When your parent is hospitalized, you experience one of your scariest moments as a caregiver. In my recent situation, I learned that a parent being hospitalized is also a huge learning experience. After Mom’s hospitalization, I have some burning questions that I wish I’d known to ask before. Hopefully, these will help other caregivers be better prepared and know what to ask when their loved one gets hospitalized.
Questions at the Hospital
1. How will we know what's happening and who to ask? What is the plan of care?
I felt like I was in the dark, waiting around for answers, most of the time while Mom was hospitalized. The first thing I would ask is how to find out what is happening and who to contact.
What is the treatment plan? Why are the doctors running certain tests? How long might we expect Mom to be here (and, therefore, when might she be going home)? What are the options to treat her condition and what’s the prognosis?
Another interesting thing we discovered during this crisis was that hospitals sometimes have a patient “under observation” or “on observation status”. This can affect a lot of things, so it’s important to be aware of your loved one’s status. The hospital is required to provide notification if the patient is under this status more than 24 hours.
2. What paperwork does the hospital need?
We rushed off in the ambulance and everything was so hectic. Now I know what to bring to the hospital, including Mom’s advance directives and her medical information. I had to run back home late at night to get Mom’s Healthcare Surrogate paperwork, which just added to my stress. I’ve now updated Mom’s medical information on an online portal so I don’t have to try to remember her current medications and other information in the midst of a crisis.
3. Who sees Mom and manages her care in the hospital?
In Mom’s case, her doctor does not make hospital visits. They assigned her a hospitalist. I never knew to ask this before so it came as a surprise. In other cases, the community doctor may visit but often at specific hours (maybe early morning or late at night). Or, the practice may assign one doctor or rotate visiting the hospital.
4. What unexpected problems might Mom experience when she's hospitalized? Does she need someone with her round-the-clock?
It turns out the elderly have lots of problems when they’re hospitalized. For example, 700,000-one million patients fall in the hospital each year. These falls are particularly devastating, and many times fatal, for older adults. Another shocking problem we dealt with when Mom was hospitalized was delirium. Apparently, up to a third of patients 70+ experience delirium, and the rate is much higher for those in intensive care or undergoing surgery. Mom became extremely confused and went in and out of varying states of awareness.
Because of this, Mom needed someone with her all the time. I also realized that given the state of her health, I probably would have wanted someone there anyway. We soon found out about the wonderful resource of hospital sitters, which enabled me to get a bit of sleep. I realized how important this was when we got to the next stage, caring for Mom after she was hospitalized.
After Your Parent is Hospitalized: Discharge Planning Questions
I had even more questions about what would happen after Mom was hospitalized...
5. How will we care for Mom at home as she recuperates? What support do we need?
This was quite stressful. Were we prepared to care for her and what should we expect? Mom was weak and in a pretty bad state. All of the hospital staff seemed to assume since she had family that everything would be fine. I think people underestimate what it is like caring for someone after they’re hospitalized.
The hospital set up Medicare home health to do nursing visits and physical therapy. However, we soon discovered we needed more help...and fast. The process of going home itself required more than one person. We had to help Mom in and out of the car. She was sick to her stomach the first night, so I couldn’t leave her. Yet, she needed new medications. And, because she wasn’t feeling well, I needed some different food and drinks at the house. I got some urgent help from a friend, and by the next morning I had set up home caregivers to assist me.
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6. What should we be looking for and when should we contact the doctor?
I didn’t want to panic and call the doctor for every little thing, but I didn’t want Mom to get into a crisis either. We really needed a checklist of what to watch for and what to do.
7. Do we need to make changes to the home? What equipment do we need?
The home environment is so much different than the hospital. We were trying to figure out what we needed to do to make it easier to care for Mom there. Given that she was at risk of falling even in the hospital, the house seemed like a danger zone. The physical therapist from the Medicare Home Health company came to the home a couple days later, but it would have been valuable to have a home assessment even before Mom returned. We felt so unprepared.
8. Have Mom's meds changed? Do we throw away old ones/do these replace them?
We got some new prescriptions for Mom. But, I wasn’t sure if they replaced any of her old medications. Or, if any of the new ones conflicted with the old prescriptions. And, I realized later that we had to be sure to update this information in our records and for her medical providers.
9. How can we prevent future hospitalizations and keep Mom healthy in the long run?
One in five elderly patients bounces back to the hospital within a month. Though the doctors addressed Mom’s immediate health issue, we were worried about preventing future problems. The hospitalization was a wake-up call for us to assess Mom’s overall health and wellbeing. And, thus, the final question...
10. What help does Mom need to remain at home, or do we need to be considering an ALF or some other option?
The smartest decision we made was to use this crisis as an opportunity. We realized Mom was slipping in some areas and we shouldn’t ignore the signs. After getting an assessment, we discussed the options for the near and further future. I think this was our most valuable lesson. Though the crisis was scary and left us with a lot of questions, that turned out to be good because we delved into them. This experience gave us a way to talk about issues that had been starting to nag us. I can now look back on the time Mom was hospitalized as a window of opportunity. We learned a lot and Mom is better off for it.