What You Need to Know Before an Unexpected Hospital Trip

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What You Need to Know Before an Unexpected Hospital Trip

Have you called for paramedics before? What happened the first time you dialled for emergency services when there was a crisis concerning the person you care for? What did you grab? Did you go in the ambulance? How long were you in the emergency department/accident and emergency department?

Before my father died in January 2020, I lost count of the number of times I dialled 999 for an ambulance in the middle of the night for him. He experienced several atrial fibrillation episodes, cardiac events, and a couple of bad falls. Congestive heart failure, rheumatoid arthritis, cancer, along with vascular dementia, and organ issues. All these health issues meant we were walking on eggshells; hypervigilance was our norm.

If you’ve cared for someone with congestive heart failure and compounding health issues, you’ll know how tricky things can be. We had to figure out what to do with what circumstances, what worked for Dad, and how to recognise when things were escalating.

This untrained, non-medical carer took the lead in emergencies time and again through trial and error. An emergency doesn’t start when you pick up the phone; it starts when you sense, very literally, that something is wrong. Do you, don’t you call for paramedics? A loud crash and thump is a faster 0 to 100% adrenaline and call compared to trying to decipher a nuanced change when they’re already very weak.

The hardest, most heartbreaking moments were having to argue with Dad about calling for the paramedics. He didn’t want to go to the hospital, and we didn’t want him admitted to that hospital either, but some events require hospital intervention.¹

I’m sure there are people curiously wondering, ‘Why can’t you just pick up the phone and get the ambulance?’ The shortest answer is that nothing is that simple, cut and dry, explicit or easy to decipher. Will the symptoms subside and calm after…how many minutes, a few, an hour? When do you counter someone’s wishes? Having vascular dementia doesn’t automatically switch off their mental capacity, nor would I want it to! So, here in the UK, as attorneys of Dad’s Health and Welfare, we always acted per his wishes (the Lasting Powers of Attorney (LPA) for Health and Welfare). So, how do you decide whether to call the paramedics at 1 am, when someone can still express their wishes and has mental capacity? I can only recommend starting to discuss ‘wishes’ now, getting the paperwork done, and seeking advice from a doctor/expert. There is no cookie-cutter answer. Sorry! For example:

• UK - When to call 999 and what happens in the call.

• US - The American Heart Association - when to call 911

• Canada - Heart and Stroke Foundation of Canada When to call 911 Emergency signs

Two weeks after Dad passed, we pivoted to my mother’s cancer surgeries, one after another, and then chemo, and then radiotherapy. So, I’m a seasoned ambulance passenger, a primed ER-cubicle camper; a carer based in the UK.

The shortest wait time in the emergency department was 6-8 hours with a subsequent discharge home. The longest was from 3 am to my Dad’s admission to a ward around 4 pm. And that was only the start of that hospitalisation journey.

Contrary to popular belief, a carer’s work doesn’t end at the door of a hospital. When the comfortable care routine is lost to a crisis, we suddenly have to dial UP our roles as the shield, the buffer, the translator, and the advocate for our loved one, their needs, their rights, AND our own!

Reclaiming some control in an emergency: 2 Go-Bags and a To-Do list once admitted

Having been in many emergency situations, we’ve developed a process that works for us. It may help you too

What worked was having one hospital go-bag for my parent and one for me. Each had its own purpose and essential contents.

The aim: to keep us comfortable for 8-12 hours, or longer if absolutely needed; to be ready for admission.

The benefit: I know the bags are always ready, primed for grab-and-go. A piece of control and calm amidst the escalating crisis. Something I can literally cling to when I’m having PTSD flashbacks of every previous ambulance trip, and walking that same hospital corridor.

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Click here to sign up to receive “Go-Bag and Admission Checklists.” This contains 3 checklists that you can download for free using this link

I want you to have these, so you're primed for an emergency. These are NOT random lists of items. They’re curated checklists I use to pack and repack what we need in these crises. Each item and action has a story.

For example, a water bottle and a plastic straw. It’s not easy to give someone water when they’re lying down on a hospital bed. It dribbles out the side of their mouth, making everything wet. One health assistant tried to be helpful by getting a paper straw from the nurses’ station. But after a short time, the straw became wet and mushy, making it impossible to drink. A plastic straw stays intact.

Every essential item has a purpose. These insights need to be shared.

I recommend reading each checklist in detail to see how they link together.

Next steps

1. After reading the checklists, please comment below. What are your learnings from an emergency situation? What questions do you have?

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1. Dad was palliative but not labelled with ‘end-of-life’, meaning all medical treatment was aimed at making him comfortable and stable. Aligning on which actions will be taken in specific circumstances, with your doctor's support, can relieve a lot of the angst and stress. For the majority of paramedic calls, Dad had to be admitted to the hospital (2015 - 2019). However, in the second half of 2019, we discussed how and when paramedics might stabilise his heart, then check with the on-call doctor, and support our collective decision for Dad to remain at home. Ask the questions and walk through the ‘what happens when’ step-by-step actions so you can communicate effectively with the paramedics/doctors and advocate for your loved one’s wishes, under pressure.