Elderly parent still in observation status after 4.5 days in hospital… Further testing not completed… Any advice?

No endoscopy.
A PET scan can diagnose cancer.
Get the patient admitted or transferred to a better hospital, like the Mayo clinic.

Otherwise, get her admitted to hospital on hospice.

I could be wrong.

The easiest way for the hospital would be to admit the patient. There most be a very compelling reason as to why the patient doesn't qualify for admission. Hospital admissions have changed drastically in the last few decades. Hospitals are now acute care facilities. Patients are discharged as soon as the acute condition has been controlled. Chronic cases are sent somewhere or just kept in observation until it's determined if they meet or not the requirements for admission.

I would be in the administration office demanding to know why my loved one hasn't been admitted. She won't be eligible for rehab without being admitted and the longer she lays in bed the more likely she will need some rehab.

Advocate for her.

When I was an RN in California lo those many years ago observation was not allowed for more than 24 hours. That's why the hospital was so anxious to corkscrew patients out before 24 hours was up. Once past that the patient would be "admitted " or "discharged" pretty much by law. This not admitting but keeping the patient is unknown to me. No one could afford the cost of this many days in hospital. Time to talk to whoever is case manager directly. Tell them you are headed next to JCAHO, the Joint Commission on Accreditation of Hospitals with a complaint, and DO IT.
"Writing the complaint: Be as specific as possible in no more than two pages and provide the name, address, city and state of the accredited hospital. For more information, call the Joint Commission's toll-free number: 800-994-6610, 8:30 AM to 5:00 PM CST."
The above is from online. Tell them you are calling and DO IT.

There very strict restrictions for admitting patients to a hospital. Many conditions have to be met. An inappropriate admission won't be covered by insurance or Medicare, and the family will be responsible for paying the bill. Many insurances do cover for observation status. Depending on the patient's age and medical condition, invasive tests might not be performed based on risks and whether follow-up surgical procedures would be worthless or not performed. Many invasive diagnostic procedures are not carried out after a certain age, because they will serve no purpose, since major surgical procedures won't be performed anyway. Assuming they found cancer, and the life expectancy is only a few more years. What will be the point in treating such cancer? The patient will die before the cancer kills him or her. Reality can be blunt, but that's reality and there is no escape from it.

I'd demand the hospital get your mom OFF of 'observation' status and admitted for a reason of some sort so further testing can happen!! Many Medicare plans will NOT PAY for 'observation' codes for hospitalization!! Get into advocacy status right away! Speak to the PCP or the hospitalist; demand answers! Get the endoscopy done by giving your okay (assuming you have medical POA). A Colonoscopy can be more dangerous than helpful due to her age, although I have no idea how an endoscopy could diagnose colon cancer, if that's what is going on. The patient advocate is 'passing the buck' over to the PCP for the 'status' matter, so raise hell with the PCP (if he's even affiliated with this hospital), that's what I'd do, but I have a big mouth and I don't apologize for it. Make it known to the hospital staff that mom suffers from cognitive impairment and is NOT to make her own decisions here, obviously, that you are her spokesperson moving forward. With this many medical conditions possibly pending, it's obvious she needs to be fully admitted so further testing can be completed and a diagnosis can be forthcoming.

I have seen nothing but BAD patient care lately for seniors in the hospital, which makes my blood boil! I'm so sorry you're going thru all of this with your dear mom and I sincerely hope you can get the answers both of you deserve. Sending prayers your way that God intervenes and helps you and mom in this situation.

Colonoscopy is not recommended…very weak…needs endoscopy first…PCP says the hospital makes the decision on observation versus inpatient status…then patient advocate says it is PCP decision..

Sorry…clicked “Depression” by accident…my elderly parent was transported by ambulance 4 days ago the nearest ER…then transferred to the hospital…diagnosis is UTI, had MRI of the brain and abdominal CT scan…has kidney cysts, and a brain arteriovenus..iron levels low and hemoglobin..possible colon cancer but because of the age risk outweighs benefit…endoscopy is recommended…but when a family member was not in the room parent said “No” but parent does not understand the procedure completely…has MCI…hospital has not changed status going on fifth day???

A little m ore info would help. Actually a lot more would be of help.
Why are they under observation?
What is the potential diagnosis?
Do you know what the delay is in diagnosing?
What does their Primary Care Physician say?
Have you talked to a Social Worker about the situation?

This is posted under "depression". Apparently this is quite serious, as it is rare to stay in this long.
Are you the POA?