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Hospital Discharge Needs of Elders

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Elders have more health care issues and have more doctors’ office visits and more hospitalizations than their younger counterparts.  Where about one in four 18-44 year olds report no visits to a health care professional in the past year, two out of three 75+ year old patients have seen a health care professional four or more times in that same time.  More than a quarter of 75+ year olds report in excess of ten visits a year.  What may not be as obvious is that seniors also require more and different recovery help from their medical episodes, especially those that have required hospitalization.

Hospitalization can be the “perfect storm” for older patients, because they have potentially more medical issues in the first place.  Second, everyone is discharged as soon as possible from hospitals these days, because insurance typically pays for the condition, not the days.  Some in the hospital business refer to this kind of logic as “discharging sicker quicker.”  A third factor can also be added, and that is the mental processing ability of an older patient is more challenged by the assault of a hospitalization, especially the discharge process.  In a study recently published in the Journal of General Internal Medicine, and reported by UPI, a researcher named Lee Linquist and colleagues followed a group of 200 patients 70 years and older.  Although all these patients lived independently in their own communities and none had been diagnosed with dementia or other cognitive medical issues, fully one-third were diagnosed with low cognition post-discharge.  The good news is that with special post-discharge care, nearly three-fifths of these same patients improved in the areas of orientation, registration, repetition, comprehension, naming, reading, writing and calculation.

There is further good news.  The researchers suggested that screening all seniors while still in the hospital could have helped to flag those in need of transitional care once they were discharged.  This would help bridge the time between not being sick enough to still be in the hospital and being fully able to take care of themselves at home.  In the past (and present) there has been no insurance that would pay for any of this, but a new bill has been proposed in the U.S. Congress.  It would make it easier for patients already receiving Medicare benefits to also receive an “observational transition” that would determine if they should have more skilled nursing care at home care once discharged.  The bill was introduced by Senators John Kerry (D-Mass.) and Olympia Snowe (R-Maine) and Reps. Joe Courtney (D-Conn.) and Tom Latham (R-Iowa).  The bill has the backing of AARP, and you can read a bit more about it in Modern Healthcare.

If you are a caregiver to an elder, be attentive to any changes you may notice in your loved one not just as they are recovering from the illness, but also as they are being prepared for the transition home.  The general rule of thumb for physical recovery is that for every day a person is in a hospital bed they will need at least two days to get back to normal.  As much as being able to stand on their own be mindful of how they are interacting with you and others around them.

Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families throughout metropolitan Chicago. Please email your questions to Charlotte Bishop., geriatric care manager Chicago, geriatric care Chicago

Copyright ©2011 Charlotte Bishop 

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