For vulnerable, an ER visit is frightening

Better system needed for elderly and compromised, says Suzanne Westover.

My mother is 82. But she wants you to know she doesn’t look a day over 70.

Since the onset of the pandemic, she’s been scrupulously self-isolating. The phrase takes on a whole new meaning when you’re a widow. It’s a long and lonely road, punctuated by the latest British detective release streaming on Netflix and bimonthly wine deliveries courtesy of Dial a Bottle.

She’s on sabbatical from her book club of 40-plus years, her lunch dates are on hold indefinitely, and she hasn’t had her hair done in five months (for those who know her, this is a monumental sacrifice). My brother and I are equally cautious given we’re her primary support network.

Even as the rest of the province began to reopen, those in the elderly cohort are consistently told to stay at home and stay safe.

Given that this advice comes directly from the medical community, it seems ironic and inexcusable that these same “vulnerable” people have no choice but to potentially expose themselves to the virus to obtain routine medical care.

My mother’s primary care doctor took vacation in July, and an eye infection she’d been battling got progressively worse. Left with few options, she elected to seek emergency care at the Queensway Carleton. She waited more than five hours in a busy emergency room to receive antibiotic drops. How are we not making provisions within our system of care to triage especially vulnerable populations, like the immunocompromised or elderly, to ensure that meeting urgent medical needs doesn’t require compromising the protocols of self-isolation?

Even if one argues that the risks are low in hospital emergency rooms given mask-wearing and hand hygiene (though little physical distancing, according to my mother), that does nothing to mitigate the perceived risk and the attendant anxiety my mother felt at the extended duration of her exposure. The full waiting room seemed doubly crowded after months of being completely removed from group gatherings.

To add insult to injury, the eye drops she was given caused an allergic reaction, which required a further five hours at the General Hospital’s ER. These visits finally culminated in a referral to the hospital’s dedicated eye clinic, but they took a very real and unnecessary toll on my mother’s mental health. Not least because she felt compelled to avoid even those within her bubble for the two weeks following her visits, lest she’d been exposed and risked transmitting the virus to us.

As my mother says, “you can’t un-scare people.” After months of being told to avoid groups — literally on pain of death — going into the ER felt very much like engaging in risky behaviour.

It’s not enough to mount a public awareness campaign urging people not to neglect health concerns aside from COVID-19. We need a reason to trust in the system of care.

The precautions can’t just be in place, they must be perceived to be in place by the people who are accessing the services. That could entail online check-in to the ER, with real-time updates so people know when to arrive. It might be even simpler, allowing people to wait in their vehicles or providing a virtual consultation to ascertain if a visit is necessary.

Maybe we require a more in-depth overhaul, with hospitals dedicated to infectious diseases, or clinics specifically to serve those who are vulnerable. Just because something has always been done a certain way doesn’t mean it can’t be done better.

Surely the best and brightest minds in health care can devise ways and means to ensure that an ER visit doesn’t do more harm than good.

Suzanne Westover is the manager of strategic communications and a speech writer at the Mental Health Commission of Canada.