Tuesday, May 26, 2015

Hospitals, Seniors, and Safety

I have had a influx of people calling and seeking advice after an elderly relative was sent home from a hospital into what the family viewed as an unsafe situation. Over and over I heard, why would the staff kick my relative out when they are sick and weak to go home and be alone. It's cruel.

Today I want to address this from multiple sides.

First, let's look at the hospital's role. They have a patient that does not need to stay in the ER or in a room any more. There is nothing more the hospital can do for them. And keeping them in the hospital increases the risk of new infections. They ask the patient if they feel ready to go home and the patient says yes. So the hospital releases the patient to go home. The system works great for most everyone. Who would want, at age 40, to get the second degree from the hospital staff when you are ready to go home. New York State law says if the patient says they are safe to go home, then they can be sent home.

Second, let's look at your elderly relative's role. If they can live at home safely before they went into the ER, they should be safe when they go home afterwards. Frequently, they were not really safe at home alone to begin with. The illness or the fall or whatever sent them to the hospital was a result of the fact that they were not safe at home alone. But if the senior refuses to see that or act on that fact, then they will be discharged from the hospital back into the unsafe environment. We live in a state that allows elderly people to make their own decisions, even if they are totally the wrong, highly unsafe decisions.

Third, is there a role for the family in this mess? When your elderly family member entered the hospital, is there a reason a family member didn't take him/her and stay? No one would send a five year old to the ER alone and no senior should go either. The family must be proactive in sharing their concerns with their elderly loved one so that when he/she decides to seek treatment, the family knows and someone is headed to the hospital with him/her.  This would allow the family to ensure that their senior is cared for, understands what is going on, and has a safe way to get home and be cared for.

From now on, let's try to stay calm when dealing with the health care system. No one went into medicine to put people into danger. Medical staff try their best to make sure everyone who comes in and out of the ER or hospital is safe, healthy, and treated with respect. While insurance companies don't want to pay for unnecessary time or treatments, they also don't want a senior returned to an unsafe environment where they will get injured or sicker. But they don't even get to talk to your loved one. They are relying on the hospital, senior, and family to make sure all is well. 

One of the key pieces to this puzzle is the reality that, at some point, seniors are more concerned with being independent than with their safety and health. When "I'm independent" is all the family member hears, they need to put into existence a game plan to ensure health and safety needs are being met. Because the loved one is now incapable of making that call for him/herself. This includes having a plan for when something happens that sends the senior to the hospital.

The earlier people can begin to make a plan, the more likely the senior is to follow it when the brain says "I'm ok, I don't need my family right now." Use this blog post as a starting point in your family to have this discussion. Some of the questions you might need to answer are: who will the senior call when he/she needs to go to the hospital, are health care proxies and other forms filled out, does everyone understand what the priorities are for your senior's long term goals on life, and how often do we need to review these plans and have these discussions to ensure the right decisions are made in an emergency.

Aging is a tough reward for not dying. It comes with constant ever-changing challenges that need the most open lines of communication possible. Illnesses, safety issues, healthcare systems, and insurance providers don't make any of this easier. In fact, those problems often take a mild situation and turn it upside down, sideways, and inside out. Don't get caught in the blame game, it doesn't help anything. Make a plan. Be prepared. Help your senior live out the rest of their live in peace, comfort, and safety, but also make sure they are LIVING their life to the fullest.

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