Professional Geriatric Care Manager Supervisor Eileen Zagelow, BA, CMC

How often I have heard from a family member that their mother is in the hospital and seems so confused! 

Patients who were functioning fairly well at home often seem unaware, forgetful or anxious when in the hospital. Sometimes there are reports of combative or agitated behavior; or concerns that a patient can no longer function in their current living situation.  Disorientation, unusual behaviors and the inability to follow directions are words that break families’ hearts and cause them enormous stress.

It is important to remember that even for slightly confused seniors being out of their regular environment and structure can be overly stimulating. When that is added to their current illness, treatment and a parade of strange people popping in and out of their room all day, confusion can rise dramatically.

Dementia has many faces. Alzheimer’s disease, vascular disease, medication related confusion and oxygen issues are just a few of these faces. When a person suffering from dementia finds themselves chemically altered, physically displaced and surrounded by unfamiliar faces it is “normal” for them to experience an exponential increase in confusion. 

When concerns arise about whether Mother or Dad can return home, it is very important to know that this is not a desirable time to make a placement decision.  Often times once seniors have been medically treated for their illness and return to the familiarity of their home they can recoup a level of function befitting their living environment, not necessarily back to their previous level, but possibly enough to manage. Indeed, the familiar environment itself can often help in stabilizing seniors.  This happened with my own father who had COPD.  The doctor said that although he would like to keep my father in the hospital a bit longer, he could see that his confusion and agitation were getting worse.  He thought Dad would improve more rapidly in his comfort zone – home.  And he did!

There are occasions when a temporary stay at a skilled nursing facility might be part of the “return to home” care plan and other times when bringing in live-in or hourly caregivers may be appropriate until the patient has an opportunity to stabilize. 

Fortunately, Geriatric Care Managers are highly skilled in navigating these waters. Their knowledge, empathy and organizational abilities can clarify options and assist families and patients in attaining the best solution for the senior.

Founder and Executive Director Linda Fodrini-Johnson, MA, MFT, CMC

When your parent is ready to be discharged from a hospital, short-term help could prevent him or her from being readmitted. About 1 in 5 Medicare patients is re-admitted within 30 days according to the New England Journal of Medicine. Often discharge instructions are not understood, medications are changed (but no one cleans out the medicine cabinet at home) and sometimes follow-up appointments with primary care doctors don’t get scheduled.

Be pro-active when parents are hospitalized, even with those who are fiercely independent. Most of us at any age are somewhat off balance after an illness in more ways than one . However, our aging family members have even more difficulty regaining strength due to the aging process. Try to convince your parent to agree to even a few hours a day of caregiving support after any hospitalization. Reminding the elder of new routines (part of the discharge plan), new medications and even new diets can be the difference between health and a re-admission.

Eldercare Services’ Geriatric Care Managers coordinate discharges in a personal client-centered way that can result in increased health and independence. Short-time help for long-term wellness.

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