By Marlo Sollitto
Going to the hospital is somewhat like traveling to another country - the sights are unfamiliar and the people you meet there often speak a foreign language. No matter what the reason for the trip - whether it's an overnight visit for a few tests or a longer stay for medical treatment or major surgery - nearly everyone worries about entering the hospital. Learning more about hospitals and the people who work there may help make your elderly parent's hospital stay less stressful.
The following hints are meant for people whose senior parents plan to enter the hospital by choice rather than for those who go to the hospital because of an emergency. Relatives and friends of patients who are admitted to the hospital also may find this information useful.
What to Bring to the Hospital
It's best for caregivers to pack as little as possible for their senior mom or dad. However, be sure to bring the following items:
- nightclothes, bathrobe, and sturdy slippers (label all personal items)
- comfortable clothes to wear home
- a toothbrush, toothpaste, shampoo, comb and brush, deodorant, and razor
- a list of medicines, including prescription and over-the-counter drugs
- details of past illnesses, surgeries, and any allergies
- health insurance card
- a list of the names and telephone numbers (home and business) of family members to contact in an emergency
- Money for newspapers, magazines, or other items from the hospital gift shop
What to Leave Home
Leave large amounts of cash, jewelry (including wedding rings, earrings, and watches), credit cards, and checkbooks at home or have a family member or friend keep them. If an elderly parent must bring valuables, ask if they can be kept in the hospital safe during their stay. In addition, leave electric razors, hair dryers, and curling irons at home.
The first stop in the hospital will be the admitting office. Here your elderly mom or dad will sign forms allowing the hospital staff to treat them and to release medical information to their insurance company. They also will be asked about advance directives.
Most people 65 and older have Medicare health insurance, which has two parts: Part A (hospital insurance) and Part B (medical insurance). Medicare Part A helps pay for care in hospitals, skilled nursing facilities, and hospices, as well as some home health care. It covers a semiprivate room, meals, general nursing, and other hospital services and supplies. It does not pay for private duty nursing, a television or telephone in their room, or a private room, unless medically necessary. For more information about Medicare coverage, call the toll-free helpline at 1-800-MEDICARE (1-800-633-4227).
If your senior parent doesn't have health insurance, an admissions counselor can advise you and them about other payment methods and sources of financial aid, such as the Hill-Burton program. Hill-Burton hospitals provide free or below-cost health care to people unable to pay. Eligibility for these free services is based on family size and income. For more information, call the Hill-Burton hotline at 1-800-638-0742; Maryland residents should call 1-800-492-0359.
Once all the forms have been filled out, your elderly mom or dad will be taken to his or her room. You both will then begin to meet the health professionals who will care for them while they're in the hospital.
Doctors are in charge of their overall care. They'll have an attending physician, who may be their primary doctor, a doctor on the hospital staff to whom you've been referred, or a specialist. In a teaching hospital (where doctors train), several doctors care for each patient. For example, the attending physician directs the house staff - medical students, residents (doctors who have recently graduated from medical school), and fellows (doctors who receive training in a special area of medicine or surgery after their residency training).
Nurses - registered nurses, nurse practitioners, licensed practical nurses, nurse's aides, and nursing students - provide many patient-care services. For example, nurses give medicines, check vital signs (blood pressure, temperature, and pulse), provide treatments, and teach patients to care for themselves. The head nurse coordinates nursing care for each patient on the unit (the floor or section of the hospital where your senior parent's room is located).
Physical therapists teach patients how to build muscles, increase flexibility, and improve coordination. They may use exercise, heat, cold, or water therapy to help patients whose ability to move is limited.
Occupational therapists work with patients to restore, maintain, or increase their ability to perform daily tasks such as cooking, eating, bathing, and dressing.
Respiratory therapists prevent and treat breathing problems. For example, they teach patients exercises to help prevent lung infections after surgery.
Technicians perform a variety of tests such as x-rays or procedures such as taking blood.
Dietitians help plan specialized menus for patients and teach them how to plan a well-balanced diet.
Pharmacists know the chemical makeup and correct use of drugs. They prepare the medicines used in the hospital.
Social workers offer support to patients and their families. They can help patients and families learn about home-care, social services, and support groups.
Discharge planners help patients arrange for health and home care needs after they go home from the hospital.
Some older people have many health problems that threaten their ability to live on their own after they leave the hospital. In some hospitals, a team that includes a doctor, nurse, and social worker addresses the special needs of older patients. This team also may include other specialists and therapists. The team performs a thorough exam, called a geriatric assessment, to learn about the patient's physical and mental health, family life, income, living arrangements, access to community services, and ability to perform daily tasks. The team diagnoses health problems and develops a plan to help older patients get the health care and social services they need.
Hospitals have many patient-care areas. For example, patients may be in a private (one-bed) or semiprivate (two-bed) room. The intensive care unit (also called the ICU) has special equipment and staff to care for very ill patients. Coronary care units (CCUs) give intensive medical care to patients with severe heart disease. In both the ICU and CCU, visiting hours are strictly limited and usually only family members are allowed to see patients. Surgery is done in the operating room (OR). After an operation, patients spend time in the recovery room before going back to their own room.
In the emergency room (ER), trained staff treat life-threatening injuries or illnesses. Patients who are badly hurt or very sick are seen first. Because the ER is so busy, less seriously ill patients may have to wait before they are seen by an emergency medical technician, nurse, or doctor.
Because your senior parent may feel weak or tired, please take a few extra safety steps while in the hospital:
- Use the call bell or button when you need help.
- Use the controls to lower their bed before they get in or out.
- Be careful not to trip over the wires and tubes that may be around the bed.
- Keep the things they need within easy reach.
- Make sure they take only prescribed medicines. If they bring their own medicines, tell their nurse or doctor. The nurse on duty will usually assess this upon admission. Don't let your parent take other drugs without a doctor's permission.
- They should hold on to grab bars for support when getting in and out of the bathtub or shower.
- Make sure they use handrails on stairways and in hallways if they are allowed to walk.
During the hospital stay, your elderly parent will probably have many questions about their care. They should always feel free to ask the doctor these questions. The doctor is there to help them get the care they need and to discuss their concerns. The nurse or social worker also may be able to answer many of their questions or help them get the information them need.
You or your elderly mom or dad may find it useful to write down your questions as you both think of them. For example, you may want to ask the doctor or nurse some or all of the following questions:
- What will this test tell you? Why is it needed, and when will you know the results?
- What treatment is needed, and how long will it last?
- What are the benefits and risks of treatment?
- When can my parent go home?
- At home, will they have to change their regular activities or diet?
- How often will they need checkups?
- Is any other follow-up needed?
Before going home, your senior mom or dad will need discharge orders from their doctor and a release form from the hospital. Discharge planning before leaving the hospital can help your elderly parent prepare for their health and home-care needs after they go home. The discharge planner can help arrange for a visiting nurse, medical equipment, meals-on-wheels, or other services. The discharge planner also knows about senior centers, rehabilitation centers, nursing homes, and other long-term care services.
The National Institute on Aging (NIA), one of the 27 Institutes and Centers of the National Institute of Health (NIH) leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people.