Although hospitalization is often unavoidable as we age, whether due to illness, disease, or injury, it is important to know that hospitalization itself comes with a series of risks, especially for elderly patients. It is natural for us to think of hospitals as places of healing, where our needs will be taken care of with an appropriate level of sensitivity and supervision. However, various factors can make the reality of hospitalization quite different.
There are currently no alternatives to hospitalization after heart attacks, strokes, broken hips, and other such conditions, where outpatient services certainly cannot suffice. However, it is important to be aware that not only are these types of health problems more common in older adults, their vulnerability to the risks of these hospitalization are also greater as well.
Generally speaking, hospitalization itself tends to cause a great deal of stress, both physically and emotionally. And for elderly patients, in particular, it can lead to several serious, well known consequences.
- Lying in bed waiting to recover from a medical procedure causes a loss of strength and mobility. Among the elderly, this effect can happen very quickly. Further, the degree to which strength and mobility are lost is greater among elderly patients, many of whom are already suffering from some degree of weakness and lack of mobility. The longer the hospital stay, the more severe this effect becomes.
- It is a well-known fact that healing requires proper rest. Unfortunately, the nature of the hospital environment is not conducive to proper rest. In addition to being noisy, uncomfortable, and unfamiliar places, it is the normal practice of hospitals to constantly monitor their patients. This often involves drawing blood several times a day, and throughout the night. It involves having a nurse or doctor come into the room, alternate four-hour intervals, to check blood pressure and other vital signs, whether or not whether the patient is asleep or awake. The sleep deprivation caused by these activities makes it difficult to for an elderly hospitalized person to regain their strength; in many cases it can cause them to become more fragile and more sick.
- Among the elderly, extended hospitalization and delirium often go hand-in-hand. The stress and pain caused by delirium, both for the patient and for family members and friends, can not be overestimated. While there is no single cause for delirium, the above-mentioned inability to get a normal night’s sleep, the level of noise, the unfamiliar environment, and the constant prodding and poking by unfamiliar people, are all known to contribute to it.
- A variety of drug-resistant bacteria thrive in hospitals, and elderly people are especially vulnerable to them. In many cases these drug-resistant bacteria are more dangerous to an elderly patient than the original cause for which they were hospitalized. Indeed, bacterial illness is a major cause of death among hospitalized elderly patients.
Recently, a new movement was started that seeks to create a better hospital environment for geriatric patients. It is known as the Age-Friendly Health Systems movement. In the last few years Dr. Stephanie Rogers, a geriatrician at UCSF and her colleagues have initiated several new programs at UCSF. These include:
- An acute care unit specifically designed for elders
- A special hip fracture management unit
- A delirium reduction unit
One of the main aspects of these new programs is that all elderly patients are assigned a geriatrician to assist with their recovery. It is true that a skilled orthopedic surgeon may successfully perform a hip replacement, but it is rarely the case that they have the knowledge required to help their elderly patients make a smooth, comfortable recovery, since this requires a specific knowledge of the problems elderly patients face as well as solutions to these problems.
An important point for us to remember is that if we, or somebody we love, is elderly and facing an extended hospital stay, a geriatric advocate can be an important addition to the team of people providing treatment. Even though the Age-Friendly Health Systems movement has not been universally adopted, it is important for us to be proactive and try to provide the best environment possible for a speedy and full recovery for any health problems we may face.
Part of that recovery includes moving the patient to a rehab facility as soon as is possible. Transfer to a facility such as Atlantic Coast Healthcare and Rehabilitation Center, in Lakewood, NJ, can minimize the risks of extended hospitalization, and actually accelerate the return to health. Atlantic Coast takes a restorative approach to senior health, maximizing function and mobility in a positive and upbeat atmosphere.
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