I tried not to use the ER for my mother, but she was having an acute asthma attack and I couldn’t find an urgent care center nearby. I made the decision not to go to a trauma center, but chose a nearby hospital that specializes in geriatric patients. My mother is 80 years old. She had been wheezing for days and I was concerned about pneumonia and stroke. She had left her nebulizer in Florida and was in total denial about her symptoms.

Luckily we got right in. The staff was superb. They were concerned, professional and quick. Unfortunately, we had to spend six hours there because my mother wasn’t responding to any of the treatments, and ended up being admitted for two days. I’m waiting for the discharge to come through now.

There were several things over the past 48 hours that got me thinking about our health care dilemma of cost versus care:

First, we were in the ER, which you always try to avoid because it’s the most costly. She had enough medicine and tests to rack up a pretty good size bill, and none of it made a dent in her wheezing and coughing. The EKG, chest X-ray and blood work came back normal. She had an IV put in for three different types of medicine and two nebulizer treatments, plus Tylenol and codeine. She also was given oxygen.

The private room charge is $1,500/day, not including treatments. She is on Medicare so I started wondering how much Medicare would actually pay. The hospital only has private rooms, which was good because the way my mother was coughing and wheezing she would have driven a sick roommate crazy. For the $1,500/day you are woken up every hour so sleep is scarce. The rooms are old and mostly clean, but by no means like an $1,500 room would be at the Four Seasons. Of course, the Four Seasons doesn’t have 24/7 nursing care either.

The attending doctor came in and suggested my mother stay because she hadn’t passed the acute stage and her blood pressure was still high. She made it clear it was only a suggestion and that it was really my mother’s decision on whether or not she should spend another night in the hospital. The doctor did say that if she sent her home and then she was readmitted Medicare would look down on her for it. A lot of the treatment recommendations were done in a very passive manner, which meant my mother had to take choose what treatments to accept. She looked helpless most of the time, and asked me to make the decisions. I don’t know how elderly people with no relatives by their bedside make these decisions after years of being in a support role in their own health care.

Between the care and cost decisions we’re being asked to make now, we’ve entered a whole new world of decision making. We’ve been thrust into the drivers seat, which is unnerving for most people, especially our elderly. No one knows what things cost or whether they should ask for treatments. They just wait until the bill arrives to see if they’ve made the right decisions.

Once my mother’s bill arrives, I’ll let you know if we chose wisely. It’s possible she’ll think she should have stayed home and continued to self-medicate.

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