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