Avoiding Hospital Re-Admissions

 

Avoiding Hospital Re-Admissions

 

Whether you are a senior or a young adult trips to the hospital can be stressful, annoying and scary. Even if it’s visiting a loved one or having yourself admitted, we all can agree that the longer you stay out of the hospital, the better life is.

In Canada, seniors (age 65 and older) 137,500 seniors (age 65 and older) were hospitalized (spent at least one night in the hospital) for injuries in 2017-2018. Though most of these were due to falls, according to the Canadian Institute for Health Information (CIHI), seniors accounted for more than half of all injury-related hospitalizations among Canadians. Furthermore, one in every eleven patients will be re-admitted to the hospital within a month of the initial discharge.

Though some hospital stays cannot be prevented due to chronic health issues, the need for constant medical care, and/or specific administering of medication, other concerns and dangers can be avoided by simple lifestyle changes. Through this article, we will explore the reasons for senior (re)hospitalizations as well as how to best avoid unneeded (re)admittance.

If you would like to read our past articles on more on Fall Prevention and Winter Safety.

At Senior Homecare by Angels we can identify areas of vulnerability after returning from the hospital and can provide home care solutions to support your recovery. We can provide you with transportation, personal care, medication reminders and specific support tailored to your needs. Whether you are in Calgary or surrounding area. Check out our life care navigation here for a list of our services and programs.

 

Reasons for (Re)Hospitalizations

According to CIHI, between 2017-2018, 4 out of 5 senior hospitalizations (112,008 cases) were due to a fall with vehicle collisions (5,885) and accidental poisoning (2,713) rounding out the top 3. Falls are also the top reason for trips to the emergency room (ER). Falls accounted for 60% of trips to the ER with 20% of patients being admitted into the hospital soon thereafter. In terms of re-admittance, patients with longer hospital stays had lower re-admission rates. It was also supported that re-admittance is often due to the same underlying health issue the patient was originally hospitalized for, though, 9%-59% of re-admissions may be preventable.

The study also showcased the need for homecare as shorter hospital stays were beneficial only if the seniors had access to homecare afterward. In this case, rural senior patients (13.2%) had more readmission cases than urban senior patients (12%) due to a lack of home care services available in the community. Additionally, re-admissions cost more than 1.8 billion a year and seniors will often have extended stay in hospitals until home care services are available. Unfortunately, according to a University of Alberta study, 20% of just over 700,000 older adult patients died during the re-admission process due to health status, health-care-related transitions, and mismatch of needs and services provided by primary care and home care.

For the full CIHI study click here.

 

How to Prevent Hospitalizations:

As stated, the older you get the more detrimental hospital stays can be. Though specialized hospital care may be needed for a full recovery, it is not without its risks. Whether it’s with the care, medication, resistant superbugs (such as the bacteria Clostridium difficile [C-diff] or Methicillin-resistant Staphylococcus aureus [MSRA]) or the hospital environment, hospital stays can have serious risks to your health.

According to the Canadian Medical Association Journal, seniors that are older or frailer (a patient who has diminished physical ability) are more likely to have greater complications from a hospital stay. It is also researched that the frailer the patient is, the more likely they will be readmitted or die upon re-admission. Though sometimes hospitalization is a guarantee for some patients, it can be avoided for others. Below we will outline some tips to help you stay at home and out of the hospital.

 

Maintain a Healthy Diet

Maintaining a nutritious and balanced diet is a great first step to keeping healthy as you age. Focus on eating whole foods and avoiding highly processed meals. Remember, freezing leftovers is always a more viable and healthy option than getting takeout or eating processed foods. Focus on eating protein, reduce sodium intake and eat a ton of veggies. If you have a hard time chewing, try eggs, potatoes or steamed veggies rather than cookies, muffins or snacks.

Even if your medication causes side effects with certain foods, doctors, caregivers, and nutritionists will gladly help provide you with healthy alternatives. Luckily, if transportation isn’t possible a lot of grocery stores offer online shopping with delivery! Even at Senior Homecare by Angels, we will run errands, go shopping and cook so you don’t have to. Our expert caregivers will plan, prepare and serve you the healthiest of meals according to your needs.

 

Keep Active

In addition to diet, exercise is the next best thing. Exercise can help maintain your physical health as well as release stress-relieving endorphins. Since falls are the leading cause of senior hospitalization, fall prevention exercises can help increase your balance and gain back your confidence while moving. Even walking can be a great start to get the body going!

