Introduction
Hospitals save lives. But you’d be hard-pressed to find many people eager to spend time there.
Most medical professionals agree that staying healthy enough to avoid a hospital stay should be the ultimate goal. That’s especially true for seniors. Professionals who work with seniors often observe that older adults who are hospitalized don’t always go home the same. Or, they don’t go home at all.
Several potential risks or aftereffects of hospitalization could hit seniors particularly hard, according to a survey of 400 North American nurses* who specialize in senior care and conducted by Home Instead, Inc., franchisor of the Home Instead Senior Care® network. Leading the list is hospital-acquired infections followed by difficulty getting back into a routine, more health declines, confusion and inability to regain full function.
Dr. Carolyn Clevenger, clinical director of the Integrated Memory Care Clinic at Emory University and past president of the Gerontological Advanced Practice Nurses Association (GAPNA), explains how the potential issues surrounding hospitalization can jeopardize the health of older adults.
A hospital stay may be necessary and beneficial. But if there are ways to safely avoid it, most seniors and their caregivers are all for it.
To that end, some experts predict that
48.5% of senior hospitalizations
could, in fact, be avoided if proper preventative steps are taken.
There’s one powerful factor in helping keep seniors out of the hospital: support. Nearly 100 percent of the nurses surveyed agreed that a family’s role in keeping seniors healthy and out of the hospital is as important as that of the medical community. In spite of that, less than half of the seniors (48.6%) they see have family members who serve as active advocates for their care, according to the survey.*
The research conducted by Home Instead, Inc., revealed these five preventative actions that could help keep an older adult out of the hospital:
1. Work with a trusted medical practitioner
2. Don’t ignore symptoms
3. Reduce risks of falls and accidents
4. Stay active physically and mentally
5. Maintain a healthy diet
Whether you’re a family member or another advocate, like a professional caregiver, read this guide to learn more about some of the warning signs, risks and preventative measures that could help keep a senior out of the hospital.
For more information and resources, including a “Hospitalization Risk Meter” to help assess a senior’s potential risk of hospitalization, go to PreventSeniorHospitalizations.com.
*Survey results found at PreventSeniorHospitalizations.com
Please note that the content, suggestions and tips included in this guide are provided for informational purposes only. They are not intended to be and should not be construed as being medical advice or a substitute for receiving professional medical advice, diagnosis or treatment. Always seek the advice of a physician or other qualified medical provider for any questions you or a loved one may have regarding a medical condition. Home Instead, Inc. and the Home Instead Senior Care franchise and master franchise network expressly disclaim any liability with respect to the content, suggestions and tips included in this guide.
Warning!
A survey of North American nurses who work with seniors says one of the biggest culprits when it comes to a senior’s risk of hospitalization is not engaging with a trusted medical practitioner. Why? Three reasons surfaced in Home Instead, Inc.’s research: unwillingness to change ways, denial of health issues and apathy.
Good medical practitioners should be collaborating with seniors and their families to help develop treatment plans older adults are comfortable following. “Watch for red flags (such as those listed below), help serve as an advocate for older adults and build a support system around the senior,” said Dr. Clevenger. “And make sure the medical practitioner and his or her staff are available and accessible.”
The Signs and Risks
Some signs that a senior may not be following a medical practitioner’s orders and issues that could make complying with those orders more difficult:
- Missed medical appointments
- Lack of transportation or the inability to get to medical appointments
- Skipping health maintenance checks
- A worsening of chronic conditions such as high blood pressure, diabetes or congestive heart failure
- Presence of Alzheimer’s disease or another dementia, which can make following a doctor’s orders difficult
- Unfilled prescriptions or unused pills
- Taking four or more medications, which can lead to confusion
- Apathy or disinterest in overall health
- Lack of anyone to advocate or assist with health issues
The Remedy
Here are some steps to help an older adult better engage with a medical practitioner.
- Download a medication tracker at SeniorEmergencyKit.com.
- Learn more about the potential impact and risks of the chronic conditions a senior may be experiencing. Visit ReturningHome.com.
- Work with your loved one’s practitioner to track medical appointments and encourage your senior to keep those appointments.
- If your senior doesn’t have transportation to a medical appointment, contact a relative, friend, the local Area Agency on Aging or a professional caregiving company such as a local Home Instead Senior Care office.
