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Am I crazy to be trying to avoid hospitals like the plague? My husband with dementia has lung problems as well and I can hear that he has some congestion, but I feel like I want to try to do things here, to try to avoid a hospital trip. He is generally stable, so this is not a usual thing, but I just cannot face the long ER wait times with him to be seen, and even the thought of a hospitalization, which I don't know that he needs, is enough to send me running the other way. I know he will get delirium again if he is hospitalized, and that is not something I want to happen, much less the decline from that with his dementia that seems to linger.

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Have you tried getting him enrolled in hospice?
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Once we determined that hospital visits were doing more harm than good, we told the NH "no more". We got mom palliative care are and later hospice.
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The way to avoid ER wait times is easy.
Call EMS for transit.
Make up whatever lie you must. Unable to breathe. Low 02 sats. Grimacing with pain and clutching chest.
The ambulance delivers DIRECTLY to the cubical. You take him in you will cool your heels endlessly in the waiting room.

And the answer, if you want him to live and he is not (like me) a DNR, then you do not ignore heart and lungs. This could be pneumonia, long considered the old man's friend because it TAKES him to his end. This could be CHF and his heart could be in failure.

That's this old retired RN's suggestions.
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I agree with AlvaDeer to call an ambulance when your LO needs to be hospitalized in order to avoid the long wait time in the ER.

You stated that you “want to try to do things here” when your husband has problems with his lung congestion. The question that you should ask yourself is are you prepared to take on this role when you don’t have the equipment to perform the lifesaving techniques on your husband? The hospital is the best place for your husband to be for his medical condition as they have the equipments and doctors and nurses who are trained to take on your husband’s care.
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Will your husband cooperate with an xray to see what's going on in his lungs? He may have pneumonia, which should be treated. Will he cooperate with taking any antibiotics? Will he stay in bed in the ER or hospital (If he's admitted)? If no to these questions, then you have to make a decision about next steps if you don't seek treatment for him.
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Going along with some of what has already been said, have you reported this congestion to his medical provider? Will his medical provider order a chest xray, if you call and ask? Does he have breathing treatments ordered as needed? Have you tried those? Would an urgent care situation be more appropriate?
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Get hospice on board and he'll never have to go to the ER again, in most cases. Advanced dementia ALONE is enough to qualify, nevermind the heart and lung disease issues he suffers from.
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