I’ve just finished reading a Washington Post opinion piece, We Need to Take Better Care of Our Elderly by Jerald Winakur. The March 20, 2015 article describes a hospital experience of a 91-year-old woman, who may be the author’s mother.
Winakur, a geriatrician, describes what happens to an elder who enters the hospital’s complex world of unfamiliar physicians, none of whom are the person’s primary care physician. He describes how wide-ranging medical tests, medical care recommendations, few explanations, and very little personalized care combine to create confusion for the patient and for family members. And, of course, there are the always-connected medical devices. Continue reading →
Click on this image to check out images of the well-designed new gowns. With thanks to the Henry Ford Health System.
If you are like my parents, me, or people of almost any age, you HATE hospital gowns.
Sometimes putting on or wearing the gowns is worse than the test or the hospital visit. If you have ever helped an aging parent or other elder get in and out of bed with one of those gowns — or take a walk in a hospital corridor — you know how they keep opening up so a patient feels exposed. Currently these gowns are designed to make it easy and simple to examine a person, but not to make a person feel comfortable.
Well now there’s reason to hope that this situation may be improved.
Just when you think that you have settled the most significant adult child-aging parent issues — when you and your parents have spoken about medical care support, finances, and the range of their end-of-life wishes — along comes another concern to worry about, and it’s one that may be completely out of our control.
We now need to be concerned about the possibility of a parent entering a hospital and assigned to observation status for several days. Observation means that, rather than being officially admitted as a patient, the person is there to be watched, sort of like an out-patient, but not really an out-patient. The problem is, it’s difficult to discover what status a hospital assigns a patient — the two look almost alike with nurses, doctors, hospital rooms, blood pressure checks, etc. Admission and observation do not look that different to the patient and family, and apparently many hospitals are not especially forthcoming with the information.
Why is patient status significant? It’s simple, really. If your parent needs to enter a skilled nursing facility or nursing home after three days of observation status, Medicare will not pay and the family will be required to pay all of the bills, including the hospital costs. For Medicare to pay the bills, a family member must be admitted as a patient for at least three days and not assigned observation status.
Over the past year newspapers and medical or health journals have carried stories about elders and observation, and I share them here so that you can learn as much as you can.
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 →
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.
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.