Why Preparing For A Hospital Discharge Is Key To Ongoing Recovery

Sure, it’s a reason to celebrate when you get the news that you’re being discharged from the hospital. But, there are important steps seniors should take if they want to stay out and get better. A recent Medicare survey shows that 18% of patients over the age of 65 discharged from a hospital are readmitted within the next 30 days. 

Preparing for a successful hospital discharge can reduce the possibility of this, and much of it can happen before even leaving the hospital. Here’s what you need to know.

What a Discharge Means

We tend to think of this as an end state, but really, it’s more of a continuation. When you’re discharged from the hospital, it simply means that your doctor has determined that you’ve recovered enough to no longer need hospital-level care. It does not mean that you are fully recovered.

In many cases—especially with older adults—it means you may still need extra or specialized care. You may need this for weeks or even months to come.

Participating in the Hospital Discharge

Your physician and a hospital discharge nurse determine when you can leave the hospital. It’s not an accusation, but rather an observation. These professionals are extremely busy. It’s not that they are unwilling to spend enough time with you to make sure you understand everything you need to know about post-hospital recovery. They often assume that you are aware of what’s necessary.

This is why it’s important for both caretakers and senior patients themselves to be advocates in the process. Make sure you have all the necessary information you need—and that all of your concerns have been answered—before you leave the hospital.

To help you with this Medicare has created an extremely helpful hospital discharge checklist. Download it here. This checklist is an important tool because it provides you with the key questions to ask about follow-up care, medication, equipment and supplies, and even problems to watch for. These are all questions you must have satisfactory answers for before a senior patient leaves the hospital.

And, you really do want to get this information prior to discharge. It can be much more difficult to get helpful answers afterwards.

The discharge checklist helps both caregivers and senior patients understand what’s necessary for a successful recovery. It’s a partnership between caregiver and patient. Think of it as a handoff. The medical professionals at the hospital have started the process that gets you back to wellness. Now, it’s your turn to keep the process going.

Embarrassing, Uncontrollable, But Common: A Side Effect From Stroke That Leaves You Laughing Or Crying

Mention stroke and you might think of physical side effects like paralysis or muscle weakness. Or there are cognitive issues that make it difficult to speak. There are other side effects—cognitive in particular—that are possible, too.

A common cognitive post-stroke side effect is called pseudobulbar affect, or PBA for short. It’s a brain disorder that causes uncontrollable crying or laughing. These unintended emotional outbursts can be extremely embarrassing for everyone involved. Here’s what you should know.

Totally Unintentional

Often people who observe stroke victims with PBA think that there’s some exaggeration going on. The responses seem inappropriate. One thing’s for sure: the response does not represent this person’s true feelings.

Unfortunately, someone with PBA might cry when hearing good news. Or they may suddenly burst into a sobbing fit while they are laughing. Something only mildly sad can cause them to become hysterical.

Even more alarming, someone with PBA can have these spontaneous emotional outbursts without any trigger at all. And perhaps most troubling of all is that these episodes can happen up to 100 or so times daily.

Not Well Known

The unpredictable nature of PBA can be embarrassing for those who have the condition, as well as those who care for them. Many older adults experiencing PBA simply become unwilling to be around other people.

Although more than half of all stroke survivors report having PBA symptoms, less than 20% of them know the cause. In most cases, they’ve never even heard of the condition. Life for them becomes frustrating and sometimes devastating because they have no idea why this behavior is happening to them.

What Causes BPA?

The condition occurs when a stroke damages areas of the brain controlling how emotion is expressed. The damage short circuits brain signals, causing involuntary episodes of laughing or crying. And, since it’s a short signal, the laughing or crying is usually highly exaggerated.

Although stroke is the likely cause of PBA, it’s also a side effect caused by other neurological disorders—including dementia, and Parkinson’s disease.

PBA causes uncontrollable crying, so it’s often mistaken for depression—and this is a condition that many seniors experience. As a result, PBA might be misdiagnosed. Both PBA and depression are conditions that can last for extended periods of time, so it’s important to make sure a correct diagnosis is determined.

There are specific medications to treat PBA, but a medical professional also may prescribe an anti-depressant. Both can help to suppress the involuntary emotional outbursts, but it may not be possible to stop them completely.

FAST: The Acronym Every Senior and Everyone Who Is Around Seniors Should Know

According to the Centers for Disease Control and Prevention, a stroke happens every 40 seconds. They take the lives of over 140,000 Americans every year—at the pace of 1 person every 4 minutes.

Seniors are more prone to strokes, and quick medical treatment is absolutely necessary to increase survival. What does FAST have to do with strokes? Here’s what you need to know.

