Prepare. Prepare for a hospital stay. Whether the stay is for you, or a loved one you’re caring for, good preparation will ease concerns, increase confidence, and very likely positively affect the outcome. Any and all efforts to ease pre-hospitalization anxiety will help older seniors, who are especially vulnerable to confusion during a hospital stay. The strange surroundings, change in routine, and disrupted sleep all work to compound the anxiety most of us have about hospitals. When a person has dementia, or even mild cognitive impairment, the stresses of a hospital stay can lead to unusual or extreme behaviors, such as wandering, combativeness, and hallucinations, even in people who have not experienced these behaviors before. For the safety of the older person who will be hospitalized, consider arranging for someone to accompany them at all times, from admission to release.
Here are 15 more tips for a successful hospital stay:
- Prepare an advanced medical directive (AMD):
- Everyone over 18 should have an AMD
- Explains medical treatments you want and don’t want, in the event you cannot speak for yourself (Living will)
- Names who you want to make medical decisions for you; could be relative, friend, trusted advisor (Durable Power of Attorney for Healthcare)
- Make 6-8 copies of the document(s)
- Give a set to the person named the POA for healthcare
- Give a set to your next of kin
- Give a set to your primary care physician
- If you know the doctor who will supervise your hospital stay, give him or her a set
- If the doctor indicates the prescribed treatment will leave the patient unable to care for themselves for awhile, arrange for hospital to home help.
Bring to the Hospital
- Copy of doctor’s orders, if you have one
- Health history, including all medical conditions, past or present, all medications taken within the last year, including over-the-counter medications
- 2 copies of Advanced Medical Directive, one for admissions, and one for the supervising doctor
- Emergency contact information
- Insurance card
- Photo Identification
- $10-15 in cash, for newspapers and magazines
- Basic toiletries (toothbrush, toothpaste, brush, comb, razor) (check with your doctor about deodorant, as it can interfere with certain medical equipment)
- Glasses, hearing aids, cane, walker
- Leave at home: all valuables, including personal jewelry, cash and credit cards
Go the Admissions Office First
- Identify yourself with photo id and state your treatment (doctor’s orders, if available)
- Provide health and medication history, 1 copy of AMD, insurance and emergency contact information
- Receive an identification bracelet; check to see all information is correct
- Tests: Why is it needed? What will the results indicate and when will they be available?
- Why is it needed and how long with the effects last?
- Benefits and risks?
- When will I/patient be released to go home?
- At home/released from hospital:
- Changes in diet?
- Changes in routine?
- Changes in exercise needed?
- Will the patient need in-home care or visits from a home-health nurse?
- What is the follow-up program:
- Visit needed and scheduled?
- Other doctors or providers to meet with?
- Medication to take, when, and for how long?
- Therapies needed (physical, occupational)
Safety Tips: (Patients are often tired, weak, and affected by medication)
- Use the call bell or button to summon help, especially if you/patient have been instructed to stay in bed
- Use the bed controls to lower the bed before getting in or out
- Sit on the edge of the bed for a minute or so before getting up
- Check for and avoid cords or tubing which may be around the bed
- Take only medication approved by the supervising doctor. Do not take any medication brought from home without the doctor’s permission
- Use grab bars for support in the bathroom and when walking down the hallway, even if you/patient don’t normally use them
The Boy Scout motto is “Be Prepared.” It is a great motto for the rest of us, too, whether caring for others or ourselves. Completing necessary groundwork prior to a hospital stay is especially important for older adults and their caregivers, since the process can help reduce anxiety. Adhering to post-hospital follow-up routines can prevent a return to the hospital.
Additional Sources: National Institute on Aging, American Hospital Association