Best Practices For Avoiding Hospitalization

Whether you are a senior, a child or a young adult, trips to the hospital can be stressful, annoying and scary. Even if it’s visiting a loved one or having yourself admitted, we all can agree that the longer you stay out of the hospital, the better life is. In Canada, seniors (age 65 and older) 137,500 seniors (age 65 and older) were hospitalized (spent at least one night in the hospital) for injuries in 2017-2018. Though most of these were due to falls, according to the Canadian Institute for Health Information (CIHI), seniors accounted for more than half of all injury-related hospitalizations among Canadians. Furthermore, one in every eleven patients will be re-admitted to the hospital within a month of the initial discharge. Though some hospital stays cannot be prevented due to chronic health issues, the need for constant medical care, and/or specific administering of medication, other concerns and dangers can be avoided by simple lifestyle changes. Through this article, we will explore the reasons for senior (re)hospitalization as well as how to best avoid unneeded (re)admittance. If you would like to read our past articles on Fall Prevention and Winter Safety click here and here.  Be sure to check out the resources tab below for a list of links that can help you maintain a safe and healthy lifestyle.

At Senior Home Care by Angels we can identify points of interest and vulnerability in everyday life and provide home care solutions. We can provide you with transportation, companionship and specific care tailored to your needs. Whether you are in Edmonton, St. Albert, Sherwood Park, Spruce Grove or the greater Edmonton area, if you do end up needing transport to a hospital, we can pick you up! Check out our life care navigation here for a list of our services and programs.

Reasons for (Re)Hospitalizations

According to CIHI, between 2017-2018, 4 out of 5 senior hospitalizations (112,008 cases) were due to a fall with vehicle collisions (5,885) and accidental poisoning (2,713) rounding out the top 3. Falls are also the top reason for trips to the emergency room (ER). Falls accounted for 60% of trips to the ER with 20% of patients being admitted into the hospital soon thereafter. In terms of re-admittance, patients with longer hospital stays had lower re-admission rates. It was also supported that re-admittance is often due to the same underlying health issue the patient was originally hospitalized for, though, 9%-59% of re-admissions may be preventable.

(photo taken from CIHI study)

The study also showcased the need for home care as shorter hospital stays were beneficial only if the senior had access to home care afterwards. In this case, rural senior patients (13.2%) had more re-admission cases than urban senior patients (12%) due to a lack of home care services available in the community. Additionally, re-admissions cost more than 1.8 billion a year and seniors will often have extended stay in hospitals until home care services are available. Unfortunately, according to a University of Alberta study, 20% of just over 700,000 older adult patients died during the re-admission process due to health status, health-care related transitions, and mismatch of needs and services provided by primary care and home care.

For the full CIHI study click here.

How to Prevent Hospitalizations:

As stated, the older you get the more detrimental hospital stays can be. Though specialized hospital care may be needed for full recovery, it is not without its risks. Whether it’s with the care, medication, resistant super bugs (such as the bacteria Clostridium difficile [C-diff] or Methicillin-resistant Staphylococcus aureus [MSRA]) the hospital environment, hospital stays can have serious risks to your health. According to the Canadian Medical Association Journal, seniors that are older or frailer (a patient who has diminished physical ability) are more likely to have greater complications from a hospital stay. It is also researched that the frailer the patient is, the more likely they will be re-admitted or die upon re-admission. Though sometimes hospitalization is a guarantee for some patients, it can be avoided for others. Below we will outline some tips to help you stay at home and out of the hospital.

Maintain a Healthy Diet

Maintaining a nutritious and balanced diet is a great first step to keeping healthy as you age. Focus on eating whole foods and avoiding highly processed meals. Remember, freezing leftovers is always a more viable and healthy option than getting takeout or eating processed foods. Focus on eating protein, reduce sodium intake and eat a ton of veggies. If you have a hard time chewing, gravitate towards eggs, potatoes or steamed veggies rather than cookies, muffins or snacks. Even if your medication causes side affects with certain foods, doctors, caregivers and nutritionists will gladly help provide you with healthy alternatives. Luckily, if transportation isn’t possible a lot of grocery stores offer online shopping with delivery! Even at Senior Homecare by Angels, we will run errands, go shopping and cook so you don’t have to. Our expert caregivers will plan, prepare and serve you the healthiest of meals according to your needs. 

