DSC_0720-3Being in the hospital stinks.  There’s just no other way to describe it.  Whether it is a knee replacement planned months in advance, or an emergency appendectomy that brings your senior family member to the hospital, the experience can be stressful and somewhat unpredictable.  

In this 4-part series, we will explore the before, during, and after of a typical hospital stay.   Click the links below for the prior posts:

Mom’s in the hospital! What do I do? Part One: How to Prepare
Mom’s in the hospital! What do I do? Part Two: What to Expect

Once a loved one is settled into their hospital room, many people’s first thought is usually “What can I DO right now to help?”  The good news is, there are actually two really important things you can do while in the hospital with your family member.  

Advocate

The first and most important thing you can do for your loved one while they’re in the hospital is to become their advocate.  Your senior family member is likely weak, in pain, ill, and on strong medications that affect their cognition.  

They are not “themselves” at that moment, and in most situations, cannot properly advocate for their needs while in that condition.  It is your time to step in and be their voice.  

→Be There

Ensure that there is someone in the room with your family member at all times. Whether it is you, your brother, your daughter, or a rotation of people, make sure that the advocate(s) is someone who knows your family member well: their medications, their history, their preferences, their temperament, etc.  

The person in the room functioning as their advocate at any given time will need to be able to remind hospital staff of the patient’s needs and educate them about their preferences.

→The Notebook

advocateGo down to the hospital gift shop and buy a notebook.

This notebook will be used to communicate vital information between family members taking shift as advocates, and will serve as a record of your loved one’s hospital stay.  This will help you to keep track of what’s going on.  

Stick a copy of the information you gathered in part one of this series in the front of the notebook: their medical history, medication allergies, etc.)  

Track the meds they are being given in the hospital (name, dose, time, reactions, effectiveness.)  

Write down their symptoms—what happened and what time it occurred, and keep track of their food and water intake.  

As your loved one will likely be cared for by multiple physicians, make it a point to write down each doctor’s name and specialty.  Record notes from your conversations with them.  Write down what day and time they will be rounding next.  

→“Can you come back later?”

Know that it is within your rights to ask people to come back at another time.

You know your family member better than anyone.  If they are having a moment of confusion, if they are absolutely exhausted and just fell asleep a few minutes ago, or if they are feeling agitated, you may feel it would be best for someone to return at a later time.  

Be it a visitor, a hospital social worker, or an aide, you can ask them to come at a more convenient time.  Sometimes they may be persistent, but it is your job to be firm and advocate for your family member.  

Of course there are some things that are medically necessary and must be done at a certain time (e.g. administering medication), but many things can be pushed back on the schedule to allow your family member time to rest.

→Rounding

Ask the nursing staff when the various specialists will be rounding.  Some doctor’s schedules are unpredictable, but others always do rounds at a specific time of day.  It is worth asking so that you can do everything possible to be there during that time.

→Dementia

advocate sitting in chairIf your loved one has dementia, your role as an advocate is especially important.  

It is your responsibility to educate each nurse, therapist, and aide that enters the room about your family member’s specific triggers, needs, and preferences.  If you are not a primary caregiver and are not aware of this information, you need to ask the care facility where they reside or their in-home caregivers.  

You may need to remind staff not to rush, to keep their voices down and their demeanor calm, to keep instructions clear and simple, to keep the door shut to minimize noise, etc.  Maybe your family member is triggered by bright lights.  You will need to post a sign on the door to that effect and remind people as necessary.  

Perhaps your dad becomes agitated when a female aide attempts to assist him in the bathroom.  Be ready to educate staff and remind them to send in a male aide instead.  

Be proactive and ask when shift change is.  Right after shift change, educate the new nurses and aides about your loved one’s needs and preferences.  

Many aides and nurses in the hospital are not experienced caring for those with dementia, and that is why your role as a constant advocate will be very important during your family member’s time at the hospital.  

→Ask!

Ask questions.

The hospital staff is there to ensure that your loved one is cared for, but they are also there to make sure that you understand everything that is going on so that you can make informed decisions about their care.  

