People 65 years and older represent nearly 40 percent of hospitalized adults and are said to account for nearly half of all health care dollars spent on hospitalization. They comprise less than 13 percent of the population, which means if you are a senior you are more likely to be hospitalized than a younger person. I had occasion to contribute to that statistic recently.
My experience with hospitals is based on working in a hospital setting for more than 40 years, being a patient a dozen or so times, and visiting or being an advocate for a family member. A recent three day stay, mostly for tests, suggests these words to the wise.
Your room: Hallelujah, the 20- bed wards that persisted until the 60’s are now history. The double or four-bed rooms replacing them are all but gone. The modern hospital room in nearly every case is a single. Rejoice.
Your bed: It will be narrow, and the perfectly cornered sheets are a thing of the past, but these beds are mechanical marvels. They provide safety and convenience for the patient and efficiency and utility for care givers. They are not your comfy four poster, but that is not the role of the hospital bed.
Interruptions: You can expect to be awakened at least once during the night when a tech checks vital signs including blood pressure, pulse and temperature. This is done for a reason and includes everybody. It is a valuable and proactive policy. How would you feel if you were ignored?
The dreaded needle: Everyone admitted to the hospital can expect to provide a blood sample for routine tests. The needles will be sharp, small caliber and sterile. They are a vast improvement over the “good ol’ days” when needles were sterilized, re-used and often dull. Most blood drawers (phlebotomists) are expert. If blood drawers have had difficulty with your veins, tell the person attending you. If they are not confident, they may be able to call on an “expert”.
The “IV”: While a hospital patient, you are likely to be connected to an IV bottle containing a clear salt solution. This requires that a small catheter is threaded in a vein after being introduced with a sharp needle. The needle is withdrawn, and the tubing taped securely which provides hydration and, when needed, the rapid and painless injection of intravenous medication.
The IV where? It is very important for your comfort to have the indwelling IV tubing in the right place. The wrong place is the antecubital fossa, which is a fancy way of saying at the inside of your elbow. This is the site of the fattest and most accessible veins. It is also where you bend your arm. An IV placed here will mean that you should keep your arm extended, straight, to keep the tubing from kinking, stopping the drip, and setting off an alarm that requires the nurse or tech to visit your room and turn off the squawking. If that is the only vein available, have it placed in the left arm if you are right-handed ,and vice versa if you are left-handed. This will make it much easier to eat.
Food: Study the menu. Look for the “safe bets”. These include soup, eggs (omelet or scrambled), breads and pastries, fruit, most desserts, and my favorite hospital food, the hamburger. Most of all, be realistic. After all, you are in a hospital and your orders might include dietary restrictions that limit the amount and type of food. In that case just chill. If you have experienced delays, order well in advance of when you plan to eat.
Your doctor: You may remember, when you were a child, that your family doctor made a house call. There wasn’t much he could do, but just his presence was comforting. This is rarely done today. Better transportation, efficient communication, cost and other factors have made the house call a thing of the past. Likewise, the regular hospital rounds that had been a ritual in medicine have been eliminated in many institutions. These have been replaced by the hospitalist who stays in the hospital and assumes responsibility for admitted patients. These doctors work full time in the hospital and can work with your doctor but are in charge during your admission. In cases where your doctor still conducts rounds every day, it is possible you will be seen by a partner or colleague who assumes that role, rounding on all patients in the practice on that day. This is somewhat like the hospitalist, but constant presence is lacking when some type of rounding persists.
The advocate: There are times when the presence of a family member can be an advantage, or even necessary, and other times when this is not a good idea. There is no definitive rule. The fact that many rooms have a pull-out sleeping couch for a visitor suggests tacit approval. This is something for you and your family to work out. One example, a friend offered to assume management of his wife’s ileostomy during a prolonged hospital stay. The hospital had an ostomy team, but they were limited when it came to routine care. The nursing staff accepted this help eagerly.
Pajama bottoms: This is for men. If you are entering the hospital for a planned admission, consider bringing a pair of cotton pajama pants that fit loosely and have a string tie. The back-opening gown given to you on admission is a miserable concoction that can be made tolerable if you can augment it. If you didn’t bring your own, ask the nurse for a pair. They can provide these for you in every case. It will make your stay much more enjoyable.
Back scratcher: This unorthodox advice may not be considered acceptable by the hospital but give it a try. Bring a back scratcher that you can modify by cutting it to about one foot and it will still get the job done. In those “good ol’ days”, nurses provided in-bed baths and back rubs, which for the most part are distant memories. During my recent three days in the hospital the greatest discomfort I endured was an itching in the middle of my back that was inaccessible. Oh, what I would have given for a back scratcher.
By Savvy Senior
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