How seniors can avoid the emergency room — and what to do if they end up there
No one wants to end up in the emergency department of a hospital. While you can’t prevent all accidents and health emergencies, you can improve your odds of avoiding them. 

No one wants to end up in the emergency department of a hospital. While you can’t prevent all accidents and health emergencies, you can improve your odds of avoiding them. Here are some research-based tips for protecting your safety and health as you age:

1) Remember those check-ups: See your doctor regularly and make sure you’re up to date on recommended tests and screenings. Discuss any health issues you’re experiencing, such as vision or hearing difficulties, balance problems, dizziness or feeling faint. Ask your doctor or pharmacist to review medications you’re taking for possible conflicts or side effects.

2) Don’t put off care: If you have unusual symptoms, don’t wait until your annual check-up to consult your doctor. Symptoms such as unexplained weight loss, fever, fatigue, unusual bleeding, skin changes or odd bowel movements can signal disease. Catching and treating the problems early could help prevent life-threatening consequences later.

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3) Check your eyesight: Vision problems can increase your risk of falling. Have your eyesight checked by a professional at least once a year.

4) Go easy on pain medications: Regularly popping prescription or over-the-counter painkillers such as ibuprofen has been tied to an increased risk of heart attack and stroke. Don’t take pain pills unless you have to and, if you do, stick to the lowest dose possible.

5) Keep moving: Exercise is a powerful tool for improving and maintaining health as we age. Walking, dancing, exercise classes and other physical activities can boost cardiovascular health, strength, flexibility and balance, reducing the risk of health problems and falls. Ask your doctor what kind of activity is best for you.

6) Fall-proof your home: Loose rugs, bad lighting and slippery floors or bathtubs at home can all present a fall risk. Remove rugs or fix them to the floor, install bright lights where needed and consider putting up handrails in the bathroom and along stairs. Visit SanDiegoFallPrevention.org for a list of home modification programs for seniors and people with disabilities.

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7) Get enough sleep: Studies show getting less than six hours of sleep a night almost doubles your risk of heart attack and stroke. Try to get between seven and nine hours of sleep per night. Almost half of seniors experience insomnia. You can help improve your sleep by getting regular exercise. And work with your doctor if you have a medical condition that’s disrupting your sleep.

8) Make friends: Loneliness can increase your risk of functional decline and early death, studies show. Keep in touch with friends and family, get to know your neighbors, participate in social activities at your local senior center, attend a class, volunteer or join a club or special-interest group. Even interacting with friends online can help you live longer, according to a UC San Diego study.

9) Adopt a pet: A four-legged friend can help ward off loneliness and keep you physically active. Some studies have found that owning a pet reduces anxiety and lowers blood pressure and heart-disease risk.

10) Eat healthy: Keep a balanced diet made up of nutrient-dense foods such as fruits and vegetables, whole grains, fish and nuts. Limit consumption of sugar, salt and processed food. Healthy eating may reduce the risk of heart disease, stroke, Type 2 diabetes, bone loss and some kinds of cancer.

Of course, staying out of the hospital isn’t always possible. These pointers can help minimize problems during and after you or a loved one visits the hospital or emergency room:

* Bring items you need: Take items such as glasses, hearing aids and dentures. Being able to hear, see and eat properly at the hospital helps reduce the risk of delirium. For comfort, it may help to bring familiar objects from home such as family photos or a favorite blanket or book.

* Know your meds: Doctors need information about all the medications you’re taking — including over-the-counter pills and supplements — to identify possible side effects and avoid prescribing the wrong drugs. It may help to bring your medication bottles with you to the hospital (or get a friend or relative to bring them).

* Have information ready: Create a “medical information sheet” you can take to the hospital. List allergies, known medical conditions, names and phone numbers of your doctors, and your usual pharmacy.

* Say no to sedatives and tranquilizers: It’s common for older people to become confused and delirious in the hospital, which can further damage their health. Sedatives and tranquilizers — even mild ones such as Benadryl — can increase the risk of delirium. Try to find ways to relax without drugs, such as listening to music, drinking a cup of herbal tea or talking with a loved one.

* Bring a loved one: Having a family member with you at the hospital is both comforting and helpful. Your loved one can speak up for you if you’re in need and be there for you if you get confused or require help getting to the bathroom. They can also listen in when the doctor is giving instructions on what to do after you leave the hospital.

* Get some sleep: If you spend a night or more at the hospital, try to maintain your regular sleep schedule. Ask the nurse if you can avoid blood-pressure checks during the night, and don’t take sleeping pills as these increase the risk of delirium. If possible, try to get a room with natural lighting.

* Move around: If you’re staying in the hospital for awhile, get up and move around (if necessary, with the help of a nurse or family member so you don’t fall). Spending too much time in bed can lead to physical decline.

* Create an advanced directive: These legal documents allow you to appoint a representative such as a family member to speak for you if you can’t speak for yourself, and to specify the types of treatments you’re willing to receive or not if you become incapable, such as CPR and mechanical ventilation. Keep in mind that emergency medical personnel cannot honor these requests until they’ve stabilized a person for transfer to the hospital. Advanced directives vary by state. Visit www.caringinfo.org for more information.

* Plan for when you leave: Ask hospital staff if they have special planners available to help you plan your departure from the hospital, including whether they’ll be communicating with your primary care provider about follow-up care. Ask about what medications to take or avoid, and how to get help if you need it after returning home. Ask for this information in writing.

Boyd-Barrett writes for the Center for Health Reporting at USC’s Leonard D. Schaeffer Center for Health Policy & Economics.

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