If something doesn’t feel right, or if you have any confusion about anything: ASK.  

Don’t be intimidated by “medical speak.”  If the doctor or nurse says something that you don’t understand, remind them to speak everyday English and ask questions to clarify.  They may use jargon out of force of habit, not realizing that you don’t understand.  

Usually, doctors are on tight schedules, and try to round as quickly as possible.  If they seem to be in a rush, don’t let that intimidate you.  Simply explain that you have a few more questions for them, and ask them to stay.   

Keep a running list of questions in your notebook throughout the day, so you are ready when the doctor comes in.

Sanitize

The second thing you can do while in the hospital with a loved one is to sanitize their environment.  

Most of us probably think of hospitals as being perfectly sanitary environments.  However, it is important to remember that hospital-acquired infections are becoming an increasingly serious problem, especially for seniors, who have weakened immune systems.  

Hospitals are doing their best to address this growing issue, but there are ways you can help as well.

→Clean the room

As soon as your loved one is settled in their hospital room, it’s time for you to roll up your sleeves and get to work!

Buy a huge container of disposable Clorox wipes, a big can of Lysol, and a big pump bottle of Purel.  You don’t know how long your senior will be there, and you will be using these items often.  You don’t want to run out.  

These things are your best line of defense against germs, as well as frequently washing your hands with soap and water.  

Use the Clorox wipes to wipe down all high-contact surfaces: doorknobs, countertops, bedside trays, call buttons, TV remotes, phones, chair armrests, and faucets.  This should only take about 10 minutes.  

Then, spray Lysol in the air all around the room.  Spray it around the commode or toilet as well.  

Use the Purel hand sanitizer often.  Help your loved one use it frequently, and encourage everyone else in the room to use it often as well.  

Get in the habit of using hand sanitizer every time you enter the room (hospitals usually have wall-mounted hand sanitizers either just outside the door or right inside the room.)

→Screen visitors

advocate visitorsIt is your responsibility to screen all potential visitors.  Ask them if they have a cold, or have recently had a cold, fever, cough, etc.  

It may feel awkward to ask these questions, but it is vital that anyone who has been sick recently STAY OUT.

Everyone means well, and they may even say “Oh, I’ll just stand over here by the door.” DO NOT let sick people do this.  

This puts your loved one at risk for picking up their illness and prolonging their hospital stay.  

Seniors are already more vulnerable to illness due to their weaker immune systems, and they are especially vulnerable when they are already ill.  What may be a simple cold for a younger person can easily manifest as something more serious in a senior citizen.  

Catching an additional bug from a visitor will complicate your loved one’s recovery and could lead to more severe problems.

Once you have cleared someone to visit, insist that they use hand sanitizer before entering the room.  If they leave for a while to go to the gift shop, then come back, remind them to use it again.  If you or anyone else in the room sneezes or coughs, wash your hands or use Purel immediately.

Think twice before allowing children to visit.  Although they are often a most welcome distraction, they also could be sick without realizing it, or could be carrying a variety of germs that could threaten the wellbeing of your loved one.  Should you determine a child to be a safe visitor, ensure that they use hand sanitizer frequently.

→Daily once-overs

It is a good practice to run Clorox wipes over the high-contact surfaces in the room once a day.  You should be spraying Lysol in the air throughout the room several times a day.  Anytime a new person enters the room (including hospital staff) ensure that they use hand sanitizer, and spray Lysol around the room when they leave.

All of this cleaning and sanitizing may make you feel a little silly at times, but your truly are doing what is best for your loved one.  These practices help to keep bacteria at bay.  So own your role as a sanitization nazi!

Hopefully you now have a better idea of things you can be doing in the hospital to support your loved one.

Advocating on their behalf and in accordance with their wishes will help them get the best care possible, and maintaining a clean environment will help to prevent infection and delays in the healing process.  

Hang in there…discharge is just around the corner!

 

Next week—Part Four: Discharge Planning