Navigating a Hospital Stay, Are You Getting the Help You Need?

Are you getting the help you need?  Navigating our health care system is, let's just say, nearly impossible.   Many people, especially older adults, don't even know if they are getting all the help they need or is available before, during or after a hospitalization.  Why is this such a well kept secret in our health care system?

Seems to me that the more knowledge and assistance you give someone the more likely it will be that they do not end up right back in the emergency room, constantly repeating the near same scenario over and over again.  It does not take a degree in economics to see that the system would be able to keep costs down considerably by giving more priority to this very simple element of health care.  Instead this system leads you to think that it is complete ignorance on our part that keeps costs so high when it appears to me that there is just entirely too many special interests involved in the treatment of sick people.

Every time that I experience, first hand, just how difficult moving through the labyrinth of our health care system is, I am left to wonder how in the world do families that do not have a medical professional as part of their family ever get anywhere.  The education of people should be of top priority, especially during a hospitalization, yet it always feels like the patient and family are left in the dark.   WHY?

As I write, my father lies in a hospital slowly recovering from a bowel obstruction. This is the 4th, yeah that is right, the 4th hospital that he has been over the last month.   Due to preexisting difficulties with advanced chronic obstructive pulmonary disease (COPD), the proper treatment for the bowel obstruction was delayed for far too long.  We started the first week at a local community hospital that either was not permitted to refer us to a larger hospital or just simply did not consider it.  Had it not been because of persistence of the family and a family member with a medical education, my father probably would not be with us at all.  After requesting that he be transferred to a larger teaching hospital with the ability to give him the help he needed we were told by the physician that he feels that would be the best plan and my father was moved within hours and just hours after being admitted to that larger facility with more advanced technology he received the surgery he needed.  He remained at this hospital for three weeks making slow improvements everyday with a few set backs.  He was finally strong enough to be transferred to a rehabilitation hospital at which he stayed for all of 12 hours before they sent him to yet another local community hospital because his oxygen levels were low.

The frustration the I feel about the systems within healthcare are mind blowing.  Many things run through my mind in the care of my father.

1. Why did the rehabilitation hospital not call a family member when his oxygen levels became low? To at least give us the option to say: "Please send him back to the facility he just came from".
2. Why did the current hospital that he is in right now not contact the previous hospital that he just spent 3 weeks at to obtain his records?
3. Did my father miss doses of his medications when he transferred from one facility to the next?  This very fact alone may have been what caused his oxygen levels to drop...
4. Where is he going to go from here?

The common denominator in every question that goes through my head is communication and why is it so poor in our healthcare system?  In this day and age there is no excuse for it!  If I can know with in seconds what my cousin on the other side of the country is eating for dinner right now and even see pictures of it through social media then we should be able to send communications just as quickly about things that truly matter in the care of a persons life.

Not only would some real attention to this aspect of healthcare improve the continuity of a patients' care but it would also help to keep the cost of health care down.  Blood test results, x-ray reports, CT scan reports, MRI reports, medication records, patient allergies, assessments, therapy notes, specialists reports, etc. all at your fingertips thus preventing unnecessary repeat testing.

I spend a portion of each day talking to someone at the hospital, whichever one he may be in, about the care of my father.  Whether it be his social worker, care coordinator, nurse, surgeon or physician I am constantly seeking information about what they are doing to help my father,  what the next steps are going to be and what he needs to be doing to get there.  If I would not be pursuing the information, we would be in the dark.  I hate the dark, don't you!

Learning how to navigate our health care system is essential to Aging with Ease!

Geriatric Care Management

So today I learned about a service that I have not had any experience with.  It is called Geriatric Care Management.  Some of you may already be familiar with this service, but it intrigued me because of my lack of knowledge about it.  So I did some research about it. This service offers support for families caring for older adults.  Many of people who are faced with caring for a spouse or parent who is declining in their health really have no idea where to begin to look for help.  Those difficulties are escalated when you are a child of an older adult and live miles away.   The day-to-day care that is needed can leave you exhausted and feeling depleted to even have the energy to look for help.

