Jonathan Kamens 86 47Feb 11
Before I tell you why I've been angry all day, I will say up-front that Uncle is fine now. This story could have ended so much worse than it did, but that's no thanks to the people who didn't do their jobs. On to the story…
Last night, Uncle's blood sugar spiked, he said he didn't feel well, and he refused to eat, so his personal care aide called the agency and asked what to do. They told her to call 911 to have him brought to the ER. (1/15)
Show threadJonathan Kamens 86 47Feb 11
I am not sure this was the right call, but that's the least of my complaints about what happened.
For some inexplicable reason, the agency also told the aide that she should go home rather than accompanying Uncle to the ER. This is not the correct procedure. At all.
The aide is supposed to ride with Uncle to the hospital in the ambulance, and stay with him unless he is admitted. Only when he is actually admitted to the hospital is aide service supposed to be suspended. (2/15)
Show threadJonathan Kamens 86 47Feb 11
I have since asked the aide agency, in writing, for an explanation for why this procedure wasn't followed. They have not (yet) responded.
The ER diagnosed hyperglycemia, which they treated with insulin, which he could (and should) have been given at home, avoiding the need for a trip to the ER.
At around 4am the ER sent Uncle home in an ambulance, with no aide. The EMTs brought him into his apartment, transferred him from the gurney to his bed, and left him there. (3/15)
Show threadJonathan Kamens 86 47Feb 11
To reiterate: Uncle, who has 24x7 personal care aides because he cannot care for himself, was dumped into his apartment alone in the middle of the night, with no one having made any effort to resume his aide service then or at any point later in the day. (4/15)
Show threadJonathan Kamens 86 47Feb 11
When I woke up, I checked Uncle's account in the hospital portal and confirmed he had been sent home from the ER. I was a little surprised by this, because (a) I vaguely recalled that the aide told me, when she called to tell me he was going to the ER, that she had been told not to accompany him, and (b) surely the hospital would not have sent him home without an aide, right? (5/15)
Show threadJonathan Kamens 86 47
Uncle had a doctor appointment scheduled for 11:30 today, and the medical transport would be picking him up at 10:30, so I started trying to reach him by phone at around 8:30 to confirm that he was awake, having breakfast, and getting ready to go to his appointment.
Even if he had been sleeping, someone should have been answering his phone, since the aide is supposed to do that. But no one answered any of my calls between 8:30 and 10:00. (6/15)
Feb 11 at 2:40amWeb
Show threadJonathan Kamens 86 47Feb 11
At 10:00 I canceled Uncle's ride and appointment and switched from "making sure Uncle makes his appointment" mode to "Uncle is probably trapped in his bed in his apartment alone and in God knows what condition and I need to save him" mode.
[While all this is happening I'm not at home, I'm down in Maryland helping with my parents' care while my sister who lives near them is away for work, so I'm driving my dad around while desperately making phone calls trying to make sure Uncle's OK.] (7/15)
Show threadJonathan Kamens 86 47Feb 11
Next, I called Uncle's friend I know in his building and asked her to check on him. She went to the door of his apartment and found the door locked with an Instacart delivery stacked in front of it. She called back and told me, incorrectly, that this must mean he wasn't in the apartment. This just made me worry that maybe he was in the apartment and unconscious or worse (I assumed that they knocked and he didn't answer, but they didn't explicitly say they had so maybe they didn't?) (8/15)
Show threadJonathan Kamens 86 47Feb 11
While she was on the phone with me telling me Uncle wasn't in his apartment, I was on hold with the ER, which I'd called to ask for confirmation of if/when they sent him home. Right after she hung up, the ER picked up and confirmed that he had been sent home around 4am. I asked wtf they were thinking sending a disabled person home in the middle of the night without a caregiver, and she said she didn't know, she wasn't there when it happened. smdh (9/15)
Show threadJonathan Kamens 86 47Feb 11
Next, I called another friend who lives nearby and has keys to the apartment and asked him to go by the apartment and check on Uncle. He said he couldn't do that for a couple of hours since he wasn't currently at home. Another dead end.
Next I called Uncle's building's security desk and ask them to do a welfare check on him. They say they will have to ask management to do that. I say yes, please do that. They said they would and hung up, but I wasn't] convinced they meant it. (10/15)
Show threadJonathan Kamens 86 47Feb 11
Earlier I'd texted my brother asking for help with phone calls because I was dealing with our parents, but he was out and couldn't. I told him then to let me know when he was free to help.
He did that right after my conversation with the security desk, so I called him and we brainstormed next steps. He suggested asking the police to do a welfare check, since building staff would surely let them into the apartment. I asked him to make that call since I was dealing with my parents. (11/15)
Show threadJonathan Kamens 86 47Feb 11
My brother figured out how to reach the local precinct, called them, and told them what was going on. They said they would look into it, then called him back a few minutes later and said someone from Uncle's building had just called for an ambulance saying that there was a resident trapped in their bed who couldn't get up, and that it was probably Uncle. (12/15)
Show threadJonathan Kamens 86 47Feb 11
A few minutes after that Uncle's friend called and confirmed that she was in the apartment with him and that the building social worker had gone up to the apartment, gotten the maintenance staff to unlock it, confirmed that Uncle was there without an aide and unable to get up by himself, and called 911. (13/15)
Show threadJonathan Kamens 86 47Feb 11
While I was on the phone with the friend, the EMTs showed up. I could hear Uncle getting more and more irate. "Why are all these people in my apartment?" "I'm fine!" He refused transport to the hospital. The EMTs, God bless them, asked me (through Uncle's friend) for the number of the aide agency, called the agency, and convinced them to send an aide.
The agency said the aide would be there in a couple hours. The EMTs then left. Fortunately, the aide arrived when promised. (14/15)
Show threadJonathan Kamens 86 47Feb 11
In short:
* the aide agency sent Uncle to the ER when the aide could have just made him take his insulin;
* the agency abandoned my uncle when they were supposed to stay with him;
* the hospital sent a disabled man who can't care for himself home by himself in the middle of the night, and the EMTs went along with it; and
* when I spoke to the hospital staff about this, they didn't seem to think there was anything unusual or unreasonable about what they'd done. (15/15)
Show threadAaron Brick — אהרן בריקFeb 11
@jik Good summary of a bad system. You are stoic.
Show threadNick Judd, Chicago dadFeb 11
@jik there are so many indignities, near-misses and tragedies in this system.
Show threadrednikkiFeb 11
@jik I am so sorry. This is awful.
Show threadJima Feb 14

@jik This is another cross-section of how broken the medical system is.

I'm sorry it keeps happening to him (and by extension, you), and appreciate you shining a light on the systemic failures. 😔😑

Show threadAgyei GyasiFeb 11
@jik the lack of common sense protocols in our "care" system is unacceptable 😠; glad everything turned out ok 😮‍💨. your uncle's orneriness definitely cracked a smile 😆!