About The Islander. (St. Simons Island, Ga.) 1972-current | View Entire Issue (April 13, 2009)
THE ISLANDER, APRIL 13, 2009, PAGE 7 (News to Q-CeCv The Best is Yet to Be By Clark Gillespie M.D., Professor Emeritus, the University of Arkansas Hospital Bound Readers must have seen - very recently - a national report which revealed that a significant and grow ing segment of our population return to hospital within a month of our dis charge home. This return is apparently due to a failure of our home care in managing the condition for which we were originally hospitalized. It is clear from these reported fig ures that we seniors represent a great number of such returnees. The report did not make clear whether our big bite in this federal-figuring was because there were relatively more of us put into hospitals, or whether we were just the major homeward-bound screw-ups. Our generation believes the former explanation while generation X and Y believe the latter - assuming that they believe anything. Whatever, early hospital re-admis- sion is a growing problem in our society and the Johns Hopkins Health Letter has recently offered some explanations for this remarkable phenomenon, and some advice about re-admission dodg ing. The Hopkins report starts out by reminding us that while we are in patients we are really not responsible for our medical care nor for some major aspects of our personal care. Very abruptly following hospital discharge we - or our personal advocate - become totally responsible for both our medical and our personal care. Although our hospital admission event has been more completely docu mented and recorded than is a federal appointee’s vetting, we often leave hos pital without any organized instruc tions and advice to keep us on our proper medical course. Such instruc tions that are provided may come in part from our nursing attendants, from our physicians, and from consulting nutritionists, physical therapists and others, but they are often very sepa rated and disjointed and some may be written, some oral. Moreover medications can be hand ed out to us, or be given to us in prescription form when departure is being implemented. So, many of us arrive home, our brains battered by some illness or surgery, or by being confined to a “Darth Vadar” designed bed, and finally, by being obliged to remember more disjointed instructions and medications than does a departing astronaut. In order to manage this separation event so that we can continue to live successfully whilst away from our hos pitals, here follows some advice worth considering and remembering - but first, don’t let them put you out too soon! • We should ask for written instruc tions from all our providers. Although that clearly puts the compliance bur den more directly upon us, it at least gives us something to comply with or fail against. • If medications are provided to take home, we need to be sure that the tak ing instructions are clear and that they include the dosing duration and the potential side effect that any of them may produce. Written prescriptions must be given for any continuous pill taking. There is no way of determining in advance if the written instructions, interpreted by a pharmacist will be clear to us so a physician call may be needed. We further must know if any new medication will interfere with some we may already have been tak ing. And - should we continue to take any prior medication? • We must try to establish a reliable communication line with any of the special services that worked with us during our stay - just in case we should have an urgent need for assistance at home that we cannot get answered elsewhere. • Ask to be provided with some understanding of how we should feel while we are recovering, what we can do, what are our limitations insofar as diet, bed rest, physical activity, exer cise, habits, sex and other sporting activity , and further, what are the abnormal convalescent signs of which we must be aware. Certain hazards and complications may occur after any illness or any surgery, and we must be aware of those that might involve us. Many times it is advantageous to appoint a personal advocate to assist with this homeward transition. Such an advocate could be a family or friend resource or, if necessary, a paid health care worker. Such a representative should have designated responsibili ties and be allowed access to medical, instructional, even some financial areas involving their patient, and should be fully advised and be well aware of that persons condition, limitations and needs. This personal advocate is, of course, that patients firm link with the hospital experience and it appears to work very well. With all these present and growing concerns about hospital departures, it might be wise to for our medical lead ers to establish a series of printed hos pital discharge instructions that can Turn to Page 10 - Dr. Gillespie GET BACK 2 HEALTH ADVANCE REHABILITATION physical mm Advance Rehabilitation is diligent and steadfast in the pursuit of the highest quality care, and continues to rank in the 99th percentile for patient satisfaction through Press Ganey. • Physical Therapy •Athletic Training • Sports Medicine • Industrial Medicine St. Simons 124 Island Professional Park ~ 912.638.1444 Brunswick ~ 4204 Coral Park Dr. ~ 912.280.9205
