Did you know that according to the Archives of  Internal Medicine medication errors happened in nearly one in five doses given in hospitals in 2002? Nurses are stretched thin, and most hospitals don't have as many staff as they'd like to have, or need.

When someone you care about goes into the hospital it's imperative that someone be there, and that the person who's there will be an active advocate for the patient.

Patients of any age need support in the hospital if they are really ill, or if they are having a major surgical procedure. Our elders almost always need someone there even when they aren't so critically ill.

Older adults tend to be hesitant to insist on answers from doctors and nurses. Hearing or vision impairments may make it difficult for them to understand the information they do get. Pain medications can cloud their thinking. Anxiety and confusion are almost always worse during a hospitalization.

So, without sending you to medical school, here are a few important things you can do to insure that your elder has the best possible hospital stay:

1. Be there
As much as possible, be in the room with your parent. Set up a schedule if you need to share responsibility with other family members or reliable friends. If you absolutely can't be there all the time, it's especially important that you be there early in the morning (doctors sometimes make their rounds as early as 6 a.m.) and in the late afternoon and evening (doctors often visit after their office hours, sometimes as late as 8 or 9 p.m.).

2. Document your "permissions"
Get your "permissions" in the patient's chart. Give a copy of your Medical Power of Attorney to the nurse and watch to see that he or she puts it in the medical chart right then. This is the legal document you need so that medical personnel can give you information. Even if your parent has been in the same hospital before, give the nurse another copy. Old charts will be stored in Medical Records, and the copies you gave them before won't be in the working chart for this hospitalization.

3. Take notes
Have a dedicated small notebook with you at all times. Make a list of every medication and treatment that has been ordered (name, color, shape, dosage, what it's for). Record the name of each doctor, nurse and aide who works with your parent. Ask about and and record every medication and treatment. If a medication isn't on your list, ask questions before you allow your parent to take it. Write down your questions as you think of them, so you have them ready when the doctor comes in. Write down the answers.

4. Ask questions
If you have a question, ask. Most of the staff will happy to give you any information you need if they know the answer. If the nurse or therapist says "I don't know," ask who would know the answer and track that person down. Often the doctor is the only one who will be able to answer many of your questions.

5. Watch carefully
Little things can be very important. Did the nurse check the patient's wristband before administering medication? Make sure that the kitchen hasn't sent something that's not permitted (diabetics seem to get a lot of cake on their meal trays). If your parent is scheduled for surgery, she might not be permitted to eat or drink at all. If someone wants to administer a test or take your parent for a procedure you know nothing about, get answers before you allow things to proceed.

6. Stay cool and don't hover
If you're anxious and upset, the patient will pick up on what you're feeling. If you're upset about something, leave the room to talk about it. Take calming breaths and don't raise your voice. Let the patient do whatever he can do for himself, including talking with the doctor and the nurses.

7. Anticipate shift changes
Most hospitals have three shifts: 7 am to 3 pm; 3 pm to 11 pm; and 11 pm to 7 am. When shifts change, the nurses, therapists and aides will be in a meeting at the nurses' station for about half an hour. This is how they pass information about their patients from one shift to the next. Just before and during shift change you'll find it hard to get much attention for your patient, so anticipate the times that this will be a problem. Ask for what you need 30 minutes before shift change and you'll have much faster response.

8. Help the staff whenever you can
Let the nurse know before the IV bag is empty - she'll appreciate it. Offer to record vital signs off the machine if she's coming in every 15 minutes to do that. She'll appreciate it. Find out where the patients' refrigerator is and keep your parent's ice pitcher and juice supply fresh. The aide will appreciate it. Do whatever you can to be helpful within your role (don't try to take over the nurse's job).

9. Keep treats in the room
Fresh, high quality cookies will do wonders for the amount of attention you and your parent receive from the staff. If it's permitted in the room, keep a plate or basket filled and add a "Take Some" sign. Cover it lightly with clear plastic wrap and place it on a counter or windowsill away from the patient but in clear view of everyone who comes in. Make sure to offer it initially.

10. Meet the discharge planner
The discharge planner is responsible for making sure that plans have been made for leaving the hospital. If you have concerns about what will happen, or how you'll manage when your parent leaves the hospital, the discharge planner is the one who will help you find answers.

Sometimes the discharge planner won't be called in because the doctor and the nurses believe you have everything well in hand. And, like everyone else in the hospital, discharge planners are often overworked and short of time. They might not start to get involved until a day or two before discharge. Introduce yourself early, and you'll have a better chance to explore all possible options with the planner.

Follow these tips and both you and the patient will stand a much better chance of having a "bearable" hospital experience.