Considerations of a Hospitalization Part 1
Understanding the unique health circumstances of the older adult in our community is the responsibility of medical professionals at every level of care - from acute to community-based nursing. If your professional or personal role involves caring for older adults, appreciation of the impact of hospitalization should inform your care in the short and long term. As a nurse with a background in acute care, now tasked with managing care of older adults in the community, I often see a disconnect between the care for the acute illness and the knowledge the patient will need to discharge home, as near as possible to the previous level of functioning. The older adult may have a fragile state of independence. Once compromised, the older adult may never fully recover.
A condition known as Post-Hospital Syndrome (PHS) is a disorder acquired by patients (primarily older adults) in which they are susceptible to adverse health events unrelated to the original, admitting diagnosis. The duration of PHS can be weeks to months or longer. PHS places older adults at higher risk for rehospitalization along with deterioration of mental and physical health.
The changes occurring in the body of the older adult during acute illness and also as a result of the experience of residing in the hospital environment can be anticipated. The data clearly shows a reduction in ability to carry out ADLs. As outlined in this paper, we should expect deconditioning of the physical, mental and cognitive state as a rule, more so if the person has any chronic conditions prior to hospitalization. That knowledge should inform our advocacy in the acute care setting and help us reduce the risk of PHS in the patients we are managing.
If we are to allocate resources of time and attention wisely, the focus would be on prevention of hospitalization and rehospitalization. Early intervention when symptoms are manageable and avoiding hospitalization is usually possible. PHS is a result of hospitalization, but the hospitalization can often be avoided by proper management of chronic conditions. According to available data, around 26% of hospitalizations for seniors are considered potentially avoidable, meaning a significant portion of senior hospitalizations could be prevented with proper management of chronic conditions and proactive care; this translates to a large number of avoidable hospitalizations each year, with estimates varying depending on the study and population examined.
Home care and care management can support a family caregiver when medication and specialist coordination becomes more complex. To learn more about the ways HelloCare can support wellness in the home call us at 971-237-9244 to speak with one of our nurses.