Geriatric Care Management offers care managers that specialize in social services. They assist in finding the help you need based on your individual situation.  Their goal is to help older adults find the best quality of life physically, mentally and socially.   If you are looking for help finding the right long-term care or assisted living facility, they can help you with that process.  If you need someone locally to check in regularly on a loved one, they can provide that service.  They will advocate for any needs that will assist in achieving an improved quality of life for the older adult as well as for the caregiver.

Geriatric Care Managers charge clients in a variety of ways, but typically their hourly rates are between $50-$200 an hour.   Medicare, Medicaid and private health insurance very rarely pay for these costs; long term care insurance might, but most often this is an out-of-pocket cost.  I know that sounds expensive, but when you consider the convenience and security they provide, the cost can seem worth it.  Actually, Care Managers usually save families money despite being an out-of-pocket cost because their needs assessments align an individual’s present condition with only those services that are necessary at that point in time.  This prevents unnecessary fees from home care providers and assisted living residences.

This service is worth checking out if you are struggling to decide the best way to provide care for an aging adult.  The first step is to locate one and simply have a phone conversation with them about different ways that they might be able to help your situation.  A simple Google search for Geriatric Care Management will help you easily locate one near you.  If you decide it is worth the investment, they will come to meet you and your loved one to perform a complete assessment; physically, mentally, financially and socially.  Together you create a plan to manage care.

Like I said before, I do not have any first hand experience with this service but it appears to be a very useful resource in assisting caregivers to manage care.  If you have ever used this service or know of someone who did, I would be very interested to hear what the experience was like.  Did they own up to what they offer?

Finding the right kind of help that is available for you is vital to Aging with Ease!

Fulfilling Activities in Adult Day Centers

Creating fulfilling activities for seniors can be challenging at times, especially if they are suffering from memory loss or physical ailments that limit their abilities to participate the way that others can.  I am blessed to work with some of the most creative people I have ever met.   They are constantly meeting this need for the seniors in our Adult Day Center.  They never cease to amaze me and I am constantly learning from them.

There are two main things that I have learned the most from my co-workers:
1. Try anything, no matter how odd it may seem;  you never know what might work.
2. If it failed once, that does not mean that it will fail again.

We offer a variety of different activities every month.  Sometimes certain activities are scheduled on specific days of the week with certain clients in mind.  For instance, for the lawyer who only comes in on Tuesdays and Thursdays, we schedule a game called "You Be The Judge."  This game engages this client extremely well and brings back to his life a chance to share his knowledge.   Then there is the retired English Professor who misses leading lectures in his classroom; he is given an opportunity to present a different topic each month to the other clients and staff.  By providing this activity for him, we are giving him a sense of purpose and a chance to perform.  There also is a client that spent her life raising her nine children - yes that is right 9 children -  she spent much of her time after her children were grown making quilts but because of memory loss she had stopped doing this.  My staff was able to find a way for her to continue this joy in her life.  It took several different approaches to find the best way for her to be successful at it, but she now comes into the center and gets right into it without hesitation.  I could go on and on with examples of these types of great things that happen in our Adult Day Center.

As clients remain at our center over time, their level of functioning will change.   Activities they once were successful at become difficult and frustrating for them.  Again, my staff observes this and quickly adapts to these changes. An example of this would be to remind you of the client that is a lawyer, that I spoke of in the paragraph above.  Since he started at our center, his condition has progressed and he no longer finds fulfillment in that game.  So the activity for this client was changed.  We looked for another opportunity for him to feel useful.  What we found was that he needed to be responsible for something in the center that made him feel useful.  So we gave him the task of helping with setup for activities and clean up when they are over.  He takes this responsibility very seriously and it is a huge help to our staff.  A win, win situation.

These activities are a direct product of my staff - by them constantly looking for ways for our clients to feel important and useful again.   There are also many activities that, in general, can be easily managed no matter what their losses may be.   We do use these activities regularly as well.  But who wants to do the same thing every day?  We all need variety in our lives no matter what age we are.

Adult Day Services can provide useful, fulfilling and satisfying activities for seniors.  They are designed to provide stimulation and socialization, which in the long run will keep older adults more active physically and mentally.  With all that to offer, it seems kind of silly not to check them out.  This kind of structure to a person's day will keep them living independently longer and can provide comfort to families that their loved one is being productive in a safe environment. 

Aging with Ease can be obtained by feeling useful as older adults!