I’ve written about senior parent hospitalizations several times on this blog. When a parent is hospitalized, an adult child needs energy, clarity, and attention to detail.
Recently Dale Carter, over at Transition Aging Parents, wrote an excellent post about her experience when her mother was hospitalized for surgery, and she includes lots of ideas that can assist those of us who help to support our parents and may spend some time with them at hospitals.
Last week I shared that I had been away, helping my mother through surgery and recovery for colon cancer. As I reflect on the many lessons learned from this experience, I’ve decided to devote this post to the 5 things I believe were key in ensuring the best care for my mother. These are things that will make a true difference, regardless of the diagnosis, your location in the country, or selection of hospital. Continue reading this post at Transition Aging Parents.
One out of five hospitalized Medicare patients needs to return to the hospital a second time within 30 days of their first discharge.
A second hospital admission, shortly after the first, is a no-win situation for everyone concerned about an elder parent. Patients are often sicker, they are unnecessarily exposed to other hospital bacteria, and families of the patient have more worries and parent monitoring. Moreover, Medicare spends a lot more money — 17 billion dollars — on these readmissions.
A blog post at The Agency for Healthcare Research and Quality (AHRQ) website, explains a lot more about preventing Medicare patient hospital readmissions. Written by the agency’s director, Carolyn Clancy, M.D., the post provides links to research, successful hospital readmission prevention programs, and patient guides. Dr. Clancy’s columns are also available at the AARP website.
When your parents go to the hospital and need to stay over night or longer, be sure the medical staff admits them as official patients and not for observation (which means that technically they are not admitted at all).
People hospitalized for observation do not qualify for Medicare’s skilled nursing care benefit after leaving the hospital, and they will have much higher out-of-pocket costs because many Medicare benefits require formal admission as an inpatient to a hospital, not a stay for observation, which is more like outpatient status.
Much has been written recently about this situation. Brown University gerontologists published their findings in the June 2012 Health Affairs (abstract), explaining that the number of observations rose 34% when compared to standard hospital admissions in 2007-2009. The study analyzed a huge amount of data — the Medicare claims of 29 million individuals between 2007 and 2009.
A report on the study in the June 4, 2012 Kaiser Health News, Study: Hospital Observations Stays Increase 25 Percent in Three Years, points out how researchers also found that patients under observation stayed in the hospital longer than admitted patients — some “observed” for longer than three days.
Interesting Quote from the Kaiser Article Read more »
My mother’s laparoscopic surgery at the University of Virginia Health System went splendidly with the best possible outcome. Part of the day’s success is due to medical skills, but it’s also due to the UVA hospital staff members who treated my mother with respect, dignity, and gentleness at every point of the day.
Mom did not need to be admitted, but we did spend the night after surgery at a hotel about two blocks from the hospital rather than doing the 60 mile drive on the same day. Interestingly she spent lots more time in recovery than she did in the surgery itself. Spending a minimum amount of time at a hospital is one way to avoid age-associated hospital complications.
Just about everyone, from the first person we met in admissions to the physicians who performed the surgery — even the woman who escorted my mother to the car — took the time to offer explanations and engage us in conversation. They kept us calm and well-informed, speaking directly to my mother even though my dad and I were right there. As mother left us to go off to surgery my dad was overcome with emotion. A nurse standing with us near the elevator, struck up a conversation, rode down in the elevator with us, and chatted with my father for a few minutes before taking us to the waiting area. Read more »
Checklists are “in” right now. John’s Hopkins physician, Dr. Peter Pronovost focuses on checklists to reduce mistakes, reduce hospital-acquired infections, and improve patient safety in hospitals. Writer-physician Atul Gawande publicized checklists even more widely in his book, The Checklist Manifesto, describing more examples about how physicians can make small changes and realize dramatic results.
Now Elizabeth Bailey, after going through some dramatic aging-parent hospital experiences where quite a few mistakes were made, has published The Patient’s Checklist, a compilation of ten checklists to help patients and their families keep track of things that go right and help them be on the lookout for problems that may occur.
Read this short Detroit News article, Saint. Joseph Mercy Oakland Enhancing Hospital Environment, appearing in the paper on March 22, 2012.
Not only does this hospital currently display art on its walls, but it is now seeking art to purchase or commission to become a permanent part of the new South Patient Tower, currently under construction. The hospital plans to incorporate art into the actual architectural design and encourages artists to produce images that “…evoke images of peace and healing…” A link for interested artists is in the article.
By the way, this hospital has Michigan’s first senior emergency department.
In this day of electronic medical records, EMR’s for short, why can’t a hospital with an e-mail or fax number on file send off a copy of the discharge orders to the adult child designated by the elder parent?
Given that the private sector has figured out a way to help adult children keep track of utility bills and bank accounts, it seems like it might be easy to implement, even while keeping privacy considerations front and center.
The opportunity to read and understand the diagnosis and the specific steps that are required for recovery would help an adult children, who cannot always be right at a parent’s side, stay informed and take more knowledgeable steps to help an elder parent recover.
How about it hospitals?
From time to time a small outbreak of an uncommon disease occurs — often in an unexpected location. Sometimes it’s publicized and we hear about it, but at other times the outbreak is small enough that most people only hear after the fact. Either way, many of our elderly parents, and many of us, find out about these outbreaks while watching television, and the news reports are often hyped and scary. All of us need to develop the skill to seek more information and figure out what is left out of a news report.
Rarely do such short television news stories explain the extraordinary successes of disease detection and disease detectives — how they collect facts, put them together, and puzzle out possible answers. The people in charge of this process are epidemiologists, scientists, sometimes but not always physicians, who explore the way a disease moves from place to place and how it might be controlled.
In January, many of us heard, mostly on TV and radio but also via print and Internet sources, how a small outbreak (eight cases) of Legionnaires’ disease occurred at a hospital in Wisconsin within a short period of time. We heard about this outbreak, which occurred in 2010, because of a journal article, An Outbreak of Legionnaires Disease Associated with a Decorative Water Wall Fountain in a Hospital published in the February 2012 issue of Infection Control and Hospital Epidemiology.