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Should a person who repeatedly calls 911 EMS due to health problems, be required move into a nursing home?

where their medical problems can be more easily addressed?

Aside from the cost in tax money to send EMS to frequent users, there is also the repeated tying up of EMS services, necessitating the need for out of area crews to help cover other runs.
This person is on Medicare/Medicaid. No private insurance and no income.

As tempting as this sounds, it's not a good solution. I'm a paramedic, and our most "frequent fliers" (people who call EMS frequently) are usually from nursing homes. Nursing homes are great for people who, due to their health, are unable to care for themselves, but if they have any acute medical conditions, the nursing staff will call for the paramedics to transport, anyways.
The solution to "frequent flyers" isn't in requiring them to move into a nursing home (which would also be paid with by tax dollars).

You need to look deeper into the problem with this specific person. Why is this person calling EMS?

Is it because of issues with living independently (is the person falling, having issues with taking medications correctly, is in poor health because they can't cook for themselves or bathe by themselves)? If so, a nursing home might actually help, because they will have help with activities of daily living. Another option might be for a home health nurse to come by weekly and check on the patient. Other options might be to give the patient an aid for walking (wheelchair, cane, walker) and inspect the house for fall hazards. Placing the meds in a weekly medication organizer (with the tabs for Monday, Tuesday, etc) might prevent errors in self administering meds.

If this person is calling 911 because of a chronic health condition that has become acute (COPD or CHF exacerbation, diabetic emergencies, etc), then the patient's doctor needs to be consulted. Better disease management might be in order. A change of medications, better disease education for the patient, dietary counseling, etc, all might be in order to prevent acute symptoms.

Some people call 911 just because they are lonely. They have serious chronic medical problems, feel alone and scared, and call for help. If this sounds like your person, it might help to involve the person in clubs, organizations, or other fun activites. The patient needs more support than he's currently getting in the community, and maybe he just needs a friend.

A good first step might be to talk with the patient about what's going on. Tell him that you are concerned about all the emergencies he's been having, and ask what you can do to help.

I'd also like to mention that we in EMS don't really mind "frequent flyers" who have a genuine medical need. What gets on our nerves are the patients who aren't really sick, and are just using us to get insurance money from a car accident, or to get out of work the next day. No matter what the reason, I'm always glad to do what I can to help my patients, even if their family and friends think they don't need to call 911.

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This entry was posted on Saturday, December 18th, 2010 at 12:23 pm and is filed under lab equipment worksheet. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.