Older Adults: Hospital Hints : Geriatric Assessment, Safety Tip, Discharge

by National Institute on Aging

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Geriatric Assessment

Some older people have many health problems that threaten their ability to live on their own after they leave the hospital. In some hospitals, a team that includes a doctor, nurse, and social worker addresses the special needs of older patients. This team also may include other specialists and therapists. The team performs a thorough exam, called a geriatric assessment, to learn about the patient's physical and mental health, family life, income, living arrangements, access to community services, and ability to perform daily tasks. The team diagnoses health problems and develops a plan to help older patients get the health care and social services they need.

Hospital Geography

Hospitals have many patient-care areas. For example, patients may be in a private (one- bed) or semiprivate (two-bed) room. The intensive care unit (also called the ICU) has special equipment and staff to care for very ill patients. Coronary care units (CCUs) give intensive medical care to patients with severe heart disease. In both the ICU and CCU, visiting hours are strictly limited and usually only family members are allowed to see patients. Surgery is done in the operating room (OR). After an operation, patients spend time in the recovery room before going back to their own room.

In the emergency room (ER), trained staff treat life-threatening injuries or illnesses. Patients who are badly hurt or very sick are seen first. Because the ER is so busy, less seriously ill patients may have to wait before they are seen by an emergency medical technician, nurse, or doctor.

Safety Tips

Because you may feel weak or tired, please take a few extra safety steps while in the hospital:

• Use the call bell or button when you need help.
• Use the controls to lower your bed before getting in or out.
• Be careful not to trip over the wires and tubes that may be around the bed.
• Try to keep the things you need within easy reach.
• Take only prescribed medicines. If you bring your own medicines with you, tell your nurse or doctor. Don't take other drugs without your doctor's permission.
• Hold on to grab bars for support when getting in and out of the bathtub or shower.
• Use handrails on stairways and in hallways.

Questions

During your hospital stay, you'll probably have many questions about your care. Always feel free to ask your doctor these questions. Your doctor is there to help you get the care you need and to discuss your concerns. Your nurse or social worker also may be able to answer many of your questions or help you get the information you need.

You may find it useful to write down your questions as you think of them. For example, you may want to ask your doctor or nurse some or all of the following questions:

• What will this test tell you? Why is it needed, and when will you know the results?
• What treatment is needed, and how long will it last?
• What are the benefits and risks of treatment?
• When can I go home?
• When I go home, will I have to change my regular activities or my diet?
• How often will I need checkups?
• Is any other follow-up needed?

Patient Rights

You can decide in advance what medical treatments you want or don't want in the hospital in case you lose your ability to speak for yourself. You can do this by preparing something called an advance directive. In an advance directive, you tell people how to make medical decisions for you when you can't make them for yourself. You also can name someone else to make medical decisions for you. Two common advance directives are a living will and a durable power of attorney for health care.

In a living will, you write down the kind of medical care you want (or don't want) in case you are unable to make your own decisions. It's called a living will because it takes effect while you are still alive.

In a durable power of attorney for health care, you name someone else (a family member or friend, for example) to make medical decisions for you if you are unable to make them for yourself. You also can include instructions about any treatment you want to avoid.

If you have an advance directive, tell your family and make sure they know where it's located. Also, tell your doctor and make sure that the advance directive is part of your medical records. If you have a durable power of attorney for health care, give a copy to the person you've chosen to act on your behalf.

If you need help to prepare an advance directive or if you would like more informa-tion about them, contact your doctor or lawyer. You also can consult your State Attorney General's Office or State Office on Aging.

Discharge Planning

Before going home, you'll need discharge orders from your doctor and a release form from the hospital business office. Discharge planning before leaving the hospital can help you prepare for your health and home-care needs after you go home. The discharge planner can help you arrange for a visiting nurse, hospital equipment, meals-on-wheels, or other services. The discharge planner also knows about senior centers, rehabilitation centers, nursing homes, and other long-term care services.

About the Author

www.nia.nih.gov
NIA, one of the 27 Institutes and Centers of NIH, leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people.