caregivers & healthcare corner By Lisa M. Monge, MSN, RN
April showers bring May flowers! It also brings us Autism Awareness Month! In fact, the fourteenth annual World Autism Awareness Day is April 2, 2021. On this day, you can expect the international community to ‘Light It Up Blue’, in recognition of people living with Autism Spectrum Disorder (ASD) and those who love and support them. What happens when the person living with Autism isn’t feeling well, or is feeling a little blue? An emergency department (ED) is often a place of stress and overwhelming for a patient living on the spectrum and their caregiver.
EMERGENCY DEPARTMENT VISIT:
Reducing Anxiety and Stress in the Emergency Department Spectrum Disorder or their loved one can do to reduce anxiety and stress for both of them. Communicate the Diagnosis
Each and every person with autism is unique and each face a different set of challenges. If at all possible, call ahead to the ED and notify staff you are en route. Staff may be able to accommodate a private room or reduce waiting time. It is important to educate staff on whether the patient is verbal or non-verbal, hyper- or hypo-sensitive, and any triggers that may cause negative behaviors. Open communication with between the patient and healthcare team will allow for customized health care in an effort to reduce stress and anxiety. Bring Comfort Items for Distractions
Research suggests the average number of emergency department encounters is approximately 30% higher for children with ASD, 70% higher for teens with ASD from ages 15 to 18, and twice as high for adults with ASD. Given the data, it is likely the person with ASD and their family will inevitably visit an emergency department at some time in their life. The ED is busy, loud, unpredictable and has many bright lights. This environment is overwhelming for a neurotypical patient, but for the person living with Autism, this can quickly amplify an adverse behavior due to heightened sensory input or stimulations. Autism Spectrum Disorder is a neurological disorder that has an effect on communication and with the heightened sensory stimulations, the stress can be so overwhelming, it quickly can undermine their ability to tolerate the treatment they need. In the event a person with autism may require an ED visit, there may be a few things the person living with Autism
38 Special Needs Living • April 2021
Wait times can be long in an emergency department. With the overwhelming environment, it is important the loved one remain positive and remember their mood can impact stress levels. Preparing a “fun bag” of items can be helpful! Dressing in preferred clothes instead of hospital gown can reduce sensory issues from clothing. Any items from home that are familiar that can allow for a less foreign experience are also helpful in reducing stress.
and their family. Visits to the ED, or any medical setting, can cause stress and anxiety. Being prepared for the encounter can optimize the patient and family experience; resulting in appropriate medical interventions and interactions, and ultimately allow the patient to receive the highest quality of care. Nurses and Healthcare Professionals Can Do More
**a personal note from the author** While in graduate school, I began taking courses to learn about ASD and other developmental disabilities. I chose to create a personal philosophy regarding persons with developmental disabilities and how nursing staff and healthcare personnel should integrate disciplines to optimize healthcare potentials for all. I am reaching out to all providers in every setting to please come together as a community to reduce health disparities and improve the life for this unique population. Thank you, Nurse Lisa A Call to Healthcare Professionals
Advocate, Advocate, Advocate
It is vital loved ones be the voice for their family with ASD if receiving care in the ED or any healthcare setting. They know the patient and it is vital to notify staff of triggers as well as techniques to cope with difficult situations. Be involved with care as much as possible! For example, administer the medication to your loved on with ASD, if allowed, if it reduces stress. It is also beneficial minimize encounters and cluster care. For example, instead of having an assistant get the vital signs and the nurse provide care, have the nurse obtain both the vital signs and provide essential care only. Communicate, Distract, Advocate
Autism Spectrum Disorder is a life-long neurodevelopmental disorder. ASD has a substantial impact on the health and well-being of the affective individual
We, as nurses, must advocate for the family, community, teachers and healthcare providers to treat the patient and family as an entity and ensure care is integrated. All nurses, novice to expert, have a duty to acquire the knowledge, skills and attitude necessary to provide compassionate and appropriate care for this unique population. Nurses, or any healthcare provider who may encounter a patient with ASD, or any developmental disability, please consider advocating for the following • Nurse educators to introduce ASD and developmental disabilities to students through academia and clinical settings
