Of course, if it’s an emergency call 911 and let the concierge know of your call (or have them call 911). But often, it’s not a 911 issue. What about having a concern about COVID symptoms or a urinary infection or other non-emergent concerns? It’s 10 AM on a Sunday morning and your doctor’s office recording advises you to go to urgent care (which may be at Northgate or University Village).
One resident recently solved the problem by having a home visit from an In Home Urgent Care provider called DispatchHealth (click on the link to visit the web site). She was visited by a nurse practitioner, had an on site quick lab test and a specimen taken for culture. Her insurance was billed and she had a co-pay of $35. The cost is similar to a visit to urgent care and much much less than an ER visit. The DispatchHealth visit can be booked by phone or on-line.
I have no personal experience with DispatchHealth and would appreciate any comments from others who have used them.
This situation is a direct consequence of TA policy. Torsten et al refuse to allow Terraces nurses to respond to urgent requests from Independent Living. I have been pursuing this for 11 years now, having known how well Horizon House handles sub-emergency situations.
By Skyline offering no intermediate between first aid and lights-and-sirens,
we are setting up problems for those who are reluctant to declare an emergency
over something strange that isn’t getting better. Such residents would like to talk
to someone knowledgeable first.
My mother was such a case at age 92, living independently in Horizon
House, when she could not get to sleep because she felt strange. After
several hours, she called the front desk and was connected with the
night nursing supervisor. My mother could not really explain what felt wrong and the
nurse decided to come take a look. Arriving in three minutes, she soon
suspected (correctly) a stroke and called 911, then called me in Phoenix.
I can guarantee you that my mother would never have called 911 and, had she
lived here at Skyline under present management, she would have avoided
phoning the front desk–knowing that they would automatically call 911 and
subject her to the discomfort of transport and long hours in an emergency room.
She would have waited until morning when, given how things progressed, she
would have been unable to call anyone. My mother had little experience with
emergency rooms, merely a horror of causing people so much trouble (stopping traffic en route, etc.) over what could be flu or an upset stomach. Others of us may have additional reasons, valid or not, for hesitating.
My point is: since there are always RNs on duty in the Terraces, there is
really no excuse for not copying the procedures at Horizon House. Nursing
supervisors, with more of a roving brief, would be a logical choice for occasional
calls, day and night. Most will take no more time than a coffee break.
There has been a big push to treat stroke symptoms as an emergency, given the
first-two-hours window of opportunity for the anticoagulant therapy. But fewer
than half the stroke patients are going to have such classic signs as a weak arm or a
numb leg. “Feeling funny” is all the others may be able to describe, yet they
too need diagnosis and treatment in that two-hour window.
We are going to lose some of them if they
cannot talk first to someone who can
make the declare-an-emergency decision
for them. That’s one of the services that
CCRCs ought to be providing via the RNs
already on staff.
—W. H. Calvin 2014