Early Action

The chances that you will survive a stroke increase when you receive emergency treatment as soon as possible. The Centers for Disease Control and Prevention (CDC) report that people who get treatment within 3 hours of the first symptoms of a stroke experience less disability than those who receive delayed care.

The CDC also reports that nearly 75% of all strokes occur in people over the age of 65, making it the 5th leading cause of death in our country. The American Heart Association reports that while the percentage of strokes has increased as a result of heart disease, the actual number of stroke deaths has declined. This is largely due to FAST.

What is a Stroke?

Strokes occur when the blood flow to a certain area of the brain gets cut off. The cells in this area of the brain begin to die because they are starved of oxygen. The resulting damage causes loss of muscle control or memory. Serious strokes are fatal.

Here’s the thing about a stroke: they may not be obvious. Television and movies may be entertaining, but they aren’t always realistic. Transient ischemic attacks—also known as mini strokes—have symptoms that are short-lived or may even spontaneously resolve.

FAST

There are 4 common signs of a stroke, and that’s where FAST comes in. These symptoms often appear suddenly, so if you see them in a senior—or someone of any age—it’s important to get immediate medical help.

  • Face: Ask them to smile. Does it appear uneven?
  • Arms: Ask them to raise both arms and hold them level to the floor. Does one arm drift downwards?
  • Speech: Ask them to repeat a simple phrase, like “Let’s have tacos for lunch today.” Do they slur their words, or maybe even miss a few?
  • Time: This isn’t a symptom—it’s a reminder of what to do. Fast medical treatment is crucial. It’s time to call for emergency medical help.

Make a note of the time if you should happen to notice any of the FAST symptoms. This piece of information is important to medical professionals. Clot-busting drugs called tissue plasminogen activators reduce long-term disability for certain kinds of strokes. This type of medication, however, is approved for stroke treatment only if given within 3 hours of the onset of symptoms.

Take As Prescribed: Why Seniors Fail To Follow Medication Schedules

It’s not just seniors. The New York Times reports that at least half of the medications for chronic diseases simply aren’t taken as prescribed. That’s a serious issue for a person of any age, but it can have even worse consequences for seniors. It’s estimated that 10% of hospitalizations for seniors happen annually because of missing medication doses.

Here are the three main reasons why seniors decide not to take medication prescribed to them, and suggestions on what to do about it.

1. They have difficulty understanding the cost

Not all prescription medications are expensive, but much of it is. Many seniors know that they are on a fixed and limited income, and sometimes they decide it’s a better idea to take less than what has been prescribed.

While it may make the prescription last longer, it can make the benefits of the medicine far less effective—or even totally ineffective. If it’s possible, find out whether this is why a senior is skipping taking their medications. It may be necessary to have a frank discussion with them, reminding them that they’re really not saving money. It will cost far more in hospital or medical bills if their condition is not kept in check.

2. They don’t believe there’s any benefit

Serious health conditions like a heart attack or kidney failure often have a long recovery period. During that time, it may not seem as if the daily medications prescribed are doing anything at all. Seniors may start to lose faith that they indeed will get better. Even worse, taking regular medications is a daily reminder that they are not well.

Keep an ongoing dialog with seniors about the medications they’re taking. Remind them that the medicine works best with a healthy diet and lifestyle changes. Point out improvements you see, which they may not. This can help to associate taking the medication with gradual health improvements.

3. They think there’s no longer any reason to take it

Sometimes it seems like a waste of time—and money—to take a medication if you’re feeling better. That’s always a decision best left to a health professional. Often, medications must continue to be taken even after a senior recovers from a health crisis.

No one is likely to appreciate hearing that they’ll have to take a daily medication for the rest of their lives. Seniors may exercise curiosity and decide to stop taking a medication to see if it changes the way they’re feeling. And, they probably will continue to feel fine for the short term.

The problem with this false sense of wellbeing is that they won’t really be able to determine whether drugs that treat conditions like heart disease or high blood pressure are working or not. Many health conditions in the elderly have few or no noticeable symptoms.

The most important thing to remember as a caregiver is that most seniors do not purposely skip medications with the intention of harming themselves. Many times, they simply need a reminder or reassurance that it the medication really is good for them, regardless of what they can or can’t feel.

Helpful Tips for Hearing Impaired Seniors

Age isn’t the only thing that can impair our hearing, but as we grow older it’s a common occurrence. It’s frustrating—for both those who can no longer hear well, and for those who are their caregivers.

Older adults who experience hearing loss often struggle with everyday things we take for granted, such as knowing when there’s someone at the door, reacting to threatening situations like smoke alarms, or even everyday conversations. Here are some ways to help them—and yourself if you care for someone who needs to hear what’s going on around them.

