Why older patients could be worse off after going to the hospitalSenior Health
By pH health care professionals
Imagine arriving to the hospital with injuries from a fall, hoping to be treated and released so you can get back to your home and your life. But bad turns to worse. You’re almost entirely immobile the whole time, stuck on bedrest, tethered to your IV and oxygen. You’re not eating or sleeping well, and it doesn’t help that you’re in a noisy ward, having your vitals monitored at all hours of the night. And then you’re subjected to potentially unnecessary procedures, as well as repetitive or even harmful medications. By the time your stay is over, you are unable to walk, bathe or dress on your own. Even your memory is failing. Instead of going back home, you are discharged to a nursing home.
That’s the reality many older patients face, according to a recent Medscape article. Around one-third of patients over age 70, and over half of patients over 85, leave the hospital more disabled than when they arrived, the article reported, citing a recent study in JAMA.
Many older patients arrive independent but leave unable to care for themselves. Hospital-acquired infections, excessive bedrest and lack of mobility, and poor eating/sleeping conditions can all contribute to deteriorating health in a hospital setting.
“The older you are, the worse the hospital is for you,” said Ken Covinsky, a physician and researcher at the University of California, San Francisco division of geriatrics to Medscape. “A lot of the stuff we do in medicine does more harm than good. And sometimes with the care of older people, less is more.”
So what’s the solution?
The government penalizes hospitals when patients fall, get preventable infections or return within a month of discharge, Medscape reported. But they aren’t penalized for things like patients losing their ability to walk or their memory, so they aren’t tracked or measured. Hospitals that proactively monitor all outcomes for their older patients may find ways to address this population’s unique needs.
Another way to address older patients’ needs is with a specialized unit, like San Francisco General’s Acute Care for Elders (ACE) ward, with a focus on helping patients foster their independence so they can return to their homes. Patients are encouraged to be mobile, eat in a communal dining hall, and practice taking care of themselves as much as possible, Medscape reported, noting that such units have been shown to reduce hospital-inflicted disabilities, lengths of stay, and the number of patients discharged to nursing homes.
Lastly, older patients and their families can enlist the services of a patient advocate -- someone who will be on the patient’s side, advocating for the best care possible. A pH Patient Advocate is also a medical doctor, meaning he or she can review your records and provide a qualified second opinion about treatment options. You can learn more about patient advocates here.
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