[Reblog] Keeping Elders Out of Hospitals as Much as Possible

From the December 4, 2013 post  by Marti Weston at As Our Parents Age

 

Anyone who has spent time with an elder parent in the hospital knows just how easy it is for one problem to be solved only to have the person discharged with different problems. This is not necessarily the fault of the medical caregivers or the hospital itself — it’s a result of a system that puts older people into beds and keeps them there. Add in bed alarms, the inability to move much, and that hospitals isolate elder patients from their routines and support communities, and you have a recipe for unsuccessful care, a result of age associated hospital complications.

So I recommend reading The Hospital is No Place for the Elderly, a November 20, 2013 article that appeared in the The Atlantic. This piece aptly illustrates the conundrum of frail elderly patients with chronic health issues admitted to hospitals where medical care focuses primarily on fixing acute health problems. The difficulty is that most of frail elders’ medical issues cannot be fixed — but the quality of their lives can improve. Author Jonathan Rauch also describes several programs in the United States — teams of physicians, nurses, and other health professionals — that collaborate to keep patients as healthy as possible and out of the hospital. The teams even save money.

Many team-based support programs for frail elders run deficits, despite that they are so successful, but Rauch reports that the climate is changing, as Medicare and some insurance companies develop a more welcoming attitude toward innovative health care programs. The Affordable Care Acthas designated money to support innovative and new models of care delivery. (To learn more about other innovative programs you might also want to read Atul Gwande’s 2011 New Yorker article about changing models of medical care.)

One of the most interesting parts of The Atlantic article was the description of the team meetings where participants collaborate and coordinate patients’ medical care in order to help elders stay as healthy as possible.

Best Atlantic Article Quotes

• The idea is simple: rather than wait until people get sick and need hospitalization, you build a multidisciplinary team that visits them at home, coordinates health-related services, and tries to nip problems in the bud.
• These people aren’t on death’s doorstep, but neither will they recover. Physically (and sometimes cognitively), they are frail…
• Patients were presented not as bundles of syndromes—as medical charts—but as having personal goals, such as making a trip or getting back on their feet. The team tries to think about meeting patients’ goals rather than performing procedures.

 

 

Related articles

• One-third of older adults admitted to ICU deemed “frail” (medicalnewstoday.com)
• Elderly patients are at risk of readmission after hospital stays (express.co.uk)