals they called refused to even answer their question citing privacy issues.  The 90 minutes it took to finally locate their loved one, seemed endless. This reminded me of my own similar situation several years ago when I received an early evening call from a distraught client (who was in a rehab setting)  that her elderly sister (age 94) had not arrived to visit her as she had daily for the previous eight days. I had no idea what had happened, so I called the property management company of the apartment building where she lived, who called the superintendent who agreed to go to her apartment to see if she was there.  Fortunately she was not there, although I certainly had thoughts of her lying unconscious on the floor.  I then called the non emergency police number and explained my situation and asked if they had received any 911 calls from her building and if they had attended to her.  I took a while until I was able to locate her at an emergency department where she was receiving treatment after having fallen on the sidewalk outside of her apartment building.  My client was able to communicate (although she could not recall the name of the rehab hospital were her sister was receiving care); however in these two other situations, the older person had dementia and was not able to express themselves. Can you appreciate the angst and worry of these families?

In both of these cases, this could have been avoided if:

  1. The caregiver was able to either attend with them in the ambulance or allowed to follow them to the hospital OR
  2. If the paramedic was able to call the contact number once they knew they were not going to hospital A and were rerouted to hospital B OR
  3. If there was a patient/family contact in the emergency department who could have called their contact phone number.

This past week, (April 28, 2021) the Ontario government announced that hospitals were now able to discharge patients to any long term care facility without their consent.

“Ontario will begin moving chronically ill hospital patients out of hospitals and into long-term care homes without their consent to free up space for COVID-19 patients, the province announced Wednesday. With an amendment to the Emergency Management and Civil Protection Act, the province will be able to move hospital patients to long-term care homes or retirements homes, provided their doctor agrees their medical needs can be met in that setting, without the patient’s consent or the consent of their substitute decision maker.”     It would seem that these patients have lost their rights.   What about those patients with dementia? Who is looking out for them?

Imagine how awful this scenario will be when there is no involved family or when no contact name is available.  A very unfortunate and sad situation and one I hope will be challenged and changed.


Leave a reply