In most professions, you can tell how well someone is doing at their job by how often their customers come back for more. Health care, though, is kind of the opposite, especially when it comes to hospitals. Success in this context usually means not having to go back anytime soon.

 

It’s not always easy to avoid a return visit to the hospital, however. In fact, as we get older and medical concerns become a more central aspect of our lives, the work of staying healthy grows steadily more difficult.

 

For those of us who are at that stage of the human experience, or for those of us who have a stake in helping someone who is, it’s a good idea to know the challenges before us. And, ideally, what we can do to overcome them. After all, vacations are great, but a hospital stay doesn’t make for a very affordable getaway.

 

Seniors and Hospital Readmission

 

A quick clarification: hospital admissions and hospital readmissions differ primarily in, well, the fact that they’re happening a second time. To be a “readmission,” though, it has to be tied to a recent treatment of the same condition. Here are some examples:

 

  • Treating a secondary infection occurring in the wake of a surgery
  • Returning for admission when an initial treatment was unsuccessful or exacerbated symptoms
  • Rapid-onset pneumonia symptoms due to the patient aspirating during a procedure
  • A patient’s condition failing to improve after treatment due to insufficient aftercare

 

Now, obviously, if you need to go to the hospital, you should go to the hospital, whether that’s for something new or something you were already seen for. But in theory, proper healthcare should address an issue, and when you’re discharged, you’re hopefully in the clear. Some return visits are going to be difficult or impossible to avoid. But a lot of them are completely preventable.

 

As a matter of fact, seniors are at elevated risk for readmission. One in five elderly patients are readmitted within 30 days of the previous treatment. For a demographic that’s already vulnerable to significant risks whenever they make a trip to the hospital, it’s less than ideal. Retirement-age patients are susceptible to infections, are more likely to be injured in a fall, and critically, face increased risks of negative outcomes when receiving treatment altogether.

 

The dangers are severe enough that Medicare has been taking steps to counteract and reduce the hospital readmission rate among seniors.

 

Preventing Hospital Readmissions

 

Admittedly (no pun intended), there are a number of factors that are outside of the patient’s control. It’s hard to avoid something like picking up a bug during your hospital stay, for example. That part of the circumstance is in the hands of the facility and the other people in the building, mostly. Same is true for times when something is missed in treatment, or unforeseen complications arise.

 

What can be influenced on the patient’s end is what happens after they’re discharged and they go home. Or, to state it more directly, the quality of aftercare and in-home care service after hospital discharge are the most significant indicators of whether or not the patient will be “returning for seconds.”

 

Another quick distinction: aftercare refers to the discharge instructions following a treatment (no matter how invasive), and the follow-through the patient performs regarding those instructions. Following a laparoscopic surgery, for example, a patient may be instructed to clean the incision points in a specific manner. Proper aftercare consists of adhering to those instructions closely, and following up with the care provider as needed.

 

In-home care, on the other hand, is when an individual is assisted with or provided medical care for concerns (including post-treatment aftercare) by a family member, or in more severe cases, a professional caregiver. This home care help could be as simple as a partner or family member assisting the patient in performing aftercare steps (cleaning incision points for them, helping them avoid discouraged physical activities, etc.).

 

The reason this is so topical for seniors is that getting older already makes taking care of yourself harder as time goes on. Everyone’s level of fitness, health, and self-sufficiency is different, but our twilight years have a tendency to trend more toward naps in recliners than toward triathlons (and to be fair, if they’ve reached that point, they’ve probably earned a few naps).

 

With that in mind, it makes sense why an elderly patient may return home, only to struggle to follow the instructions, or struggle to remember them well enough to do them consistently. Particularly in the case of individuals who are already battling health conditions that reduce their mobility and independence, aftercare is an uphill battle at best and nearly impossible at worst.

 

All of that is to say that preventing hospital readmissions with effective aftercare will likely require, bare minimum, someone checking in on the patient to make sure that follow-through is happening. And for many patients, it means they need some onsite assistance from a caregiver. And for others still, it may require dedicated in-home care from a qualified care provider.

 

Is In-Home Care Needed to Prevent Readmission?

 

There are a few frustrating realities that are highlighted by the readmission problem. First, other countries have this figured out a little better than the US does. “Hospitalization at home” is considered the standard of care in places like Australia and across Europe. In the US, the biggest obstacle between here and there is (as you might expect) insurance.

 

As it stands, billing Medicare for these at-home healthcare costs continues to present a major hurdle, and that’s to say nothing of other insurance providers.

 

Another tough pill to swallow is this: for many patients, the potentially avoidable readmissions may be the initial impetus to seek in-home care in the first place. It’s not until then that the patient and their loved ones realize how critical the need is.

 

So, if you or a loved one is in a scenario like this, start by asking if aftercare (and other important health-promoting activities) can be handled exclusively by the patient without any external support. More than likely, the individual would benefit from someone “checking in” with them after hospital discharge, at the very least.

 

Beyond that, once you’ve determined you might need to consider in-home care as an option, you’ll want to take some basic things into account, including:

 

  • The patient’s overall health and self-sufficiency
  • Age
  • Access to less formal support (family, friends, community, etc.)
  • Relevant health insurance details
  • Mobility limitations and challenges
  • Conditions of their home environment (e.g. safety hazards, accessibility needs, distance from possible assistance, etc.)
  • The nature of the condition (i.e. acute vs. chronic, and recovery time if applicable)
  • Financial status
  • Mental health status
  • Logistical concerns (access to food, necessary medical supplies, transportation challenges, etc.)

 

At the end of the day, these discussions are uncomfortable, but they’re important. And as hard as it can be, it’s easier than having to struggle against major health challenges alone.

Ensure a safe, happy home for your loved ones using the resources provided on our site. With the right information and careful consideration, you can make the best choice for your loved one’s care and well-being.