Managing a Senior Health Crisis: What to Ask Before Leaving the Hospital

When crisis happens, we’re often caught off guard. Perhaps your mom fell at home and broke her hip, or your uncle suffered a heart attack in the nursing home. They are rushed to the hospital, and then discharged after a few days of acute care. But what happens when they arrive back at home or their senior living community and are unprepared for life after the crisis?

Connie Smith, director of health and wellness at Mercy Ridge Retirement Community in Maryland, offers advice on what to ask before leaving the hospital with your senior loved ones so you can be proactive about their care.

Ask about medications.

The first thing Smith suggests is to ask for a copy of the medications the senior received during the hospitalization, as well as the results of any testing done. You will need this information for anyone who will have a hand in your loved one’s care. “All instructions need to be reviewed with the senior and someone else before the senior signs the discharge form,” adds Smith.

Ask about physical therapy.

If your loved one has been hospitalized for more than three nights, Smith recommends asking for a physical therapy consult and evaluation. “The biggest issue I have seen is that after a brief hospitalization, seniors are deconditioned and may need intense therapy to regain their before-hospitalization status,” she says. After a three-day stay, she adds, Medicare will pay for sub-acute care if needed.

Ask about assistance with activities of daily living (ADLs).

“Since a lot of procedures are now done in an outpatient center, I see seniors returning to their homes and not being able to meet their ADL needs,” says Smith. She notes that the hospital social worker or discharge planner is typically responsible for making sure all services are set up prior to the patient’s leaving the acute setting. Caregivers should check in with the responsible party to ensure that any required services have been put in place.

Ask about requirements for discharge.

“If there is a valid reason that you feel your loved one is being discharged too soon, that should be expressed to the discharge planner or case manager,” says Smith. But, she notes, the hospital is not required to keep your loved one just because you feel he or she is too weak. “Once the issue they were admitted for is gone, then the hospital is free to discharge.”

The good news, though, is that premature hospital discharge may be a thing of the past. “With all of the changes in health care, I foresee that there will be a little more due diligence on the hospitals’ part before discharging someone,” says Smith. “Hospitals and physicians are monitored for any readmissions within 30 days of discharge and can suffer a fine if the person is readmitted.”

Make sure the senior living community is part of the conversation.

If your loved one is returning to a senior living community such as a nursing home or CCRC, the community should be aware of any health crisis. At Mercy Ridge, for example, a case manager follows up with the family and the hospital social worker or case manager for hospitalized residents of assisted living, nursing home, and skilled care. She does note, however, that “there are always those who fall through the cracks.” Make sure your loved one stays on the radar by talking with the case manager and nurses yourself.

Slow down.

“Typically the senior is just wanting to go home and will not look at what they will need when they get there,” says Smith. That’s why it’s so important to slow down and be the voice of reason for your loved one. “Every person, not just seniors, should have an advocate with them at discharge who is able to ask questions.”

This article was originally posted at http://ppsplus.com/blog/managing-a-senior-health-crisis.

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