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

Question

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.

Answer 1

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.

Answer 2

Regardless of a persons "insurance", if they are in need they should call EMS. The EMS system is there for a reason, and because the person has frequent medical problems that requires the EMS is no reason to automatically force them into a nursing home. The medical community's resources are taxed far more by individuals that use them for non-emergency related services (ER, EMS, etc...). To be truthful, a nursing home is not a hospital, and when an emergency arises they will also call the EMS. If that person has frequent medical issues then the EMS will be called each time. So simply putting this person in a nursing home will not alleviate the situation if the person is in need of it.

Answer 3

911 is not for routine medical issues or chronic problems, it's for emergencies. This person should call a CAB for a ride to the ER! I hate when people do that.

A skilled nursing facility is probably a very good idea, or at least living in a senior community where doctors and nurses are on staff is probably what this person needs.

If this person routinely takes up the time and services of EMS, the ER staff can speak to that patient about using other methods for medical treatment. If you were to meet that person at the ER and speak to a nurse or administrator about their use of EMS as their personal chauffer to the ER, they might help out.

One would think this person needs to see a physician during regular office hours, undergo regular treatment and manage their illnesses like a normal person. Even if that means they get seen every two weeks, it's still better to regularly manage their problems. EMS is not the way to manage medical needs!

Answer 4

It's interesting that I recently had a neighbor going through a very similar situation. If a person with health problems is living alone, or with someone but that person is unable to care for them, then a facility could be needed. Forget about the costs, because with no income and no insurance the public will likely foot the bill no matter the setting. The point is that if a person isn't being helped and cared for like they need, they could be having more injuries and problems because of this.

My neighbor didn't have anyone living with him to help him care for himself, so he ended up falling multiple times and needing EMTs. He also got sick a few times which would have been avoided if somebody had been there to make sure he was eating well. Granted we as a neighborhood did everything we could including buying him groceries, but we couldn't be there 24/7. The state ended up stepping in and removing him from the home and placing him in a facility after taking away his daughters power of attorney. She had been grossly abusing it and neglecting him. He's much better, and healthier, in the facility.

Answer 5

I do beleive that 911 is not for this reason, yet I from experance from an older person know that people can not afford to live in a nurseing home.
And at the same time the billing for 911 can be left outstanding, since the 911 can not refuse to come to the home.
It another way our country has over the years made sure that people can not take care of themselves when in trouble.
Lets have more companies with no health care insurance.

Answer 6

I've known individuals who work hard everyday and contribute to the welfare of our economy and have had to use EMS services several times. These people shouldn't be charged any more than anyone else should be, let alone be taken to a Nursing Home. Each situation can be different and should be judged accordingly as to whether there should be a cost to them or whether they should be forced into a Nursing Home Facility. We pay that cost many times as well. Something to think about.

Answer 7

...it sounds like the "person" needs a Court assigned "guardian" to care for the "person"... the next time EMS shows up... ask about it...

Answer 8

If they are footing their own bill than I say let them call, if the bill is going to the taxpayer then put them away!

Answer 9

yes they should if they are frequently calling!

Answer 10

maybe not mabe yes u will never know