Your 85-year-old father has Parkinson’s and loses his balance, falling and breaking his hip. Or your 79-year-old mother has congestive heart disease and is hospitalized for shortness of breath. Fill in the blank for the precipitating event: when your aging loved one lands in the hospital for an extended stay, he or she will need help.
The Long Road to Recovery
For all the wonders of modern medicine, getting appropriate care in a hospital is not guaranteed. Even in the best hospitals, many factors contribute to elderly patients’ risk of decline during their stay. Uncomfortable diagnostic testing, repeated blood draws and vital signs checks, noise, light, a rotating cast of health care professionals visiting at times that are convenient to their schedules, rather than the patient’s—not to mention the persistent risk of infection and complications following surgery or other medical procedures—all add up to sleep deprivation, confusion and stress when the patient is already in pain or a weakened state.
Delirium—the rapid onset of confusion and reduced awareness of physical environment—caused by illness, medication side effects, disorientation from lack of sleep, and unfamiliar surroundings, poses a significant risk for patients over 65, Another risk is malnutrition in patients who refuse to eat while in the hospital. The rush to discharge patients as soon as possible, prompted by Medicare and private insurance reimbursement rules, can result in complications from inadequate follow-up care. Even with a solid discharge plan, elderly patients take longer to recover from hospitalization—about one week for every day spent in the hospital.
Improving Chances of a Good Outcome
Here are some ways to help your loved one have a better chance of a successful outcome from a hospital stay:
- Whenever possible, make sure that a responsible family member or friend is with your loved one. The doctor’s arrival is never predictable, and it’s essential that someone who can understand the medical issues and treatment options is present, both to advocate for your loved one and to help him make any decisions. An Aging Life Care Manager™ can be a key member of this team effort.
- Understand that your loved one’s primary care doctor is usually not in charge. Even if the physician has hospital privileges, there is a special team of hospitalists who oversee patient care on the floors. When you or your loved one has questions, ask for the doctor managing the case and request to speak to her personally. Nothing will replace the trust established in a long-term doctor-patient relationship, but quality communication with the hospitalist is essential for informed decision-making.
- To protect your loved one’s privacy, conduct any conversations about her in a private space—not the hallway or in front of a roommate’s family or other visitors.
- Keep a notebook by the bed, with names and pager numbers of all essential members of your loved one’s medical team. Take notes when the doctor visits. Keep track of test results.
- Bring your loved one’s advanced planning documents and have them scanned into his record. There is no need to fill out new forms if this work has been done in advance and represents your loved one’s current wishes.
- Collaborate with your loved one’s hospital case manager and/or social worker to provide accurate, timely information that will enable them to create a realistic, workable discharge plan. Include your Aging Life Care Manager™ in the discussion.
- If your loved one is able to return home, recognize that she has a new baseline. Make sure she is comfortable and has necessary support during the day during her transition back to health. If she is confused, have a family member or reliable help stay overnight until the confusion clears.
President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified Aging Life Care™ manager. Drawing on more than 30 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.
For more on coping with aging, follow us on Twitter: @DeborahFinsALCM.
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