- If you think your senior is depressed or apathetic about his or her future, contact a practitioner to discuss options and a possible referral to another professional. Attend medical visits with a loved one, if you can, or contact a local Home Instead Senior Care office to arrange for a CAREGiverSM to accompany your senior.
Warning!
It can seem like just another ache or pain – to the senior you love and you. After all, doesn’t growing older come with those issues?
Maybe, but feeling ill should not be ignored. According to Dr. Clevenger, when one local hospital partnered with a home health agency to look at readmissions, “Here’s what they saw happening: the home health aide would call the senior to say they were coming by that day. The older adult would say they didn’t want a visit because they weren’t feeling well. The next day that senior would be in the emergency room.”
Better to be safe than sorry and seek help.
The Signs and Risks
Some signs that a senior’s aches and pains – or health conditions – could be putting them at risk:
- Ignoring symptoms such as chest pain, shortness of breath and abdominal pain
- Discounting subtle changes or issues such as changes in walking speed or shuffling, inactivity, loss of appetite and weight fluctuations, and unsteadiness
- Living alone or not having someone checking in daily
- Presence of three or more chronic conditions
- A recent hospitalization (Visit ReturningHome.com to learn more.)
- Unwillingness to change ways
- Putting off medical appointments
- Lack of funds or perceived lack of funds
The Remedy
The following steps can help a family stay on top of the issue.
- Help your loved one find out from a medical professional the issues that could be putting him or her at potential risk of hospitalization. Staying on top of health problems with a medical practitioner could help reduce the risk of hospitalization.
- Go to the Hospitalization Risk Meter at PreventSeniorHospitalizations.com to help determine that risk.
- Change in appetite or weight is a warning sign that something could be amiss. Check out others at CravingCompanionship.com.
- Before going to the medical practitioner, help your senior loved one prepare a list of questions about medications they are on or that may be prescribed at CaregiverStress.com.
- If an older adult lives alone, make sure someone is checking in on your loved one each day and helping to manage his or her care. And to be better prepared for emergencies, go to SeniorEmergencyKit.com.
Warning!
When it comes to falls, older adults can be evasive, which creates the potential for an accident and a trip to the hospital. Each year, nearly
3 million older people are treated in emergency departments for fall injuries, and more than 800,000 of these patients are hospitalized, according to the Centers for Disease Control and Prevention.
In 2015 alone, more than one in four older adults reported falling and more than 28,000 older adults died as a result of falls—that’s 74 older adults every day. But less than half of seniors talk to their medical practitioners about falls, according to the CDC.
The Signs and Risks
Some signs that a senior may be a fall risk and could end up in the hospital include:
- Previous falls and accidents
- Alzheimer’s disease or another dementia diagnosis
- Inactivity
- Isolation
- Presence of throw rugs and other tripping hazards
- Lack of grab bars and proper lighting
- Problems with vision or hearing
- Decrease in walking speed or shuffling
- Mobility issues
The Remedy
Here are some steps to help identify potential fall risks and solutions.
- The assessment and balance video at PreventSeniorHospitalizations.com can help family caregivers determine the potential for their senior loved ones to fall and tap into exercises that could help strengthen their balance.
- Many emergency room doctors recommend that families conduct an annual home safety check of their seniors’ homes. Go to MakingHomeSaferforSeniors.com for an interactive home safety tour to learn how.
- A home safety checklist at MakingHomeSaferforSeniors.com includes a comprehensive list of ways to help safety-proof an older adult’s home.
- Go to GetMomMoving.com to learn how some seniors become frail and review simple exercises that could help to improve their physical health.
- Make sure that someone is checking on an older adult each day if he or she lives alone. Look into an emergency alert system or call your local Home Instead Senior Care office to learn more about home care assistance.
Warning!
Illness or prior hospitalization can leave some seniors both physically inactive and mentally in a slump. “A colleague found, on average, older adults in the hospital are only out of bed for 30 minutes in a 24-hour period,” noted Dr. Clevenger.
Whether it’s a hospital stay or illness, physical inactivity can leave an older adult prone to a worsening of chronic conditions and the prospect of depression.
On the flip side of that: “Research has shown that people who remain active over a lifetime decline for a shorter span of time,” Dr. Clevenger said. “Studies reveal that individuals have the potential to build muscle mass, even 100 years of age and older, with the proper exercise. And more muscle mass can lead to better balance and joint health.”