If you not confident to go on your own, take a family member, caregiver or loved one out for a stroll. As winter is more prominent throughout the year in Alberta, check out some of these home exercises here in case you cannot go outside or make it to a gym. If you are in a wheelchair, check out some seated exercises here. Exercise is a great tool to promote overall physical confidence. If you are living with injuries or have limited mobility, be sure to ask your doctor or physiotherapist for customized exercises tailored to you and your needs. Don’t forget to do things you want to do! If possible, go outside, see family, and enjoy your favorite activities. Socialization and hobbies are great motivators for getting active.

 

Home Safety

As explored in our Fall Prevention article, updating your home with safety precautions can help you avoid an unneeded fall. From easy solutions like non-stick rugs to more permanent renovations such as handrails or ramps, any form of safety proofing will help you avoid nasty falls, and, in turn, a trip to the hospital.

 

Follow Doctors Orders

Though it goes without being said, following the doctor’s orders is the most important thing you can do to stay healthy. Take your medications, take them on time, and ask for help if you cannot manage on your own. Remember, the only person responsible for your health is you. You are your own best doctor and patient. If you aren’t feeling well, go see your doctor. Nobody can explain your symptoms better than you so don’t hesitate to go to the doctor at the first sign of pain or discomfort. As they say, it’s always better to be safe than sorry.

 

How to Prevent Re-admission

Though re-admission is a guarantee for certain patients, others can easily avoid another trip to the hospital through proper discipline. Even at the institutional level, implementing proper techniques to improve patient life at home can highly reduce the risk of re-admission. For example, follow up phone calls, patient education and improved discharge planning can all improve the safety, well-being, and health of the patient. Though we can’t control the type of care provided by institutions, we can suggest strategies to reduce re-admission at the patient level. Below we outline the best practices to avoid another unneeded trip to the hospital. For additional reading on this topic check out How to keep seniors safe at home after hospital discharge.

 

Medication Management

Medication management is a huge factor when it comes to maintaining a healthy lifestyle while at home. One of the most important things patients do to maintain their health is not only taking their medications as directed but also understanding their effects and dosage.
According to CBC, it’s estimated that $419 million dollars are spent on seniors filling prescriptions for risky medication. Don’t be afraid to ask your doctor about the risks of the medication including its side effects. Remember, if you aren’t feeling good due to a dosage change, make sure you talk to your doctor as soon as possible. However, once you do have your medications set, it’s important to be organized. Make sure your medication is categorized by the day/hour, the proper dose is set, and the medication is stored properly (usually in a cool and dry place).

Another good rule of thumb is pre-sorting your medications for the week and making sure your medication list is up to date. If you need reminders, set alarms (timers [phone], alarm clocks, trackers [apps]), or get a family member or caregiver to remind you about your medication. If the instructions aren’t clear on a certain medication, make sure you ask your doctor before you leave their office. Most importantly, make sure you plan when your meds need to get refilled. As most medications can be refilled online or via phone, make sure you don’t wait till the last minute to get a prescription filled.

 

Hire a certified Caregiver

After a grueling hospital stay, some patients are recommended continual care while at home. For family members, spouses and the patient themselves, this can lead to exhaustion and stress. This does not always have to be the case as certified in-home caregivers can be hired to take the load off. For example, at Senior Homecare by Angels, we can take your loved one to and from appointments, remind them to take their medication, provide light housekeeping duties and, most importantly, provide companionship and support. Having another trustworthy person in the house can help reduce stress and keep your loved one healthy and under constant care. As most falls, slips, and other life-threatening dangers happen when the patient is alone, having a health Care Aide or Personal Support worker in the house can help reduce these risks and avoid unneeded injury.

 

Establish Effective Communication with your Hospital/Doctor

Just because you are discharged from the hospital doesn’t mean contact with your doctor needs to stop. Be sure to book follow up appointments to ensure your health is properly maintained. As follow up appointments are used to adjust medication and help with recovery, be sure to take them seriously. If something is unclear, ask for clarification! If you are feeling unwell or if a certain medication isn’t working as directed, contact your doctor immediately. Remember, just because you are out of the hospital doesn’t mean the doctors aren’t still there for you.