Keep Active

In tandem with diet, exercise is the next best thing. Exercise can help maintain your physical health as well as release stress-relieving endorphins. Since falls are the leading cause of senior hospitalization, fall prevention exercises can help increase your balance and gain back your confidence while moving. Even walking can be a great start to get the body going! If you aren’t confident to go on your own, take a family member, caregiver or loved one out for a stroll. As winter is more prominent throughout the year in Alberta, check out some of these home exercises here in case you cannot go outside or make it to a gym. If you are in a wheelchair, check out some seated exercises here. Exercise is a great tool to promote overall physical confidence. If you are living with injuries or have limited mobility, be sure to ask your doctor or physiotherapist for customized exercises tailored to you and your needs. Don’t forget to do things you want to do! If possible, go outside, see family, and enjoy your favourite activities. Socialization and hobbies are great motivators to getting active.

Home Safety

As explored in our Fall Prevention article, updating your home with safety precautions can help you avoid an unneeded fall. From easy solutions like non-stick rugs to more permanent renovations such as handrails or ramps, any form of safety proofing will help you avoid nasty falls, and, in turn, a trip to the hospital.

Follow Doctors Orders

Though it goes without being said, following the doctor’s orders is the most important thing you can do to stay healthy. Take your medications, take them on time, and ask for help if you cannot manage on your own. Remember, the only person responsible for your health is you. You are your own best doctor and patient. If you aren’t feeling well, go see your doctor. Nobody can explain your symptoms better than you so don’t hesitate to go to the doctor at the first sign of pain or discomfort. As they say, it’s always better to be safe than sorry.

How to Prevent Re-admission:

Though re-admission is a guarantee for certain patients, others can easily avoid another trip to the hospital through proper discipline. Even at the institutional level, implementing proper techniques to improve patient life at home can highly reduce the risk of re-admission. For example, follow up phone calls, patient education and improved discharge planning can all improve the safety, well-being and health of the patient. Though we can’t control the type of care provided by institutions, we can suggest strategies to reduce re-admission at the patient level. Below we will outline the best practices to avoid another unneeded trip to the hospital.

Medication Management

Medication management is a huge factor when it comes to maintaining a healthy lifestyle while at home. One of the most important things patients do to maintain their health is not only taking their medications as directed, but also understanding their affects and dosage. According to CBC, it’s estimated that $419 million dollars is spent on seniors filling prescriptions for risky medication. Don’t be afraid to ask your doctor about the risks of the medication including its side affects. Remember, if you aren’t feeling good due to a dosage change, make sure you talk to your doctor as soon as possible. However, once you do have your medications set, it’s important to be organized. Make sure your medication is categorized by the day/hour, the proper dose is set, and the medication is stored properly (usually in a cool and dry place). Another good rule of thumb is pre-sorting your medications for the week and making sure your medication list is up to date. If you need reminders, set alarms (timers [phone], alarm clocks, trackers [apps]), or get a family member or caregiver to remind you about your medication. If the instructions aren’t clear on a certain medication, make sure you ask your doctor before you leave their office. Most importantly, make sure you plan ahead when your meds need to get refilled. As most medications can be refilled online or via phone, make sure you don’t wait till the last minute to get a prescription filled.

Hire a Caregiver

After a grueling hospital stay, some patients are recommended continual care while at home. For family members, spouses and the patient themselves, this can lead to exhaustion and stress. This does not always have to be the case as in-home caregivers can be hired to take the load off. For example, at Senior Home Care by Angels, we can take your loved one to and from appointments, remind them to take their medication, provide light housekeeping duties and, most importantly, provide companionship. Having another trustworthy person in the house can help reduce stress and keep your loved one healthy and under constant care. As most falls, slips, and other life-threatening dangers happen when the patient is alone, having a caregiver in the house can help reduce these risks and avoid unneeded injury.

