Crisis Intervention

Aging With Dignity is also able to help in medical emergencies. First we’ll establish an emergency protocol before an event happens – who gets called, ensure that the client has completed an advance directive (any written health care instruction specifying your wishes or naming a health care proxy). Advance directives include both health care proxy forms and living wills. These are legal documents which dictate, only when the person has been determined to lack capacity, what forms of care should and should not be given, and identify who the client’s health care proxy is – the person who is able to make medical decisions on the client’s behalf if the client is unable to do so.

The MOLST (Medical Orders for Life Sustaining Treatment) form is available to all New York State residents. This is a medical document which conveys a patient’s wishes regarding cardiopulmonary resuscitation (CPR) and other life sustaining treatment. The MOLST form contains actionable medical orders that are effective immediately on a patient’s current medical condition. It contains valid medical orders and are the same as any medical orders followed by health professionals. It is intended for patients with serious health conditions who want to avoid or receive any or all life-sustaining treatment, residents in long-term care facilities or those who require long-term care services, and/or those might die within the next year.

The MOLST form is the only authorized form in NY State for nonhospital DNR and DNI orders as well as being honored in a variety of health care settings (home, hospital, long-term residence).

If there is an emergency that requires the client needs to be taken to the hospital, we will:

• Assess and determine the best course of action in consultation with the client’s physician, home health aide and family members.
• Meet the EMTs at client’s home and ride alongside the client to the hospital and/or meet them there.
• Encourage EMTs to take client to the preferred and/or most appropriate hospital
• Ensure all proper documentation (insurance, medical, legal, advanced directives, etc.) is produced to the hospital staff and that client’s medical history is properly conveyed.
• Help to advocate and work with hospital administration to expedite treatment so that client is not kept longer than necessary in the ER or under observation.
• Encourage hydration or food intake, if client is cleared to do so, if the wait is significantly long to begin assessment of needs.
• Alert home health agency (if required) to send a home health aide to the hospital vs. client’s home or, if nothing is in place, obtain coverage so that the client is not alone should they need the support.
• Getting updates from the ER physicians to make sure the client is being treated in a timely fashion.
• Working with families to provide updates of their loved one’s condition and determine the best course of action moving forward.
• Help with transitioning the client from the ER to the next step for recovery.