Abandoning family in the ED during the holidays

Published

Every year, during the holiday season, we have an influx of patients that seemed to have been dropped off in the ED for the convenience of their family. Some people will probably say that there's no way for me to know if that's what is really happening, but we have noticed there are a few things these patients have in common. Nurses that have been there a while say it happens every year.

These people will come in via ambulance, from home, no family present. Chief complaint will be something like the patient suddenly started acting weird. The patient will show no signs of distress, all vital signs normal, labs and scans will be either normal or no changes since their last visit. Pulling up the patient's history will show an extensive and well documented history of Alzheimer's or dementia. All phone calls to emergency contacts will be ignored. While in the hospital, these patients are always VERY difficult...they are confused, trying to escape, biting, kicking, screaming.

Occasionally we will get someone who is A&Ox4, with reported suicidal ideations (which they deny). They will have some sort of chronic illness, but no s/s of an exacerbation. These people are usually HUGE jerks, abusive towards staff, sometimes to the point of being violent.

A day or two after the holiday, right when we've started trying to line an LTC bed, the family shows up, and wants them discharged immediately.

It's not just a couple people, it's a TON of them, each holiday. Sometimes, the same person will be there over Thanksgiving and Christmas. It's almost like word has gotten out in the community that the hospital can babysit Grandpa so they can enjoy Thanksgiving without any interruptions. Am I crazy, or is this a common occurrence?

Up Vote Up Vote ×
Specializes in Surgical, quality,management.

Granny dumping its called in oz. Just like they see their granny for the first time in a year and want to fix her up......however granny is 95 with a bad heart, lungs, liver, kidneys, pancreas etc. Then the sensible family member who visits every week comes back off her well earned break and yells at the "concerned" granddaughter.

Up Vote Up Vote ×

Oh, yes...the "failure to thrive" all come around the holidays--and suddenly, the family shows up right about when the threat of the social security check that Mom/Dad receive each month could go to the nursing home as opposed to them.

Or the creepy hanger-ons--the "friend" that has planted themselves in an older person's life who has no family. THEIR family wants to come stay for the holiday, so off the elderly person goes for their "change in mental status" to have a stay in the hospital, the "friend" (who is a "caretaker" who rents a room) has a grand old holiday at the person's home, and then shows just in time to take the person to the bank to cash the check. (and don't even GET me started on when this person passes--the creepy friend is the first in line with their hand out, the other with the will in it-- noting in detail that they were the "only ones" who cared for this person--sometimes for years upon years).

Sick stuff. My greatest holiday joy is when these patients are put in a LTC that they thrive at and love! Get fully involved in activities, outings and all the joys of the holidays--and have the time of their lives!

Families and creepy friends should be ashamed of themselves--

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Yup...has gone on for years. Sad really

Up Vote Up Vote ×

Hospitals should stop admitting people that don't qualify for admission.

Up Vote Up Vote ×
Specializes in Trauma, Teaching.
Hospitals should stop admitting people that don't qualify for admission.

Problem is, when you can't get a hold of the family, and there is no way to send these poor souls home alone. They don't need hospital but aren't capable of caring for themselves.

Up Vote Up Vote ×
Specializes in Med nurse in med-surg., float, HH, and PDN.
Hospitals should stop admitting people that don't qualify for admission.

I ask this because in all honesty, I do not know: What can you do with a 'drop-off' who has no-one with them and no place to be returned to? It's not like child-protective services where they can foster kids on a fairly short notice; or is there a place? I know there is APS, but can they find someone a bed on the spur of the moment?

Families or CG's who do this should have some kind of legal action taken against them.

Up Vote Up Vote ×
Specializes in Med Surg, Perinatal, Endoscopy, IVF Lab.

LOL.. this happens here all the time. Tis the Season :yes:

Up Vote Up Vote ×

We get the same thing- but I work peds. :( We will predictably get some of our more complex kids- the ones who are a lot of work with central lines, g-tubes, trach/vent, and neuro issues. They will start coming in about 2 days before the major holidays. They are admitted with reports of hypoxia or vomiting at home, but when they get to my floor they seem baseline. Families will not visit. Many times the family will stay just long enough to see the kid get tucked in bed and we won't see them again until they come to pick the kid up a day or two after the holiday. These families know how the system works and they play they system well. The worst part, besides the fact that the kid is spending their holiday in the hospital, is they are fragile and get exposed to all kinds of germs inpatient, and sometimes will actually get sick for real on the day they are supposed to go home. Secondly, I think about the huge unnecessary hospital bill, which is usually paid for by the state.

Up Vote Up Vote ×

Yep, it sure does happen :(

There's also a couple of nursing homes in the area that are famous for residents who develop 'fevers' and simply must be sent to the hospital......usually on a Friday, and usually before a holiday. And if it's a holiday weekend? Bang: a few more senior citizens who have a 'change of mental status'. Yeah....that's the same 'change' you sent them here for before the last TWO holidays. Can always tell when their staffing is low. :(

Up Vote Up Vote ×
Specializes in Trauma, Teaching.
I ask this because in all honesty, I do not know: What can you do with a 'drop-off' who has no-one with them and no place to be returned to?

We end up admitting.

Up Vote Up Vote ×
We end up admitting.

"Social Admissions" is what I've known them to be called. Have hated being the nurse who has to contact family of said "S.A." because details are missing, need clarification on meds, etc, and the family CANNOT be found, won't answer cell phones, won't return calls. Burns me! :madface:

Up Vote Up Vote ×
+ Join the Discussion