Establish Effective Communication with your Hospital/Doctor

Just because you are discharged from the hospital doesn’t mean contact with your doctor needs to stop. Be sure to book follow up appointments to ensure your health is properly maintained. As follow up appointments are used to adjust medication and help with recovery, be sure to take them seriously. If something is unclear, ask for clarification! If you are feeling unwell or if a certain medication isn’t working as directed, contact your doctor immediately. Remember, just because you are out of the hospital doesn’t mean the doctors aren’t still there for you. Their job is to keep you healthy so you can maintain a happy home life not to set you up for re-admission. If your doctor’s office has a hotline, call them for information. When you have a follow up appointment, bring a family member or request the doctor to write down the information to ensure instructions are clear. When you are discharged, make sure you know what is expected of you once you get home. If you do need to purchase medical equipment, ask the doctor what vendors to buy from. If you have not done so already now might be a great time to contact your insurance to have a discussion on coverage.

Take Care of Your Emotional and Mental Health

Though you may be treated for something entirely physical, don’t forget to take care of your emotional and mental well being as well. As the healthcare system and news of your health can be depressing, don’t forget to take time for you and your mental wellness. Book an appointment with psychologists and counsellors if you have feelings of depression, anxiety or other forms of negative emotions. Luckily, hospitals have a vast access to social workers, psychologists and counsellors so you don’t have to worry about searching for them yourself, just ask your doctor! Remember, just because you can’t visually see mental illness like the way you would a broken bone, it doesn’t mean the emotions aren’t real. As awareness for mental illness is more widely accepted in society, it still contains a lot of stigma. Don’t be afraid to talk to a professional about your emotions, how you are feeling about your diagnosis, and how it is impacting your life.

At Senior Home Care by Angels we can help you book follow up appointments with your doctor and remind you when to take your medications. Our experienced caregivers can help around the house as we provide light housekeeping, meal planning and preparation, home making activities and to keep you safe, healthy and happy. Feel free to ask any Senior Home Care by Angels caregiver for advice on how best to contact healthcare professionals about your medication, mental health and overall well-being.

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Reach Out Today

You can reach Senior Home Care by Angels here, or by phone at (780) 487-4256. We look forward to meeting you and your family to provide you with all the home care solutions you need!

Resources:

Alberta Health Services (phone 811)

https://www.albertahealthservices.ca/

Mental Health Services

https://www.albertahealthservices.ca/findhealth/Service.aspx?id=7484

Mental Health Hotline

https://www.albertahealthservices.ca/findhealth/Service.aspx?id=6810&serviceAtFacilityID=1047134

Senior Exercises

https://www.lifeline.ca/en/resources/14-exercises-for-seniors-to-improve-strength-and-balance/

Seated Exercises

https://www.youtube.com/watch?v=3ANUed30Bgk&feature=emb_logo

Fall Prevention Exercises

https://www.youtube.com/watch?v=z-tUHuNPStw&feature=youtu.be

Tips for Medication Management

https://dailycaring.com/medication-management-for-seniors-10-safety-tips/

Sources:

CIHI Falls and Vehicle Collisions Top Causes of Injury Hospitalizations for Seniors

https://www.cihi.ca/en/falls-and-vehicle-collisions-top-causes-of-injury-hospitalizations-for-seniors

CIHI Study on Hospital Re-admission

https://secure.cihi.ca/free_products/Readmission_to_acutecare_en.pdf

U of A Study

https://www.folio.ca/study-finds-high-rates-of-hospital-readmission-out-of-home-care-for-older-adults/

Injuries Among Seniors

https://www.cihi.ca/en/injuries-among-seniors

All Patients Re-admitted to Hospital

https://yourhealthsystem.cihi.ca/hsp/inbrief.#!/indicators/006/all-patients-readmitted-to-hospital/;mapC1;mapLevel2;overview;/

News Stories:

CNN “The Older You Are, the Worse the Hospital is For You”

https://www.cnn.com/2016/08/15/health/elderly-hospital-patients/index.html

CBC “Frail Seniors at risk at Canadian Hospitals”

https://www.cbc.ca/radio/whitecoat/blog/frail-seniors-at-risk-at-canadian-hospitals-1.3086410

CBC “Harmful Medication Prescribing to Canadian Seniors Costs $419M a Year”

https://www.cbc.ca/news/health/drugs-seniors-inappropriate-prescribing-cost-1.3647231

CTV “Non-English Speaking Patients Need Equal Access to Interpreters Doctor Says”

https://bc.ctvnews.ca/non-english-speaking-patients-need-equal-access-to-interpreters-doctor-says-1.4668994