Their job is to keep you healthy so you can maintain a happy home life not to set you up for re-admission. If your doctor’s office has a hotline, call them for information. When you have a follow-up appointment, bring a family member or request the doctor to write down the information to ensure instructions are clear. When you are discharged, make sure you know what is expected of you once you get home. If you do need to purchase medical equipment, ask the doctor what vendors to buy from. If you have not done so already now might be a great time to contact your insurance provider to discuss coverage.

 

Take Care of Your Emotional and Mental Health

Though you may be treated for something entirely physical, don’t forget to take care of your emotional and mental well being as well. As the healthcare system and news of your health can be depressing, don’t forget to take time for you and your mental wellness.

Book an appointment with psychologists and counselors if you have feelings of depression, anxiety or other forms of negative emotions. Luckily, hospitals have vast access to social workers, psychologists and counselors so you don’t have to worry about searching for them yourself, just ask your doctor!

Remember, just because you can’t visually see mental illness like the way you would a broken bone, it doesn’t mean the emotions aren’t real. As awareness for mental illness is more widely accepted in society, it still contains a lot of stigmas. Don’t be afraid to talk to a professional about your emotions, how you are feeling about your diagnosis, and how it is impacting your life.
At Senior Homecare by Angels we can help you book follow up appointments with your doctor and remind you when to take your medications. Our experienced caregivers can help around the house as we provide light housekeeping, meal planning and preparation, and homemaking activities and to keep you safe, healthy and happy.

Feel free to ask any Senior Homecare by Angels Licensed Practical Nurse for advice on how best to contact healthcare professionals about your medication, mental health, and overall well-being.

 

 

Reach Out Today

You can reach Senior Homecare by Angels here, or by phone at (403) 862-0129. We look forward to meeting you and your family to provide you with all the home care solutions you need!

 

Gerald Gatto, OwnerGerry Gatto is a trained health care administrator and the owner of Senior Homecare® By Angels a Calgary – based company. Helping Calgary seniors remain in their homes and maintain their independence with the assistance of a dedicated caregiver.

 

 

 

 

Resources:

Alberta Health Services (phone 811)
https://www.albertahealthservices.ca/
Mental Health Services
https://www.albertahealthservices.ca/findhealth/Service.aspx?id=7484
Mental Health Hotline
https://www.albertahealthservices.ca/findhealth/Service.aspx?id=6810&serviceAtFacilityID=1047134
Senior Exercises
https://www.lifeline.ca/en/resources/14-exercises-for-seniors-to-improve-strength-and-balance/
Seated Exercises
https://www.youtube.com/watch?v=3ANUed30Bgk&feature=emb_logo
Fall Prevention Exercises
https://www.youtube.com/watch?v=z-tUHuNPStw&feature=youtu.be
Tips for Medication Management
https://dailycaring.com/medication-management-for-seniors-10-safety-tips/
Sources:
CIHI Falls and Vehicle Collisions Top Causes of Injury Hospitalizations for Seniors
https://www.cihi.ca/en/falls-and-vehicle-collisions-top-causes-of-injury-hospitalizations-for-seniors
CIHI Study on Hospital Re-admission
https://secure.cihi.ca/free_products/Readmission_to_acutecare_en.pdf
U of A Study
https://www.folio.ca/study-finds-high-rates-of-hospital-readmission-out-of-home-care-for-older-adults/
Injuries Among Seniors
https://www.cihi.ca/en/injuries-among-seniors
All Patients re-admitted to Hospital
https://yourhealthsystem.cihi.ca/hsp/inbrief.#!/indicators/006/all-patients-readmitted-to-hospital/;mapC1;mapLevel2;overview;/
News Stories:
CNN “The Older You Are, the Worse the Hospital is For You”
https://www.cnn.com/2016/08/15/health/elderly-hospital-patients/index.html
CBC “Frail Seniors at risk at Canadian Hospitals”
https://www.cbc.ca/radio/whitecoat/blog/frail-seniors-at-risk-at-canadian-hospitals-1.3086410
CBC “Harmful Medication Prescribing to Canadian Seniors Costs $419M a Year”
https://www.cbc.ca/news/health/drugs-seniors-inappropriate-prescribing-cost-1.3647231
CTV “Non-English Speaking Patients Need Equal Access to Interpreters Doctor Says”
https://bc.ctvnews.ca/non-english-speaking-patients-need-equal-access-to-interpreters-doctor-says-1.4668994