It happens to most caregivers. The one you are caring for winds up in the hospital. It’s easy to feel overwhelmed when this happens, or even guilty that you missed something. You didn’t. Things like heart problems, pneumonia, kidney infections, and more happen to many older people regardless of how closely you care for them.
Should that happen, there is much you can do to keep a senior safe while in the hospital.
I learned this the hard way—after many trips to the emergency department…which often led to hospitalizations. Sometimes it was from an uncontrolled urinary tract infection. Other times, a broken bone after a fall, or a bout of pneumonia after a cold. Too often, I would witness my mother being “cured” of what brought her there but then suffer a big step down in health, physical or cognitive function that took weeks or months to recover from.
At first, I didn’t know that there were things that I, as my mother’s caregiver, could have done to protect her. After I learned them, it made all the difference in her outcome.
As Elizabeth Eckstrom, MD, MPH, MACP, writes in our book, The Gift of Caring, geriatricians recognize that older adults are a unique group when it comes to being admitted to a hospital. They have specialized requirements and their needs are different from those of middle-aged persons. Even when the illness that necessitated them being hospitalized is remediated, one out of three patients ages 70 and older will leave the hospital worse off! Many will never recover to their pre-illness level of functioning. Many will develop memory problems, trouble walking, and lose the ability to live as they did before.
Why? Because the hospital experience is very hard on older people. They are less resilient to cope. When in the hospital, they get weak from too much bed rest…they get awakened many times during the night for blood draws and routine checks…they lose their sense of days and nights and suffer sleep deprivation. They may get dehydrated. They are often overly medicated. And they become disoriented, which can be the most serious issue of all.
Life for us changed when my mother’s care was at last overseen by a geriatrician who was aware of the disabilities that can arise when a senior enters the hospital. She was on the lookout for my mother becoming disoriented. To keep that from happening, the doctor changed things around for her, using strategies that differed from normal hospital protocol. She explained these things to me so that I could be aware and observant of my mother’s condition to make sure it did not deteriorate.
The strategies she suggested are the same ones that Dr. Eckstrom recommends in our book. It is critical to keep a senior oriented to protect their cognition. It is also important that they get out of bed and moving as soon as safely possible to help them retain (or regain) their prior functioning.
What did the doctor do? First, she had my mother moved to a room where she could see trees and the sun could shine in and light up the room. Prior to that, my mother had been placed in a dark room with only one small window that looked out on a concrete wall. Just seeing the beauty of nature had a positive and hopeful effect on my mother’s mood.
Even more critical, the doctor insisted that my mother keep on her hearing aid. Most hospitals will remove a patient’s hearing aid fearing it will get lost. That’s where you can come in as a caregiver. You can take responsibility for it, and make sure your loved one wears it. Taking away a hearing aid is one of the worst things you can do for an older person; aging patients will quickly lose their orientation.
Another strategy the doctor ordered was to make sure that my mother had good lighting in her room, and that her eyeglasses were readily available. As well, she told nurses that she did not want my mother awakened during the night—allowing for better sleep was another crucial element that helped my mother retain her orientation.
She also suggested that if I could, I should stay overnight with her. She told us to bring clothes from home that my mother could wear instead of the sterile and uncomfortable hospital gown. We also brought in family photographs for her to enjoy and food she liked to eat!
In addition, we made sure my mother did not get dehydrated—a problem rife in hospitals caring for older persons. We brought in lots of things my mother could drink—especially chocolate shakes that she loved. (The doctor said that was fine.)
In the end? My mother did not become completely disoriented with this hospitalization as she often did before when at the hospital. Even better, when her urinary tract infection was under control, she was discharged not to a skilled nursing center but to HOME.
In the US, we have a long way to go to create hospital settings that are beneficial for seniors. Until that time, caregivers can make adjustments for their loved ones to keep them safe and oriented. We can develop partnerships with our loved one’s doctor. We can become educated and empowered in our role. And with that, provide our loved ones the well-being they deserve.
Check out Marcy’s website, or click here to purchase her book, “The Gift of Caring: Saving Our Parents—and Ourselves—from the Perils of Modern Healthcare”.
