On EMS runs, age-old questions defy answers
Treating the elderly has its own special skill set, the ability to navigate a bizarre question-and-answer session tops the list
By Will Wyatt
Somebody profound once said, "It's not for the faint of heart." Of course I have no idea who. But it rings true when we are talking about growing old.
A U.S. Census Bureau report from several years ago says that seniors make up 13 percent of the U. S. population. There are a lot of elderly folks in these parts.
I submit that you will not find a medic who has not made a call to a church on a Sunday morning. The reason for this is fairly simple. You have a collection of 300 or more elderly folks in one place and that means an EMS call.
Now their reasons for being there are diverse. Some are deeply religious and are there every Sunday; some are worrying about what happens in the hereafter, which is their not-so-distant future.
But during this time of gathering, somebody will fall, experience palpations in their chest or just feel bad from not taking medicine, not eating and so on.
Can you hear me now?
Dealing with the elderly can be a challenge and in most cases a marathon exercise in patience. Of course you have the physiological problems in communication such as loss of hearing and vision or even dementia making your task even harder.
However, the kicker in all of this is the fear factor. They are in danger of going to the hospital and being taken out of their comfort zone. These folks are already losing their grip on life, now you are going to take them to the hospital.
Who will take care of my spouse? Who will feed the cat? Call my son. Call my daughter and talk to them.
It's a bad situation all around. They are treated at the hospital then sent home if they improve.
If they don't improve, they are often sent to a rehab facility due to insurance rules on how long they can be admitted at the hospital. It's kind of like: You don't have to go home but you can't stay here. All the time they are hoping to return home.
In some cases a family member takes them in. I am always amazed how many hospital beds I see in homes.
Of course the worst possible scenario is the person who transitions to the great beyond at home. I can't count the number of times I have made the long stroll from a bedroom to the living room to tell a spouse of 40 or 50 years that their mate has passed.
I remember a lady crying repeatedly asking me, "What am I going to do?" It's sad to see.
In my younger days, I viewed all of this as facts of life. When you are 25 you can't imagine yourself being 50.
Then one day you look around and you're the old guy. You ask yourself where did it go?
Now I look at things tempered with age. Now I look at an elderly person being given a breathing treatment and wonder, will this be me? Is this how I will end up? Will I have to call the fire department to pick me up off the floor and put me back in my hospital bed?
One to remember
I think my favorite all time elderly person encounter really wasn't funny because a lady died. But it shows you the extreme problems you will encounter with the elderly.
We were called to a retirement community one bright sunny morning for a cardiac arrest. The community is made of primarily of patio type homes and you have to be a certain age to live there.
An elderly lady granted us entry and led us to a bathroom. Her roommate passed out on the toilet and was in a full-blown arrest. The medical event on a toilet is always pleasant.
We asked the roommate if a do not resuscitate orders existed. Well, she wasn't sure. We suggested she go and look for them.
After a quick check of the patient, we did not find a bracelet or anything with the letters DNR on it so life-saving measures were immediately begun.
Any ole answer
The roommate was still shuffling through papers and lock boxes. I called to the roommate and asked her what kinds of medical problems the lady on the floor had.
She came back to where we were working and looked at me.
Deep breathe time — the poor soul is probably hard of hearing. "Ma'am. What kind of medical problems does she have?" I asked her very loudly.
She looked at the lifeless form in front of us and looked back at me and said, "Well, I went to the doctor the other day and my cholesterol was 345. I need a shot in my knee but Medicare won't pay for it. Sometimes when I walk it grinds and really hurts …."
This went on and on for 3 to 4 minutes. I was doing CPR compressions and I had to smile. I couldn't help it. I glanced over at an associate who was assembling a tube for insertion into the lungs; he had lowered his head and was shaking it from side to side.
We asked an elderly man the other day whose roommate was in cardiac arrest what kind of medical history the patient had. He promptly responded that he was a veteran. I'm going to quit asking that question.
I know it's difficult sometimes. But remember: We will all be there someday, hopefully. Let me hear from you.
About the author
Will Wyatt, originally from New Orleans, has been in the fire service for about 30 years. Will is a captain at a fire department near Houston. He has held numerous ranks with fire departments including full-time training officer, fire marshal and deputy chief. Will holds a master firefighter certification with the Texas, an instructor certification, pump operator certification and an associate degree from Houston Community College. Will is author of the book, "And a Paycheck, Too!" Check out an excerpt here and follow him on Twitter. Contact Will at Will.Wyatt@firerescue1.com.