Many Seniors Confused About Hospitalization

Hospitalization Studies show that approximately 20 percent of Medicare patients are readmitted within 30 days of discharge. A study in JAMA Internal Medicine1 concluded that many elder patients are confused about the reasons for their hospital admissions and by the instructions for their discharge.1 This study highlights the need for better communication with older patients about hospitalizations and discharge.

Researchers interviewed 400 patients 65 years and older discharged from a Connecticut hospital between May 2009 and April 2010 about their experiences. Although overall patients had positive feedback, they did not know actual facts about their hospitalization. Less than 60 percent of patients could accurately describe their diagnosis and 40 percent didn’t fully understand why they were admitted. In 30 percent of cases, the discharge process was rushed and abrupt, giving patients less than one day’s notice of their upcoming discharge.1

A Need for Better Communication

The confusion elder patients may face after their hospitalizations, could make it difficult for them to fully understand instructions for new medications or dosage changes for an established medication regimen. In some cases, patients may be confused by medical language used in discharge instructions. For example, instructions using the term "myocardial infarction" instead of "heart attack" may be difficult to understand. Discharged patients may also temporarily reside with a family member who is not near their regular physician(s). They may have new physical limitations making transportation arrangements more complex. They may have received numerous health care recommendations and need guidance integrating the information into their care plan.

You Can Help Your Patients Understand

As a trusted health care professional, your guidance may ease confusion and assist your patients in their recovery. Some recommendations for improving communications with your older hospitalized patients are outlined below:

  • If you conduct a hospital visit close to or on the day of discharge, speak to your patients about the reason for their admission, changes in medication made during their hospital stay, and what to expect after discharge. If possible, include family members in this discussion.
  • If you provide post-discharge care, discuss the reason for their recent hospital stay, changes in medication, and any of the patient’s concerns since discharge.

Make sure your patient understands what to do in the event their health declines. Let patients know what symptoms necessitate a visit to the Emergency Room and what symptoms can be handled in the office.

Each of these actions will help improve health outcomes for your patients and reduce the number of readmissions.

1Leora I. Horwitz, MD, MHS; John P. Moriarty, MD; Christine Chen, MD; Robert L. Fogerty, MD, MPH; Ursula C. Brewster, MD; Sandhya Kanade, MD; Boback Ziaeian, MD; Grace Y. Jenq, MD and Harlan M. Krumholz, MD, SM. "Quality of Discharge Practices and Patient Understanding at an Academic Medical Center." JAMA Intern Med. 2013;173(18):1715-1722.

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