A man sobbed in a New York emergency room. His elderly wife, who suffered from advanced dementia, had just had a breathing tube stuck down her throat. He knew she never would have wanted that. Now he had to decide whether to reverse the life-sustaining treatment that medics had begun.
Dr. Kei Ouchi, then a resident at Long Island Jewish Medical Center, had no idea what to say. The husband, who had cared for his wife for the past 10 years, knew her condition had declined so much that she wouldn't want a heroic rescue. But when Ouchi offered to take out the tube, the man cried more: "She's breathing. How can we stop that?"
As the nation's elderly population swells, more older Americans are visiting the emergency room, which can be an overcrowded, disorienting and even traumatic place. Adults 65 and older made 20.8 million emergency room visits in 2013, up from 16.2 million in 2000, according to the most recent hospital survey by the Centers for Disease Control and Prevention. The survey found 1 in 6 visits to the ER were made by an older patient, a proportion that's expected to rise as baby boomers age.
ER doctors questioned how they could handle delicate end-of-life conversations for patients they barely knew. Others argued the ER, with its "cold simple rooms" and drunken patients screaming, is not an appropriate place to provide palliative care, which tends to physical, psychological and spiritual needs.
"Our default in the ER is pedal to the metal," said Dr. Corita Grudzen, an emergency physician at NYU Langone Medical Center who studies palliative care in the ER. But when doctors learn after the fact that the patient would not have wanted that, the emergency rescue puts the family in the difficult position of deciding whether to remove life support.
Read more about this at an article written by Melissa Bailey for Kaiser Health News at https://feedly.com/i/entry/n8Sq+QUxB4R3DsjqjSAWldNzREpUpFN4xwjWEum0Pfk=_15c449e1aa1:2e3eb5:97e9e09b
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