Also many families try to push elderly to hospital for few days.
And rightly so. As people age and their health deteriorates, often a few day's monitoring and nursing care can forestall downward spirals, or catch sudden downturns so family can react appropriately, instead of the usual sudden crises and desperate scrambles. This is nursing, and hospitals used to do it, which I think is what your comment implies. But these days, without the right golden-key "diagnosis", nothing happens, and those diagnoses are certainly deployed "strategically".
There's no other accessible institution that really provides this kind of care, thus dumping responsibility on the beleaguered "community", as the social workers call it. If you happen to have insufficient wealth and willing empowered family to take care of this, I strongly suggest not getting sick. Or old.
Are there no other ER options in your area?
Closest ER to work, to home, and maybe to any place you spend a decent amount of time at.
The er was crowded and the hospital was crowded. The er clearly couldn’t treat her beyond basics, she needed to be admitted and monitored. But, as a sympathetic resident told me before mysteriously disappearing “there’s no space upstairs, I’ll try to get your mom in somehow”.
I worked with EHRs at the time and knew how to advocate. They kept trying to discharge my deeply ill mom without explanation and bumping into my objections, I was talking to a different nurse or social worker or resident every 3 hours round the clock. I felt scared to leave even for a short time lest they expel her.
In the end, I needed to go home to sleep and they discharged her at 6am, and when I arrived they had her bundled up and already waiting to be taken home, shivering and ashen. All they told me was that there’s no diagnosis, no reason to admit her and no beds anyway, she just needs to rest and have fluids, try urgent care if needed.
Multiple social workers sympathetically assured me and my mom’s aide that we were good people for being up to taking care of my mom at home, so they could tick a discharge box. We emphatically were not.
In the end, eventually, she was ok. The experience was harrowing. Many people talked to me but no one engaged with us, the interest was clearly in getting my mom out. It felt cruel and uncaring.
I’m surprised the article doesn’t address the “refusal to admit” angle. It used to be that you could admit patients for care and monitoring without a diagnosis, but this simply isn’t a thing anymore. So, deeply ill people who for whatever reason don’t have access to adequate care and monitoring from a caretaker at home are simply surrendered to their fate.