One of the most stressful moments for any caregiver comes when an elderly loved one is hospitalized. Hospitals and other facilities can be scary for an elderly patient. The fear that people feel when entrusting the care of someone dear to are very real. It is well documented that older patients are at risk for a whole host of complications when hospitalized. Some of these include confusion, infections, bed sores, weakness and falls.
The following are some tips for avoiding complications and getting the best care.
1) Avoid the hospital altogether if possible!
Sometimes it is unavoidable – and can provide important information, treatment and life-saving care. At other times it may not be what the patient needs or wants. Understand, and clarifying advance directives (i.e. living wills or health care proxy) will give you a better sense of what your loved one would like.
2) Find out which doctor will be in charge of your loved one’s care.
Nowadays many primary care doctors do not take care of their patients in the hospital. Instead they rely on Hospitalists – internists who specialize in the care of hospitalized patients. While this is a fine option, you may want to know who will be in charge of your love one’s care. If admitted through the emergency room, ask the doctor there who the “attending physician” will be. Once admitted, the patient’s nurse should be able to provide this information as well.
3) Create (and update) a simple medical record.
It is wise to keep a simple and up-to-date medical record for aging parents. This document should include: medical conditions, surgeries, medications (which should include medications that have been stopped and why), test results (colonoscopies, x-rays, mammograms etc, if available), allergies, contact information for doctors and next of kin, advance directives. This simple document will help the doctors know more about their patient and could be life saving when a loved one is in the Emergency Room. It can also prevent unnecessary testing and procedures. Creating this document sends the message that the patient is cared about and has concerned family.
4) Make sure you have a support system.
If patients have mental or physical impairments that limit their ability to express what they need, make sure they have someone to speak for them as much as possible. Family members or friends can take shifts, or hire a companion agency to provide support. Get updates on how the patient is doing and what is planned.
5) Find out who will be in responsible for discharge planning.
This is generally done by a social worker, though on occasion it may be a nurse. Make yourself known to this person early on. With hospitalizations becoming shorter, it is important that this person be aware of any concerns you have about discharge. Let them know if there are safety concerns at home. Also, if your loved one is too weak or sick to be home, the discharge planner can help you find a rehab facility as a transition to going home.
6) Ask for a second opinion.
If a treatment or procedure is being offered and you feel unsure if this is in the best interest of the patient, ask for a second opinion.
7) Ask for a Geriatrics consult.
If your loved one is over 65 and has multiple medical problems, asking for a geriatrics consult can be helpful. These doctors are specifically trained to care for older patients and are skilled in end-of-life care as well.
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