For those managing chronic or emergent health situations, navigating whether and when to seek on-site emergency services has become more difficult in the era of COVID-19. As the Coronavirus pandemic rolls through the United States (and the world) many who suffer from a chronic condition hesitate to access a hospital emergency room or an urgent care center for fear of exposure to COVID-19. This is an important reminder. If you or someone you love is coping with a chronic condition, you should seek (or help them seek) healthcare services when they are needed for non-Coronavirus related medical emergencies – this is how.
Give InKind spoke to Matthew Simons, an ER doctor in Portland, Oregon. Dr. Simons reminds us that accessing medical care before a crisis erupts is the best medicine and that deferred care for illness is likely to complicate the treatment.
There are a few possibly long term positive lessons of the pandemic. These could carry forward when the pandemic passes; among them, the fact that older citizens have become more comfortable with the use of integrated telemedical offerings on their hospital systems. This demographic is quickly discovering the relative ease of logging on for a consult. With this in mind:
- If you are supporting someone who may have emergent medical needs as a result of diabetes, cardiovascular issues, etc., do make sure that your loved one understands how to scroll through the hospital landing page.
- Make sure that if their primary doctor or treating physician is affiliated with a specific hospital, that your loved one begins there. Always call a primary care physician or a treating specialist FIRST using their website, or by telephone to learn what their preferred online platform is.
- In almost all cases, there will be an option to access telemedical care. If not, direct them to a reputable telemedicine platform. If one cannot access their treating physician, use a local hospital telemedical offering or a reputable telemedical offering to screen as to whether an on-site visit is necessary.
Those supporting people typically considered high-risk (older than 60, those with an underlying medical situation) should remember to ask specific questions. When asking about health questions, do not leave it at the general – “are you feeling well?". Instead, look for openings that invite specific questions. Do ask a diabetic aunt whether she has any specific concerns about wounds. Or, a parent with heart trouble whether s/he has experienced any chest discomfort. If these discussions cause any concern, help them calmly follow up.
The ER is still ready for and expects to be able to treat, people with day to day conditions. However, a patient or a loved one should explore options using telemedicine and follow the instructions given.
- The caregiver should make sure to understand the medical directions and should be prepared to help the loved one find a ride to a hospital if the telemedicine doctor has directed the patient to seek treatment. In some areas, ride-share services are temporarily suspended or are difficult to access. If you live close to the patient and have a car, you can assist them in getting there. But there are no easy answers in a pandemic and this may require creative thinking – as well as a mask, hand sanitizer, etc.
- Simons reminds that all patients and their caregivers who are directed to seek emergency care must call ahead to learn the best way to check-in for a non-COVID-19 situation. If they do not, their access experience will be more difficult and frightening than is necessary. There is no set procedure and so learning where to go is important. The telemedical doctor will either give you the information or will direct you to a number to call to learn about a hospital’s protocol.
- If you are a caregiver, you should be aware that ER doctors will listen carefully to you. Advocate for your loved one, especially if you worry that the patient might not accurately present the severity of symptoms or may be unable to accurately access subtle changes that are possibly clearer to a third party.
“I rely on family members for assessment. Family members are as sensitive a test as exists.”
– Matthew Simons, M.D.
- Because a caregiver may not be able to enter the hospital or the urgent care center, it is important that the patient information includes current (even up to the minute) contact information for a caregiver waiting outside. Medical teams are likely to call contacts in these kinds of circumstances in order to learn more about their situation at home. If you are not a relative, be certain that appropriate releases have been signed and are accessible by hospital staff.
Do not defer urgent medical care because of the Coronavirus pandemic. There are ways to access medical care – safely.
This the first in a series of articles to provide guidance as to navigating situations we continue to navigate during the COVID-19/Coronavirus pandemic. We recognize that life continues in all aspects, even the pandemic impacts all of us in profound ways. We are on your team now as well as post-pandemic – and beyond. We invite you to visit our library of situationally specific articles here.
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