Our natural inclination to avoid the hospital at all cost may be more than simple fear of the unknown. Research published in the Journal of the American Medical Association found that many elderly patients who enter hospital sick or injured deteriorate during their stay and end up leaving more disabled than they arrived. Nearly a third of patients over 70 and more than half of those over 85 are discharged from hospital in worse shape than when they were admitted.
The hospital is a busy place where meeting the needs of seniors, such as providing help with feeding, bathing, dressing or walking, can often fall between the cracks. Seniors may also lack proper rest necessary for recovery in noisy wards where they are poked and prodded at all hours of the day and night.
By restricting movement with catheters and IVs, seniors are often left to spend their days in bed where they become weak from lack of activity and disinterested in unappetizing food. Medication reactions and interactions combined with chronic conditions can also cause seniors to fail to recovery properly.
Hospital delirium can also be a serious risk for elderly patients as a result of the use of sedatives, sleeping pills, narcotic painkillers and some allergy, blood pressure and incontinence drugs. Immobilizing patients can increase this risk. To learn more about hospital delirium in older adults visit the Harvard Medical School at http://www.health.harvard.edu/blog/the-dangers-of-hospital-delirium-in-older-people-201111163810 .
It goes without saying that because hospitals are full of sick people, seniors with weaker immune systems may be be more likely to contract an infection which can lead to a sharp decline in health, a longer hospital stay and in some cases death.
By creating hospital units that specialize in geriatric care, older adults can recover faster and better when their needs are met. They are discharged more quickly saving quality of life as well as money by avoiding long stays, adverse events and transfers to rehabilitation facilities due to loss of function.
It is important to appoint an advocate for a elderly loved-one if they are admitted to hospital. Busy doctors and nurses may not always notice health changes or find time to keep patients from developing bed sores or other complications. If there is a choice of hospitals available, look for one with a unit dedicated to providing hospital care for elderly patients.
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I just read your artical about the traumas and illnesses that can befall a senior going in to hospital. Don’t you maybe think that you’ve scared a lot of seniors to death? If I’d never been to hospital, or I guess even if I had and I read that article I wouldn’t be able to sleep for worrying. What about the people who don’t have someone to stand up for them? If I listened to your artical (you know what I mean) I would be in the depths of despair, worrying that no one would look after me.
Mind you, my letter hasn’t really helped the situation, has it?
You give really good advice and it’s a wonderful place to go to for information and new ideas. I was just a bit worried.
I think specialized geriatric care is in line but more for things like making sure dosages have been adjusted for older bodies.This issue has a lot of facets including the difference between American medicine and the more socialized brands. Those are things that will be a long time in fixing but there are some things patients can do to make hospital stays more productive.
How we look at hospital stays is one issue. For so long we’ve looked at hospitals as places where people do stuff to you and you let them. We need to put the expectation on the patient, that the best healer they have is themselves and then teach them as much as there is time to do so. If i were to offer some advice to new hospital patients here’s what i’d offer (based on some extensive experience in the last few years):
1. Learn your health care team’s rhythm. Beginning and ending of shifts can be very busy. Try to get whatever it is you need before the rush. Know when your doctor/intern does rounds. Make sure you know what you want to ask before they get there. Take notes if you have to, to remember better. Also, understand that just because they are not at your bedside, it doesn’t mean they are not working to heal you.
2. Learn what you need to do to better heal. If you need to walk to get your bowels moving, learn what needs to happen for you to walk. And then do as much of it as you can yourself. You can unplug the pump-it’s the same type of plug you have on your vacuum at home. Ask your health team what you can do for yourself…and then do it.
3. Don’t expect regular sleep patterns. Hospitals at night can be really annoying for sleep. (This is one of things that i think contributes to the loss of health in a hospital). The rhythm of a hospital is so foreign to what is regular for most of us that this takes some getting used to. Take the sleeping pill if offered, learn to take naps in the daytime and find something to do if you absolutely, positively cannot sleep (i crochet and listen to audiobooks). Understand that you need sleep and try to find a time when you can get some.
4. Know what you can and cannot eat. This also goes for temporary changes for procedures, permanent restrictions and nutritional optimization. Just because it’s on your plate, doesn’t mean you get to eat it. If it doesn’t look right, ask. Don’t like what’s on your plate? Ask if you can get outside food. Sometimes you can and you’d be surprised how much one junk food meal or a fruit smoothie spices up a few days’ worth of vegetable soup.
5. Know what drugs you take and when. Ask how they’ll be handled while in the hospital. Check you meds when you get them. Ask about changes you see.
6. Don’t be passive. You are not there to have some people just do stuff to you (well, most of the time). Heal is an active word and just because you’re felling pretty bad, don’t mean you get to rest on your injuries/illness. Your body, your responsibility.
Don’t let the bed fool you. Hospitals are work. Set your expectations accordingly.
Lorrie! That was a brilliant artical. Very well put.
Thank you for your comment. As much as I understand what you’re saying and feeling, I am also very aware that there are issues that won’t be solved without shining a light on them. In this case, our author takes her information from the Journal of the American Medical Association which is an extremely reputable, peer reviewed journal. Perhaps people entering hospital who didn’t know of the needs patients have that aren’t always seen to by busy health care staff will be able to prepare or maybe a caregiver will spend extra time with a patient now that they are alerted to potential issues. Our author took care to suggest solutions and to look at what some jurisdictions are doing with specialized geriatric care. Just having to spend time in a hospital is stressful enough for most of us without having to worry about extra issues but they exist and as our population ages, more issues will come forward. I’m not sure we have solutions but we can start discussions and shine light on problems. I’m grateful that you took the time to write. Please keep reading and let us know your thoughts when you feel moved to do so or let us know the issues that you’re facing so that we can consider the need for an article that shines light for others who may share your challenges.
I see what you mean, plus you’re the experts and are doing a wonderful job.
I guess my bias is that I’ve had five surgeries in the last two year, with four of them in the same year. They included: removing a mass from my heart, followed by six weeks live in rehab. A little latter I had my gall bladder removed, then I had two bowell operations, the second one because the surgeon nicked me in the first one. Now I have suspected bowell cancer, if it’s positive then another operation. Hahaha! I bet you didn’t want to read all that and I bet you’re appalled that I’ve joined your group.
Not at all, Tina. We’re happy to have everyone join, read and comment. You’ve clearly had a great deal of experience with doctors and hospitals so your opinions have a lot of validity. We’ll keep you in our thoughts in the days ahead as you deal with your current challenges.
Many thanks for the kind words.
A book, “Being Mortal: Medicine and What Matters In the End””, written by a physician and a NY Times #1 bestseller for over a year has some very meaningful and insightful observations you may (definitely will) find of value. It’s a great book, well-written and engaging in addition to the info imparted.