“Will you still need me, will you still feed me, when I’m sixty-four?” sang the Beatles a long time ago. If you were 15 when the song came out in 1967, then you’re 64 today. Sobering thought.
So what do 60-somethings care about? Retirement and finances? Sure. Travel or playing with grandchildren? If they’re lucky. Being fed? Not so much.
But for millions of people in their 60’s and beyond, health is a primary concern. When I was younger, I remember being amazed at how much my parents and their friends talked about aches and pains, doctor appointments and illnesses.
“When you have your health, you have everything. When you do not have your health, nothing else matters at all.” ―Augusten Burroughs, author
Now I get it. I have a few aches and pains of my own. Many of my friends have serious illnesses. Some have been hospitalized more than once. My husband has recovered from 14 separate hospitalizations over the past quarter century. He certainly has his share of health worries and the battle scars to prove it.
Over the years, I’ve learned a lot about medicine, hospitals and how to advocate for the best care. I’ve even written a book about it.
Since May is Older Americans Month, here’s a special look at some of the issues facing elderly, hospitalized patients.
Not surprisingly, older people are hospitalized more than younger ones. Of the roughly 35 million hospital discharges every year, more than a third involve people 65 years of age and older — well beyond their share of the population.
Hospitalization is scary for everyone, regardless of age. But seniors are especially vulnerable to certain hospital risks such as falls and hospital-acquired infections. They’re also more likely to suffer confusion, delirium, depression, medication interactions and other complications.
Patients who are frail or elderly may be unable to shift about in the bed on their own and — if not turned regularly — at risk of developing bedsores, which can be very dangerous.
Older patients may not recover well from surgery, lacking essential physical reserve to rebound. What’s more, they experience greater problems with anesthesia. Some experience difficulties with cognitive functions, concentration and depression. For many people these are temporary, but for some the side effects linger much longer.
Elderly patients are not always truthful about their concerns or fears. They may be ashamed to admit their worries or embarrassed about their limitations. Special attention from a nurse or social worker may help get the issues out in the open and addressed.
Even more serious concerns may arise if an older patient is suffering pain, anxiety or depression. A palliative care consult may be needed. This somewhat new area of medicine concentrates on the overall comfort and well-being of the patient, not just treating the illness. Specialists are trained to help patients make decisions about their care choices including end-of-life concerns.
Because these problems are becoming well recognized, there is a growing trend toward hospital units specifically designed for older patients. Eldercare units can provide improved care, shorter hospital stays and lower costs. They often offer more privacy, specialized expertise and increased sensitivity to elderly patients’ needs, including special bedding, lighting and support services.
Many of these units include geriatric specialists who are specifically trained in treating elderly patients. They may also offer specialized expertise in fall prevention, physical and occupational therapy, sleep disorders, diabetes and nutrition control, wound healing and other areas of special concern.
Even if an eldercare unit is available, families should talk candidly with the doctors and nurses about their patient’s medical history, special needs and preferences to ensure that all concerns are addressed. Honest communication is critical to getting the best care.
If the patient has a Do Not Resuscitate order or other advance medical directive, it is essential that a copy be placed in the medical file and that doctors and nurses be reminded of the patient’s choices.
Needing, feeding and saving lives
Family involvement pays big dividends. For starters, families can provide essential details about the patient’s medical history, symptoms, prescription and over-the-counter drugs, healthcare preferences and concerns. They know their loved ones better than anyone else in the hospital, and that counts for a lot in making sure that patients are getting the best possible care.
Close family or even friends can help with many bedside duties such as feeding, light bathing, fetching fresh water and finding the television remote — relieving overworked nurses of routine tasks and freeing them to concentrate on more important things such as dispensing medication, conferring with doctors or tending to wound care.
Families engaged in care and discharge planning are also better equipped to help when the patient leaves the hospital, whether to go to a nursing or rehabilitation facility or to go home. And that can help reduce the chance of readmission — something no one, least of all the patient, wants to see happen.
Maybe the Beatles were right after all to ask about needing and feeding! Bottom line is this: No one should go to the hospital alone. Family or friends can make a meaningful difference in patient care. They can even help save their loved ones’ lives.