Start With Developing the Right Attitude

It’s not their fault. Hearing impairment as we age is caused by physical changes in our ears. It can also be caused by damage to the auditory nerve, or even the ability for the brain to process sound. It can be one of these, or a combination of all three.

There are also at least 200 common medications which are known as “ototoxic.” This means that they affect our ability to hear. The primary sign of an ototoxic reaction to a medication is often tinnitus, or ringing in your ears. It’s important to seek out medical advice if you suspect that medications may be the cause of hearing impairment.

In almost all cases, hearing loss is a physical thing. Unfortunately, it also has psychological and emotional impacts. First of all, it’s embarrassing. People handle this kind of frustration in different ways. Seniors may become angry or agitated because of a hearing impairment. Or, they may become distant and less responsive to what’s happening around them because it’s just too difficult to distinguish what they’re hearing.

This hearing impairment can also affect caregivers. It can be extremely frustrating and exhausting to constantly repeat what’s been said. This is why it’s crucial to remember that you’re dealing with something that’s a constant source of frustration for seniors with hearing impairment. 

The Answer Isn’t Always Hearing Aids

These medical devices can make an amazing difference. Today’s digital instruments go far beyond just amplifying general sound. After a thorough test, the hearing aids are “tuned” to amplify only the frequencies that the wearer can no longer hear.

While the technology has improved, the cost of quality hearing aids remains expensive. It’s not uncommon to pay thousands of dollars per hearing aid. Some medical insurance policies will cover some of the cost.

The devices are meant to be small and unobtrusive—which means that they might not be an optimal solution for some seniors. Others just don’t want to be bothered with the care and maintenance of hearing aids. Many of the devices require frequent battery changes. Those batteries are very small and might prove impossible for seniors to work with.

So, while this might be a primary approach, it could prove impractical.

Other Options

Thanks to other technologies—and the growth of the number of companies creating products for our growing senior population—there are simple and inexpensive devices that can be integrated into everyday situations which can help seniors use other senses to compensate for hearing impairment.

There’s a profusion of wireless doorbell kits you can buy that add a flashing light to alert you when someone rings the doorbell.

If you have a landline phone connection—and many of us still do—you can purchase a signaler that plugs into the phone jack. It will flash a light to alert you when there’s an incoming call.

You may have seen them in public buildings. When a fire alarm goes off, the devices also flash with a strobe. This technology has made it into home smoke detectors. Most are as simple to install as putting in a battery and hanging it up on the wall.

We’re all susceptible to losing our hearing, and it’s something that many seniors must live with. Thanks to the concept of mixing visual cues with audio, many of the things seniors thought they would have to tune out are now available to them again.

Steering Clear of the Flu

Don’t look now, but the flu season is here. If you’re a senior or a caregiver, you’re high on the list for getting sick.

Our immune systems weaken as we get older. Caregivers often have more stress than other jobs, and that can weaken the immune system, too. There are ways to lessen the chances of catching—and passing on the flu bug. Here are some suggestions.

Get the Flu Vaccine

This advice tops just about every list of tips you’ll find on the subject. For two reasons. It lowers your risk of getting the flu in the first place, but it also decreases the severity of illness. Both reasons are advantages for seniors and their caregivers. December is not too late to get the vaccine.

Increase the Number of Times You Wash Your Hands

The flu can bring you to your knees, but turnabout is fair play. The flu virus is fragile and is no match for soap and water. How long do you need to wash your hands? It only takes about 20 seconds—or long enough to make it through 2 rounds of “Happy Birthday.”

A trip to the restroom or kitchen sink to wash your hands isn’t always practical, whether you’re a caregiver or a senior. Stock up on hand sanitizer. It’s just as effective.

Kick Up Your Cleaning Routine

Focus on areas where germs—including the flu virus—are likely to be found, such as doorknobs, light switches, and the counters in your bathroom and kitchen. Then be sure to disinfect the rags or sponges you clean these areas with.

A bleach solution is best, but you can always throw sponges in the dishwasher, or even in the microwave for 1 minute. That’s enough time to kill most bacteria and the flu virus.

Don’t Play the Hero

It’s not always practical, but you should stay away from others if you’ve got the flu. When you are around people displaying flu symptoms, avoid unnecessary contact. Most people are unaware of how often they touch their faces—and that’s one of the most common ways we introduce the flu virus to our bodies.

We also tend to forget about things like our smartphones. Make it a habit to wipe down the phone with rubbing alcohol or a sanitizing wipe—but pay careful attention not to get too much moisture on it.

And if you do come down with the flu, follow that age-old advice about getting plenty of fluids. It’s not an Old Wives Tale. Even plain water helps hydrate you, which aids the nasal passages in staying moist—which traps germs before they can enter the body.