Getting the Best Care for Yourself During Hospital Stays
Getting the Best Care for Yourself During Hospital Stays
Staying in the hospital alone is a frightening thought but has become more common through the pandemic. Sometimes this concern comes from older adults who live by themselves and have no family nearby. It also arises when caregivers wonder who will help take care of them. Most recently, we’ve heard the worries expressed by patients who can’t have a loved one at the hospital because of Covid-19 restrictions.
As one who spends considerable time advancing the need for patient advocacy in the hospital, I ironically became the patient in a surgical center with no one by my side. The plan was for a partial knee replacement--a shorter, simpler procedure than a full replacement with less pain and recovery. Choosing out-patient surgery seemed like a good option under the circumstances.
But at the last minute, the surgeon decided a full replacement was in my best interest after all. I barely had time to process the new plan before the anesthesiologist wanted a decision on what type of anesthesia I preferred. I wanted to tell him I wasn’t the one who went to medical school, but I forced myself to listen to the options and make him repeat all the pros and cons before deciding.
It was 6:00 a.m.; I had no coffee, let alone any breakfast. I was anxious and wanted more than anything to have a family member by my side to hold my hand and help me through the process. I was probably better equipped than most to advocate for myself, which I did with the doctors and the nurses, but it made me appreciate more than ever the importance of the patient advocate. It also made me think of all the things patients can do to advocate effectively for themselves, especially when they are in the hospital alone.
Planning begins in advance--before you may even have any thoughts of a hospitalization. Then, of course, there are things you can do in the hospital to make sure you get the best care. Should the need arise unexpectedly, you want to be prepared. Whether you’re facing an overnight hospital stay or a long hospital stay alone, here are my recommendations:
Investigate nursing agencies in your area so you have information on hand about hiring a private nurse full time or just for a few hours a day; critical periods may include early morning when doctors do rounds or later in the day when lab reports may result in medication, diagnostic or treatment changes.
Seek out eldercare caregiver options in your community if you are a senior. Go to www.eldercare.acl.gov to search for services in your area. The locator is provided by the U.S. Administration on Aging. You can also call them at (800) 677-1116.
Look into hiring a geriatric care manager, again if you are a senior. Contact the Aging Life Care Association to identify and select the help you need. Or call them at (520) 881-8008.
Join a village or other aging-in-place organization in your community if one is available. Find out what support services are offered to members. Go to the Village to Village network to see if there is one near you.
Consider asking a close friend to serve as a personal advocate in case you must go to the hospital. Make sure that person is up-to-date on your medications, medical history, and preferences. Consider giving that person medical power of attorney to act on your behalf if necessary.
If there is a nearby hospital where you most likely would be admitted, make arrangements for your legal documents, such as an advance directive or medical power of attorney, to be on file there. Provide names and phone numbers of important contacts.
Tell your primary care physician about your concerns. While this doctor most likely won’t be in charge of your hospital care, he or she may have additional recommendations to help you.
At the Hospital
If you have done your research, you will be better prepared for whatever time you may have to spend in the hospital. Once there, here are other steps you can take:
Talk to the bed nurse about your situation, your worries, and concerns. Let the nurse know you have no family nearby and feel alone. Ask for as much extra time and support when possible. See if the nurse can be at your bedside when your doctor comes in to talk with you, especially during rounds.
Speak to a hospital social worker about your concerns as well. Ask if there are resources in the hospital or community to provide you with support and assistance. Be as specific as you can about what weighs on your mind.
Request a meeting with the hospital’s patient advocate or ombudsman, and let this person know you are on your own and need extra support and assistance. Ask if there is someone who can take notes for you during doctor visits and follow up to make sure all your questions are answered.
Check to see if the hospital has an ethics committee that can help you with especially difficult decisions you may have to make regarding your care. Representatives on the committee may be professionals or volunteers with special expertise and training.
Make sure your nurses and doctors know your preferences regarding end-of-life decisions, including your advance directive and medical power of attorney.
Ask your hospitalist to contact your primary care physician to discuss your case; then follow-up with your doctor for added advice. If the hospitalist doesn’t make the call, reverse the order: Call your physician and ask them to call the hospital.
Taking these steps may not be a full substitute for having a family member by your side, but they can make a big difference in your quality of care and your peace of mind.
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