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It is
an undeniable fact: Our bodies have a limited lifetime
warranty. As we get older, our bodies just simply begin
to break down; the inevitable wear and tear of 50, 60,
or 70 years of life taking their toll. A significant
medical event will often force many seniors to be
hospitalized, sometimes for the first time in their
lives. Then suddenly, hospitalizations grow more
frequent as episodes of readmission occur, often only
days after an initial discharge from the hospital.
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Reasons for these
readmissions include: poor communication with physicians
and other members of the patient’s Care Team,
conflicting and/or misunderstanding of medical
information, missed doctor visits, medication errors
during transitions and post-hospital discharge periods.
In the Medicare Care
Transitions Act of 2009, the federal government mandates
that costly hospital readmissions of Medicare patients
be reduced. The proposed legislation advocates that home
care services be coordinated with hospitals as part of
hospital discharge plans. Backed by numerous recent
studies some facts have become notably apparent
concerning discharged senior patients who had no
follow-up in-home care, nor a cohesive plan provided by
a hospital discharge planner:
- Adults 65 years
and older comprise 40 percent of elderly
hospitalizations—a group particularly vulnerable
following an initial discharge from the hospital
- 5 percent of
Medicare beneficiaries are readmitted within five
days of discharge
- 20 percent are
readmitted within 30 days
- 22 percent are
readmitted within 60 days
- 34 percent are
readmitted within 90 days
In another study,
patients who lived alone and had no in-home care,
were readmitted more than twice as often as those
discharged patients who had in-home care assistance.
Another study shows that 40 to 50 percent of
readmissions are linked to a lack of community
services or follow-up care. It was found that by age
85, more than 50 percent of discharged patients
require some form of follow up service for duties
that they are unable to perform themselves.
In one specific example, an elderly heart failure
patient living alone had been readmitted to the
hospital at least four times a year for several
years. Once an in-home caregiver was enlisted for
his service, he was able to call a nurse instead of
just automatically going to the emergency room, thus
vastly reducing his frequent hospitalizations.
Health care plans and hospitals alike are beginning
to realize that many of these readmissions are
costly, affecting quality of service and
profitability, and that they could be effectively
avoided by utilizing in-home care services to reduce
the risk of hospital readmission. By assisting a
senior and his or her family with day-to-day
post-discharge needs such as medication reminders,
meal preparation, chronic illness monitoring, and
maintaining ongoing contact with doctors, a
caregiver can devote more time, attention, and
expertise to the patient than family members are
able or are sometimes capable of doing.
Coordinating post-hospitalization in-home care with
a hospital discharge planner is the best tactic.
Through a discharge management plan incorporating
in-home care assistance, the transition from
hospital to home can be organized and worry-free.
Depending on the situation, a discharged senior or
his/her family can utilize the services of an
in-home caregiver for anything from a few hours a
day, to full time, 24-hour care. Services can be
provided on an on-going basis or simply for a
specified time period to assist in short-term
recovery. A common misconception is that hiring an
outside caregiver is expensive. The reality is,
however, that the actual costs to families who
forego such a service can translate into lost time,
lost income, lack of sleep, and sometimes even job
loss incurred by a family member trying to
personally assist their aged loved one. In many
cases, these losses would most easily justify the
expense of hiring an in-home caregiver.
Statistics show that seniors discharged from the
hospital had significantly reduced rates of
readmission when the discharge plan included in-home
care services. Overall, numerous studies conclude
that when in-home care services are included in the
discharge plan, seniors can significantly reduce the
risk of relapse or collateral medical issues that
lead to hospital readmission.
The information in
the article is not intended to substitute for the
medical expertise and advice of your healthcare
provider. We encourage you to discuss any decisions
about treatment or care with an appropriate healthcare
provider.
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