It’s something nobody wants to think about: Going to the hospital. The fact remains, though, that older people can wind up there for myriad reasons—pneumonia, influenza, urinary tract infection, trauma from a fall, congestive heart failure and many other problems. If you are “armed” with the correct medical lingo—words spoken among doctors but nearly completely unknown to the rest of us—you can better-ensure a good outcome for your loved one, with the end result that he or she comes home not too much worse for wear.
Most people don’t know this medical-speak. And so even if a loved one goes to the hospital for something often simple and curable, the outcome is far less certain.
In fact, research has shown that half of disability among older adults occurs during medical hospitalization. The older someone is, the greater the chances that when he leaves the hospital he will never return to the same level of independence as before.
Is there any way you can protect your loved ones? Yes! You can take more charge of your loved one’s health and become a partner with the doctors and other health care providers. As geriatrician Elizabeth Eckstrom, MD, MPH, MACP elucidates in our book, The Gift of Caring, perhaps one of the best ways to do this is to understand three key medical terms.
The first and most important word to understand is “baseline.” Baseline describes what your older loved one was like before getting sick. It is defined as a person’s normal functioning level and covers both physical and cognitive function—before he contracted that infection, or took that nasty spill, or caught the flu. Further, baseline is the state you hope he returns to after being cured of what sent him to the hospital.
Doctors and healthcare providers need this information to help diagnose and treat a patient. Why? Too often, when an older individual comes to a busy hospital setting exhibiting any sort of confusion, the symptoms are treated as the person’s baseline. The patient is unfamiliar to the health care team so they don’t know any better.
The second term you need to know is “ADL,” which stands for Activities of Daily Living. This is what someone can and can’t do. Can he walk five blocks? Does he need the assistance of a walker? Can he manage his own medications? Take care of his own finances? Does he cook for himself and do his own housework? Does he drive? Does he need some help or full assistance with these daily tasks? ADL is a list of your physical and cognitive functioning that closely relates to your loved one’s level of independence and how much aid may or may not be needed.
ADL’s are also critical to document. If an older loved one ever needs to go to the hospital, providers can immediately get an appraisal and understanding of the whole person behind the crisis. In other words, what he is capable of managing by himself.
The third essential term is “HAD,” short for Hospitalization-Associated Functional Decline. This is something none of us wants to happen if we are in the hospital. HADs can develop while someone is receiving treatment…and occur sometime between admission and the time of discharge.
Studies show 30% of all patients age 70 years and older who are hospitalized will be discharged with a permanent functional decline. Many will need the help of a caregiver or require long-term care.
So how do you protect a loved one from developing a HAD? Do everything you can to help him stay oriented while in the hospital! Older patients need to…
- Wear their hearing aids.
- Have good lighting.
- Advocate to have a hospital room with a view of the outdoors—trees and sky, not a brick wall. It is important that seniors keep their days and nights intact, and not have their sleep disrupted through the night.
- Get up and moving as quickly as safely possible. Periods of bedrest mean muscle wasting.
- Surround themselves with familiar items, like pictures of family and loved ones, to help normalize the hospital experience. Everything that you can do to help keep a stable sensory experience is beneficial.
So, is there an easy way you can keep all this information in one place should a crisis arise for a family member? Again, the answer is yes!
The Gift of Caring Health History Sheet © is a two-page form that can be filled out by you and your provider. It lists essential information that any new provider needs to know, especially if someone has to go to the Emergency Room. Included:
- The basics: name, address, date of birth, insurance carrier, and contact information for the primary care doctor as well as specialists.
- If there is a Health Care Directive and a POLST or MOLST.
- A list of all medications and dosages, and any allergies.
- Space for the person’s BASELINE, which includes a summary of his medical history.
- A chart of all activities of daily living.
This Health History Sheet should be updated and reviewed at each doctor visit. Keep a physician-validated Gift of Caring Health History Sheet on hand at all times. Give copies, too, to family members.
A patient is not just a collection of symptoms, but a whole individual. Learn these three terms, fill out a Health History Sheet, and become a contributing member to your loved one’s health care team! It can make all the difference on that day he lands in the hospital. And the best news of all? It could save a life.
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”.