One standard piece of advice regarding trips to the ER can actually pose  dangers for older adults. “They say bring all your medicines with you in a bag, but the nurse in the ER won’t know which, if any, you’ve discontinued. So the staff makes sure you get everything in that bag— which is why medication overdose for older patients in ERs is often a problem,” Taler says. Estimates are that there are up to 450,000 medication errors in hospitals annually.

Other aspects of the environment pose dangers. “Older adults generally don’t have strong immune systems. So you might go for a relatively mild problem, like bad heartburn, and end up catching the flu,” says Tucker Woods, vice chair of the emergency department at Long Island College Hospital in Brooklyn, N.Y.

Why are they coming?
“Too many older people use the ER as a substitute for a PCP. Sometimes lack of insurance makes it necessary, but even people with coverage find doctors’ shorter in-house hours just one of many issues that steer them to the ER instead,” Brandwin says. “Lack of transportation is a major reason we see many older adults in ERs,” Woods says. “They can’t drive themselves and they may not have family, friends, or a car service. An ambulance is their only option, and it won’t drop them off at their physician.”

Ways to stay home
“There are still some areas where doctors make house calls. If not, see if one of the local hospitals has an  emergency call number with health professionals who can talk you through your symptoms. They will tell if you really need emergency help; otherwise, they can provide advice to keep you home until you can see your doctor,” Taler says.

If you have a primary care physician, always call him or her before 911.  Nobody knows you better than your PCP. Even if he’s not available, the doctor who’s covering may have access to your records electronically. Remember that down the road, your PCP is at a disadvantage if he doesn’t know you were sick,” Woods says.

When it is an emergency
When you do go to an ER, be as prepared as possible. “Bring a list of all the medicines you currently take and your current medical history. Also bring your doctors’ phone numbers so the ER doctor can contact your physician,” Woods says.

“I’ve seen patients come in with a folder that contains this information, which definitely helps,” Woods says. Erickson communities use electronic medical records, and Brandwin encourages patients to either keep a copy or let the ER doctor know those records are available through the Erickson Health doctor on call.

Set up a system now that recognizes you may not be at your best once you get to the ER. You need someone for whom you’ve agreed to advocate for you—a family member or a friend—to answer questions. They should have your medical history plus any paperwork regarding your wishes about life-saving measures and other health decisions you have made.