Anyone who has spent time with an elder parent in the hospital knows just how easy it is for one problem to be solved only to have the person discharged with different problems. This is not necessarily the fault of the medical caregivers or the hospital itself — it’s a result of a system that puts older people into beds and keeps them there. Add in bed alarms, the inability to move much, and that hospitals isolate elder patients from their routines and support communities, and you have a recipe for unsuccessful care, a result of age associated hospital complications.
So I recommend reading The Hospital is No Place for the Elderly, a November 20, 2013 article that appeared in the The Atlantic. This piece aptly illustrates the conundrum of frail elderly patients with chronic health issues admitted to hospitals where medical care focuses primarily on fixing acute health problems. The difficulty is that most of frail elders’ medical issues cannot be fixed — but the quality of their lives can improve. Author Jonathan Rauch also describes several programs in the United States — teams of physicians, nurses, and other health professionals — that collaborate to keep patients as healthy as possible and out of the hospital. The teams even save money. Continue reading →
Our family’s dog is ready for the Red Sox celebration parade.
Ever so often a blogger, in this case me, discovers a piece of news that’s old, but so interesting and relevant. When Best Friends Can Visit, appearing in the New York Times New Old Age blog, is just such an article.
This report, written by Judith Graham, describes how some hospitals and medical centers have decided to allow pets — as opposed to trained therapy dogs — to visit sick patients. One of these programs, at the University of Maryland Medical Center, has been in place since 2008. The report is filled with patient and family testimonials, explaining the positive differences that visiting pets can make.
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.
Check out the Transition Aging Parents blog.
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.
Dr. Cleary speaks about helping patients stay involved with their medical care.
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.
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 formaladmission 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.
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. Continue reading →