I remember reading an article by CNN some years ago titled ‘The older you are, the worse the hospital is for you’. Initially I thought it was a bit over the top when it came to elderly care while they’re in the hospital. Unfortunately, they weren’t far from the mark, and did touch upon some issues that are very real and worrisome.

Mom in the hospital

Mom’s last day in a hospital

The fact is that in today’s health care environment most of the inpatients are older, Medicare aged. Since many hospitals still budget and plan based on inpatient services, the Medicare dollar for those services isn’t as high as it would be if these patients had other insurances as primary coverage. Thus, hospitals have less money, and that means offering fewer services because they have fewer people working there, especially nurses, who often work double shifts because of staffing issues. Oddly enough, it cost less to pay a nurse time and a half for that second shift than it does to hire more nurses.

Therefore, if you have an elderly relative or friend in the hospital and you’re in any way responsible for their care, it’s incumbent that you check on some things while you’re there, and try to verify other things are happening while you’re not there. Here are some of those things you should be following up on, and some of them are based on personal observation.

1. Is your loved one eating?

Sometimes elderly patients aren’t able to feed themselves while in the hospital because of the pharmaceuticals they’re being given. Our expectations are that nurses are feeding them but it turns out that’s not the case most of the time. I remember going into the hospital and being told that my grandmother wasn’t eating, but when I started feeding her she ate. Then a nurse told me she wasn’t feeding herself, which she couldn’t do and anyone looking at her should have known that.

My mother had a different issue. Like her son, she was a picky eater. They brought her stuff that I wouldn’t eat. They also brought her stuff that was sealed, and she had no clue how to open any of those items up. I had to ask them to bring her chicken strips for lunch and dinner because she knew what to do with those, and to put her drinks in a styrofoam cup (that’s what hospitals are still using) with a top on it and a straw.

2. Are they being moved?

Because it’s not anything most of us deal with, we have no idea just how bad bedsores can be and the importance of having someone making sure their patients body’s are being moved. It’s just not something we think about, but we need to.

When my grandmother was taken to a nursing home, the doctors there found that she had a hole in her back because she’d obviously never been moved at the hospital, and she had no way of communicating to anyone that she was in pain. When I broke my mother out of the last nursing home she was in, she had a massive bedsore on her backside that they didn’t know anything about because they didn’t check out that area (it was deep); I know this because I’d requested the entire medical record and they never mentioned it.

3. Are they taking the right medication?

Did you know that if you have power of attorney you’re allowed to look at a patient’s chart? I asked a nurse what medication my grandmother was taking and something she said didn’t sit right with me. I looked into her chart and saw a different medication listed, then put in a request to talk to the physician. Once we talked about what I saw he verified that she wasn’t taking what another physician had prescribed and that somehow she’d been taking something that the staff was told was a generic of the other medication.

4. How often is someone stopping by to check on them?

CLAP. La Paz, Honduras.

Pan American Health Organization-PAHO

via Compfight

Every time a physician or nurse stops by, they’re supposed to write something in the chart because at the very least they’re supposed to be taking vital signs. Even with an understanding that some hospitals are larger and that they might be short staffed, there’s no excuse for not having anyone stop by to check on patients at least once every 4 hours; that doesn’t include the person who brings the food. Even if the patient is only in recovery mode, that’s no excuse for them not being seen at least twice during an 8-hour period.

The other side of this one is that there are some patients who think someone should be checking on them every 30 minutes when they’re only in the hospital for monitoring, so you might have to keep a check on the person who’s in your care while making sure that someone still comes every once in a while, because nurses stations will turn off those contact alarms if some patients are out of hand.

My mother didn’t get a lot of attention during the day when I was with her. True, it was during the pandemic, but I still felt someone should at least stop in, take a quick look and move on. Since Mom had dementia, one could have thought that asking her anything wouldn’t have made a difference since she couldn’t respond to them, but she wasn’t always alone in a room and the other patient also rarely saw anyone while I was there.

5. If they’ve been moved to another room, has everything been set back up properly?

Many years ago when my dad was in the hospital, he was moved from one room to another overnight. When we arrived at the hospital the next day and were informed of this, once we found his room we saw that his dialysis machine hadn’t been turned back on. After I pitched a fit I learned that the nurses who moved him didn’t know how to work the machine and it didn’t occur to either of them to contact anyone in the dialysis department to ask them how to turn it off and then turn it back on, which they couldn’t have done on their own anyway. I ended up reporting that one to the director of nursing, especially after the response I received from the physician was insufficient (I wasn’t playing!).

6. Were any procedures performed while you weren’t there?

This happens more often than you might believe, and family members aren’t always told that something took place. Most of the time it’s a simple procedure, but sometimes it’s something a bit more complex, and you might not find out about it for a while.

Emergencies happen and sometimes it’s critical that patients be taken care of, but every once in a while patients might give their permission for something they really don’t have the mental capacity for at the time. That’s why notification needs to be given up front that before any procedures do happen that you’re informed.

7. Is care being taken to keep everything as clean and sterile as possible?

Many patients end up staying in the hospital because of infections. They can occur in many different ways and in many different areas of the body. Patients should be cleaned at least once every 24 hours and given clean gowns to put on; twice is much better. Extra care needs to be taken when patients have anything attached to their bodies, such as catheters, replaced. This is one of the top 5 things Medicare examines hospitals across the country for, so it’s a big deal and something you should make sure is happening on a regular basis.

Hospital stays are bad enough for all parties involved and bad things can happen. Even though it’s the hospital’s responsibility to take care of your loved one, you might want to be a bit more vigilant in making sure things are going as smooth as possible.

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