I had an interesting opportunity last month. A silver lining of sorts in a rather terrible experience. I accompanied one of our participants to the emergency room after she lost consciousness at the center. She came to before the ambulance left, but she was very confused, felt very ill, and her family was unable to get to the hospital. I went thinking I would get her settled and then return to work, but it didn’t work out quite that way.

It became very clear to me after a very short time, that I could not leave her unattended in the ER. At times she was unable to even state her name. Every staff person that entered her room asked her for information she simply didn’t possess. With each interaction, she became more confused and more fretful. I couldn’t in good conscious leave her there alone.

I have been in the ER on a number of occasions with my own family members and even as a patient myself. I have never been in the ER with someone who is completely dependent, utterly confused, and truly in a panic. For the patient with a fairly healthy brain, the experience is confusing, and so very time consuming but it makes some sort of sense and is a necessity you can deal with. For the senior with dementia, it makes no sense. As quickly as they can process that they are ill and in need of medical help, they forget. Over and over, they forget. Each person that enters the room with questions or treatments starts the wondering process all over again; and with the wondering comes questions, anxiety, and fear.

To experience the emergency room visit with our participant made me so much more aware of the shortcomings in our system, the short comings in professional training, and the dis-service we provide with the best of intentions. Some of the staff was very kind and patient while others were blatantly irritated or clearly ignorant of the realities of dementia care. As I sat there, I kept wondering: what would happen to her if she was alone? Who would answer the staff’s questions? Who would remind her to stay in the bed and not get up by herself? Who would have helped her to the bathroom every time she had to go? Who would have helped her to take a drink? Who would have reassured her she would be ok, over and over and over again? As I looked around the ER I saw so many seniors who were there alone. I wondered the same thing about them. Is the doctor getting the information he needs to help them with no one there to share accurate information? Are they really getting the care that they need if no one is there to advocate for them? Are they safe without someone to watch over them?

If your loved one goes to the ER, please go with them or designate someone in your place to accompany them. If your loved one is able to speak for themselves, you will help reinforce their independence and capacity (in a system that often ignores that some seniors are still very much intact and capable of speaking for themselves). If they can’t, you will be their voice, which is needed in a medical system that doesn’t always hear. You will be their eyes in a medical system that doesn’t always see. You will be their light in a place that is very dark and scary.