Many seniors struggle after hospital stay

Five years ago, I could not comprehend how my father’s two-day stay in the hospital resulted in a three-week stay in a skilled-nursing facility and a permanent decline in his functional abilities.

My father had Parkinson’s. At the time, he also had a form of low blood pressure that occurs when you stand up from a sitting or a lying-down position. It can make you feel dizzy or lightheaded.

The condition can even cause you to faint, which was what happened to my father and what precipitated the hospital stay.

My mother called 911 and my father was taken by ambulance to the emergency room and later admitted for observation.

Before his hospitalization my father could walk with a walker, he could assist if someone helped him off the toilet, he could feed himself and he was cognitively fit.

After two days in a hospital bed, he had significant functional decline. He couldn’t sit up, and he couldn’t walk, even with the help of a walker. He was confused and disoriented, unable to identify time or place. He was agitated, which was never a behavior he had displayed at home before the stay.

While my mother put up a fight to take my father home after the two days, the doctor felt he needed time to “regain his strength.” He ordered a threeweek stay in a facility for physical therapy and nursing care.

Now I’ve learned not only why my father declined so significantly and quickly in the hospital but also how common both physical and mental decline are after hospital stays, especially among older patients.

It’s estimated that up to 60 percent of older patients experience functional decline after hospitalization.

A study of hospitalized patients over the age of 74 noted that by the second day of admission “statistically significant deterioration had occurred in individuals’ scores for mobility, transfer, toileting, feeding and grooming.”

According to a recent article in the American Journal of Nursing, “Hospital care is often focused on treating an acute illness. Physical and cognitive function, factors that affect a patient’s independence and overall prognosis, are often overlooked.”

Bed rest was ordered for the two full days my father spent in the hospital. At home my father would have moved from room to room with his walker multiple times during the day.

My father’s ability to move and function, as well as his strength and balance, all deteriorated in that short period of time. It took three weeks of skillednursing care and three months of in-home physical therapy to regain some (but not all) of his pre-hospitalization abilities.

For those same two days, even when my mother was with my father, he wasn’t engaged in his normal routine. He wasn’t conversing with my mother, listening to his book on tape or watching the birds eat from the feeder.

This lack of social and mental stimulation led to his delirium.

My mother’s daily visits during his three-week stay in the skilled-nursing facility offered my father only a tiny taste of his normal routine and he was left alone a good part of the day, so his cognition was slow to return.

This loss in functional abilities is one reason why physicians are anxious to discharge older patients (to home if possible) as soon as they are able.

If you or a loved one is an older adult who is hospitalized, ask what can be done to reduce any functional decline. For example, if you use hearing aids, glasses, dentures or magnifiers, be sure they are with you to avoid sensory deprivation.

Is there an ability to mimic your home routine including walking the halls, getting out of bed for meals and walking to the bathroom?

Do you have the same social environment as at home, with conversations and mental stimulation?

Hospitalization may be unavoidable, but there is significant medical evidence that even a stay as little as 48 hours can result in functional decline for many seniors.

If there is an upcoming planned hospital stay, it may be worthwhile to speak with your or your loved one’s physician to put plans in place to prevent functional decline.


Categories: Elder HealthNumber of views: 1983

Tags: hospital stays

Andrea GallagherAndrea Gallagher

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