Having cared for our elder for well over two years I am very familiar with some of the things that could cause readmission to a hospital as well as repeat visits to the emergency room for the same problem. In some cases, if we hadn’t gotten complete, understandable answers to home care, it would have been a real problem.
Preventable debate: Is it possible to avoid all readmissions? Some say yes and others say no. Due to our aging population, the “no” side seems to be the more accurate. Even if all things went according to plan, diseases and conditions can deteriorate. That doesn’t mean the numbers should be high.
Still sick: Some patients are sent home too early. This usually happens in busy hospitals and at busy times. A study done in 2012 found that patients discharged at these times are 50% more likely to be back within three days.
Inadequate home care: We were well aware of what our elder needed…trained caregivers. Before she came home we had round the clock care set up, a nurse went over her needs and gave the caregivers specific instructions and they were followed. Not everyone has that. Some only have a family member or two to help. These family members may not know what to do or what to expect.
Lack of understandable information: Our situation is a little different because we made sure the doctors translated their orders into understandable English. Some may be intimidated by the white coat and the large words in “doctorese.” Some may not speak English at all. This is a definite problem.
“Booby-traps:” This can be a problem two ways. The first is that the home may not be set up appropriately for the patient to return home. If the patient is at risk for a fall, changes may have to be made to furniture arrangements and railings may need to be installed. The second is in the habits of the patient. If a bad habit is what brought the patient to the hospital and the patient goes home and continues that bad habit, they may wind up back in the hospital.
Ignoring orders: This happens more than we might like to think. If there is an order given that someone doesn’t like, they very well may ignore that order. Again, our elder provides an example. When she broke her ankle, she refused to stop walking on it and she would not wear the boot brace she was given. It took longer for her to heal than it should have.
If you or a loved one find yourself in the hospital, there are things you can do to make some of these less of a problem. Hospitals are required to give a three day notice before discharge. If they don’t do that, ask for it. If you don’t understand what the doctors are saying, ask questions. Only you can prevent booby-traps and ignoring of orders. It is worth it to avoid readmission.