Important Things to Know Before You* Go to the Hospital!

* Or someone you know

Overview • Who Goes and Why?

• What your Doctor Doesn’t Know!

• Going, Going, Gone Before you Know it!

• Admitted or Observed?

• Following Through with the Plan

I am Just NOT Going!

• Persons aged 65+ had more hospitalizations than any other group

• 74% admitted through Emergency Room

• One of five go back into the hospital within 90 days of release!

• Mortality rate and length of stay are both higher with rehospitalization

Why Do Older Adults Go?

0

100,000

200,000

300,000

400,000

500,000

600,000

700,000

800,000

900,000

Number of Hospital Admissions

Heart Failure Pneumonia

Atherosclerosis Heart Rhythm

Heart Attack Lung Problems

Stroke Arthritis

Adjust devices Dehydration

“Sicker and Quicker”

• People are in the hospital for much shorter times than ever before

– Bypass? 2 days!

• Discharge doesn’t happen when you are healed

• Most of the care takes place by your hands and in your home

You May Need a Friend!

• Your hospital stay will not go as planned…

• You will receive care which you may not understand…

• You will have questions…

• You may not be heard…

• Have someone with you to help you listen to instructions and capture the facts!

Going Home is Important • A successful hospital stay

continues with a successful hospital release

• There are several things you and your family or friends can do while you are in the hospital to make your discharge successful

• Keeping track of just four things can make a difference in whether you go back to the hospital

The First Priority—Medication

• Hospital stays can change what meds you take and how you take them

• Hospital staff will need to know what you take

• Always keep a current list of your medication in your wallet or purse

Managing Medications • Before you leave the

hospital get a current list of medicines, dose, and how to take it

• Ask about ALL medicines—those before the hospital as well as new ones added in the hospital

• Have a plan to keep them organized…

Ask Questions about Medicine • What are they for?

• How should I take them? – With food/no food

– Timing; when/how often

– Mixed or separate; OTC

– Crush or not

– When to quit?

• Talk to your Doctor before discontinuing anything

• Take everything to one pharmacist for a good look!

The Second Priority—Warning Signs

• These are things that tell you that your condition is getting worse

• Before you leave ASK what you should watch for

– Write it down!

– Don’t leave the hospital without the list of danger symptoms

Warning Signs

• At the FIRST SIGN of a problem—tell someone or call the doctor

• Know your doctors’ telephone numbers and which one to call – Know who to call after hours

and on the weekend

• You know your body—waiting to tell will only make things worse

The Third Priority—See Your Doctor

• The hospital may not inform your doctor about your hospitalization

• The hospital is most likely not going to call you or follow up with you to see how you are doing

• Your doctor may not even know you were in the hospital

Make the Call!

• You absolutely MUST see your primary care doctor within the week you leave the hospital

• When you call, tell the person who sets appointments that you just got out of the hospital

• If they tell you there are no openings, ask to speak to the nurse

• DO NOT TAKE NO FOR AN ANSWER

• Keep the appointment

• Write your questions down as you think of them before you go

• Make sure you have a ride!

Plan your Ride to the Doctor

• You may not be able to drive safely so be sure you plan how to get there…

– Friends

– Specialized Transportation

– Family Members or Taxi

– Volunteer

– Faith Community

– If eligible for Medicaid

676-6749 or 738-4554

The Fourth Priority—Make a Record • Your health is your

responsibility

• You are the most accurate source of information—only you know the whole story

• Healthcare professionals do not share your information with one another

• Keeping a record will provide a record for others when you are ill and treatment will be faster

Keep a Health Record

• Keep track of anything you think is important:

– Illnesses or problems, dates, and treatments

– Medications, including herbs and vitamins; any negative experiences

– Hospital stays, dates, why you were there and what happened to you

– Immunizations; oral health care, eye exams, mammograms, physicals

• Keep it out so you can keep it updated

It’s Your Job • Don’t expect that your

health information will be shared with other medical providers, even with electronic medical records

• If you hear misinformation, speak up!

• It is your information and your responsibility to keep it straight

NOTICE! I am in charge of my

medical care. If you have a

question, ASK ME!

When You Leave the Hospital

• Be sure you have the information you need and do not leave without it

• Remember that you may not be able to do the same things as when you left home

• ASK FOR HELP!

Not Ready To Go? • The hospital may try to discharge

you before you feel ready to go.

• If so, call the Quality Improvement Organization (QIO) 800-949-7536, (in Western Washington) before the end of the day of the planned discharge.

• Tell them you want an “expedited hearing” about your discharge.

• They will review the record and make a decision by noon of the following day.

Admitted or Observed? • You came in through the

Emergency Room.

• You were taken to a room, received medical care, tests, meals, and a toothbrush.

• You have been here for four days.

• You may be in OBSERVATION

• ASK if you are ADMITTED!

Three Is Your Lucky Number…

• Unless you have been admitted to the hospital for three days, MEDICARE will not pay for nursing home care.

• As you make plans for discharge, ASK if you have been in long enough to recover in a nursing home.

Home Might not Be Sweet • If you have ANY questions

about your ability to self care or manage with your caregiver, you may want to consider a very short stay in a nursing home until you get ready

• Medicare will pay for home health care if you are homebound, need skilled care, and have a doctor’s order

• ASK BEFORE you leave the hospital!

If You Need Help… • There are many

community agencies ready to help you and your caregiver

• Call Senior Information and Assistance for help with nearly any issue

• Call the Family Caregiver Support programs for tips with caregiving and assistance to find services and equipment

To Review… • Get prepared before

you need to go

• Get a health record set up

• Write down your medications

• Talk to close friends and family and identify an advocate to help you when you are not at your best

• Pack a “just in case” bag and include a list of things to remember – Warm socks

– A toothbrush and paste

– Your health record

– A manila folder for papers

– A family picture

– Two pairs of your

best clean

underwear

Don’t Put it Off • Planning now will assist

you to heal later

• Discuss your plan your family or friends

• Remembering is as easy as 1,2,3,4!

• Call for help with planning or for a discharge coach

360-676-6749

800-585-6749

For More Information

• Caregiver Support is available by calling the Northwest Regional Council

– Skagit—360-428-1301

– Whatcom—360-676-6749

• Aging and Disability Resource Information is available by calling the Northwest Regional Council

– Skagit—360-428-1301

– Whatcom—360-738-2500