The Signs and Risks
Some signs that a senior’s inactivity may be making him or her vulnerable to hospitalization include:
- Prior illness or hospitalization (Visit ReturningHome.com to learn more.)
- Loss of a spouse or significant other
- Poor appetite or change in weight
- Inability to drive and lack of alternative transportation
- Loss of friends
- Lack of mealtime companions
- Signs of depression
- Problems with cooking and house keeping
- Lack of interest in hobbies and activities; isolation and change in behavior
The Remedy
Look to these steps for some ways to help keep a senior on the move physically and engaged mentally.
- Stimulate an older adult’s mind by doing a puzzle a day. Go to GetMomMoving.com for the details and other ideas.
- If a loved one is alone at mealtimes, look for ways to encourage interaction such as suggesting they dine at the senior center. Check out CravingCompanionship.com for more.
- Even if a senior is homebound, you can plan activities such as movie night. For more ideas for Mom – or Dad – go to GetMomMoving.com.
- What’s more, older adults who are homebound or in care communities can still give back. Why not suggest your loved one be a greeter at church or tour guide?
- Hiring a personal trainer or certified exercise specialist is a good option for seniors who are willing and able, Dr. Clevenger noted.
- Look into resources that might be available through a local Area Agency on Aging. Contact a local Home Instead Senior Care office to discover how a CAREGiver could help.
Warning!
One of the biggest risks to a senior’s health is poor diet. There are many reasons for that, from illness that impacts appetite to medications that can change the taste of food. Various factors may conspire to keep older adults from preparing and eating the nutritious meals they need.
Diet and companionship go hand in hand. “When you eat with others, appetite is better and emotional well-being is improved,” said Dr.
Clevenger. If a senior is living alone and unable to prepare healthy meals, he or she may not be getting a balanced diet — one of the biggest risks that could send a senior to the hospital.
The Signs and Risks
Some signs that a senior could be at potential risk of poor nutrition and a trip to the hospital:
- Confusion caused by Alzheimer’s disease or another dementia
- New or increasing medications
- Inability to get to the grocery store
- No help in preparing meals
- Loneliness that negatively impacts appetite/interest in eating
- Lack of understanding proper nutrition
- No mealtime companions
- Weight fluctuations
The Remedy
The following are some steps that can help ensure a senior is getting the proper diet.
- Become acquainted with the “10 mealtime challenges” including grocery shopping for one. Look for help for a senior loved one at the local senior center or Area Agency on Aging. For other challenges and tips, go to CravingCompanionship.com.
- Remind your senior of a favorite family recipe. Then make it together.
- Learn about the signs of poor nutrition. Check out “5 Reasons Why a Senior May Not Eat Enough.”
- Mix up your senior’s food choices. For ideas, go to Making Food Interesting. Or, consider contacting a food delivery service such as Meals on Wheels.
- If a loved one has Alzheimer’s disease or another dementia, submit your questions about food challenges to the free Confidence to Care mobile app. Experts will answer your questions and offer tips.
About the Expert
Carolyn Clevenger, DNP, is Professor and Associate Dean for Clinical and Community Partnerships at Emory University in Atlanta, GA. She is a nurse practitioner and the clinical director of the Integrated Memory Care
Clinic and past president of the Gerontological Advanced Practice Nurses Association (GAPNA).
About Home Instead Senior Care
Founded in 1994 in Omaha, Nebraska, by Lori and Paul Hogan, the Home Instead Senior Care® network provides personalized care, support and education to help enhance the lives of aging adults and their families. Today, this network is the world’s leading provider of in-home care services for seniors, with more than 1,100 independently owned and operated franchises that provide more than 60 million hours of care throughout the United States and 11 other countries. Local Home Instead Senior Care offices employ approximately 70,000 CAREGiversSM worldwide who provide basic support services that enable seniors to live safely and comfortably in their own homes for as long as possible. The Home Instead Senior Care network partners with clients and their family members to help meet varied individual needs. Services span the care continuum – from providing personal care to specialized Alzheimer’s care and hospice support. Also available are family caregiver education and support resources.
In Singapore, Home Instead Senior Care is 100% independently owned and operated by Adventage Care Pte Ltd
