Hi all. I had a recent experience that I wanted to share to see if anyone else has ever had the same problem. In late April 2022 I called EMS to my house where I am the primary caregiver for my mother. She had a UTI that progressed to urine that was the color of iced tea. She was not drinking or eating well, and showed the typical confusion/agitation. When EMS arrived, I gave them a rundown including a summary sheet that contains all her health history, medications and insurance information. I told them the infection had progressed and was very concerning and that she likely needed IV fluids and medication for it to not progress further. I am her financial and medical power of attorney. They began their assessment and took vitals etc. Then they began asking her what she wanted to do. All of that was fine. I tried to let them do their job but it got absolutely stupid fast. They asked her who the President is - she knew. They asked her her name and DOB - she knew. They asked her where she was - she knew. But what they seemed to completely ignore was that she is 95, definitely had a UTI, did not understand how sick she was, can’t ambulate, and was not able to make a rational decision based upon her symptoms and condition. If you ask my mother if she wants to go to the hospital she will never say yes. Who would? If she could get in my car I would have left them there dithering about what they should do - making calls to superiors - etc. But, she is completely immobile. Can’t even stand. Now I have some experience here. At one time I was a volunteer EMT with an emergency squad. I know you can’t just kidnap someone and take them to the hospital. But you can use sound medical judgment based on facts and circumstances. I gave them plenty of medical reason to transport her and gave them legal cover by making the decision as her POA when she was in a state where she could not make a medically sensible decision. They finally took her to the hospital taking the absolute longest route possible on two lane roads and getting stuck behind multiple school buses. They did not do that on purpose - they were lost. When we finally got to the hospital they inexplicably turned into an apartment complex across the street. When they realized their mistake we sat at the longest red light ever which I swear they let cycle one time when it was green. When we finally got there I asked the driver why he took that route. Turns out he lives in another part of town and was unfamiliar with area we live in. I had offered to ride in the cab to help with directions but they turned me down citing COVID. The same county ambulance service allowed me to ride with my mother in June 2021 when COVID was worse. It helped keep her calm. I know it is not a perfect world, but they almost didn’t take her which likely would have caused fatal consequences. She was very sick and had to stay in the hospital for 8 days because the bacteria required a drug that could only be given by IV. I know my mother. I am her POA. I have medical training myself. I do not call EMS easily or often and do not use them as a transport service. These three initially showed the judgment of twelve year olds and were likely not much more experienced than that. Thank God it was not an emergency where time was of the essence. Yes I am venting because caretaking is hard enough without nonsense like this.
They have probably had it drilled into their thick heads that EMT's do not have legal authority to transport a patient if the patient is not willing...(except if the patient is unconscious, in resp. distress or bleeding profusely, in which case they might call police..) They could be in legal trouble if the patient complained.
I dealt with this once when a 95 yr. old neighbor came to my door (I'm a nurse) complaining of not feeling well. She did not appear acutely ill but due to her age I was concerned. I called paramedics. They offered to take her to the hospital for tests. She refused! And I couldn't talk her into it.
Since she is a friend, I kinda got in her face and said "do you want me to stay up all night worrying about you? If you go home and something happens to you, how do you think I"ll feel?" I tried to sound really stern. She still seemed hesitant. I said "will you do it for me?!...PLEASE.
She finally went.
Annoyed as you were, you did the right thing. You can't help it if they didn't seem too smart. No matter how things turned out, you stayed with her and did what you could do. She'll probably forgive you...maybe even thank you. If not, oh well, you did what you had to do.
And not knowing where they were going in what could have been a life and death...all EMS drivers should have an idea where the the hospitals in their town are located. GPSs do seem to take u the long way around. I live where an interstate, a turnpike and a major road to the shore meet. The road to the shore is 5 min from my house. I needed to go to a town I was not familiar with on the road to the shore. The GPS took me 30 miles out of my way on the interstate and then brought me all the way back down on another road to intersect with the shore road that was literally up the road from me.
I would call and talk to a supervisor and explain that you know its been over a month but as a professional it has been bothering you. Don't accuse, ask if this is normal protocol when dealing with a possible UTI.
By law, with a competent senior, EMS has to ask the questions they asked and find out the answers from Mom. Your POA comes to the fore when she cannot answer the questions they are asking.
Clearly a new crew and know that for what they have to see, for what they have to DO, EMS is often not as well paid as they should be,often in training to be RN or other medical, and often leave the job. This turnover means you can come up to the crew who is new. Or NEWCREW.
Good luck in avoiding them next time.
For the most part my long experience with EMS is that the patients love and appreciate them ("They were so KIND"), but you do have these experiences. And you are stuck. Can't take your business elsewhere.
Hope Mom is doing well.
I would follow up though, with a thoughtful, insightful and helpful letter to the transit company, addressing the dilemma and suggesting that it might consider a few changes. If this occurred in an actual emergency, it could have resulted in a fatality.
1. I'm surprised (or perhaps am assuming) that the vehicle wasn't equipped with some type of GPS system to help locate a more direct route.
2. I've experienced unqualified but non EMS service once, in ambulance transit from a disastrous rehab to a better one. I suspected the driver drove 10 miles over the speed limit (as I was following him as I didn't trust him) and took a longer, more rural route b/c he was annoyed that I transferred my father out of the facility which was owned by a hospital, as was the ambulance service.
3. I wish I'd gotten the name of the roundabout driver so I could have reported him to the service.
I would contact the owners of the service directly, with a gently helpful analysis of the situation and suggestions on how service could be improved. That would obviously include training of the personnel. And that makes me wonder if in fact the personnel weren't trained EMS? I thought that EMS transit people had to be trained, but I began to wonder as I read your post.
EMS was just following their protocol.
Now, if your mom was in a truly immediate life threatening situation, I would understand your frustration / anxiety with the length of time it took to get there.
You asked if your being too critical .. a bit , yes….
The bottom line is your mother eventually received the care she needed, and is hopefully doing better now, despite the hesitation on the EMT's part to take her to the hospital and them not knowing where they were going.
I know that you can't make this stuff up, as crazy as it sounds, but I'm willing to bet that every one of us caregivers have stories pertaining to our loved ones care that we're caring for or have cared for that could probably top yours.
Sadly it comes with the territory, as we all want the very best for our loved ones, and will do whatever it takes to make sure they receive the very best, even though we often have to settle for less than the best.
I'm glad you were able to vent. That's what this forum is for, as all of us who have or are caring for someone, knows just how hard and stressful it can be, and the importance of being able to vent.
So vent on any time you want. It's a safe place to do just that.
PS - in the category of “what else” all three of us got COVID over the Memorial Day weekend. My husband, me, and my mother. Thankfully we seem to be making it through what feels like a sledgehammer of a flu. You are right - you can’t make this stuff up!