Have you gotten that call in the middle of the night telling you
that your mother who is 2,000 miles away has fallen and is in the
hospital? Has your father come for a visit and had a slight stroke?
These circumstances can interrupt your everyday life and send you
into a state of panic and fear. THE MOST IMPORTANT THING TO DO WHEN
YOUR PARENT IS HOSPITALIZED IS TO PUT YOUR PANIC AND WORRY ASIDE AND
SHIFT INTO WARRIOR MODE. Here's what you need to do.1. Don't
panic. It is natural to be fearful and overwhelmed when your mother
or dad is rushed to the hospital. Accept your feelings as natural,
but put them aside right away. YOU ARE YOUR PARENT'S BEST ADVOCATE.
If you live far away, immediately call a friend who can go to the
hospital and be your liaison on the ground until you get there. You
will quickly get frustrated and angry trying to get information
about what's happening with Mom or Dad unless you have someone on
the scene looking out for YOU and letting you know what's going on.
If you can't get to the hospital, there are also elder care
advocates like myself who can be your eyes and ears and fight
through the system so your parent gets the best care.
2. Contact your mother or dad's physician immediately. As a side
note here, it is very important that your parent have a general
internist physician (preferably a gerontologist if you can find one)
WHO IS WILLING TO FOLLOW YOUR PARENT TO THE HOSPITAL IF NECESSARY.
This is obviously something to arrange now, before any unforeseen
hospitalization occurs.
Many hospitals now promote to patients a new system of
"hospitalists" -- these are physicians who only work at the hospital
and don't have a private practice. The problem with this is that
your parent will be a new patient to the hospitalist and you might
not have the same hospitalist every day. WHAT YOU WANT IS YOUR
PARENT'S PHYSICIAN WHO KNOWS YOUR PARENT'S HISTORY TO VISIT THE
HOSPITAL EVERY DAY AND DIRECT YOUR PARENT'S CARE! This is very
important for the continuity of care for your mom or dad and for
your comfort. A hospitalist might not pick up on something about
your parent that his or her own physician would because of their
history together.
3. Don't be intimidated by the hospital system. The reality is
that hospitals have their own protocols and systems which may work
for them, but may not necessarily work for you! You land in a place
that's all new to you -- and they've got the advantage. Do not be
afraid to ask questions of the nurses, other staff or the
physicians. Hospitals tell us that their mission is to take the best
care of their patients, but the reality is the only person who will
be looking out for the best interests of your parent is YOU or YOUR
ADVOCATE.
When my mother was in the hospital, I walked up to the nurses'
station behind which about 10 people were chatting away, and the one
who was sitting at the desk right in front of me refused to look up.
I finally called out, Hello, anybody home? And they all turned in
disbelief, but I got what I needed.
4. If possible, keep your parent in the hospital for THREE
OVERNIGHTS. True, you do not have complete control over this, that's
why the presence of your parent's own physician can be so important,
but if your parent will have to go to a rehab facility or go home
for therapy, and he or she is on Medicare, Medicare will only pay
for follow-up treatment if your parent has spent three full
overnights in the hospital. Not days, but overnights.
Don't let them try to push Mom or Dad out too early. If it's
legitimate for them to stay in the hospital, make sure they stay. I
had a friend who unfortunately did not know the three-day rule at
the time, and her mother wanted to leave the hospital early. She
needed therapy at home as the doctor prescribed but had to pay for
it herself because she did not meet the three-overnight rule.
5. Manage the hospital's discharge planner. Within a day or two
of your parent's admission, you will meet the discharge planner,
whose job it is to arrange for where Mom or Dad goes and what help
they need after the hospital. THIS IS VERY KEY -- if your parent is
going to have to go to a rehab facility, a skilled nursing facility,
and the three-day rule is met, Medicare will pay for the best or
worst facility. IT IS YOUR JOB AS ADVOCATE TO FIND OUT THE BEST
FACILITY AND GET MOM OR DAD IN THERE! This will make a world of
difference in their aftercare.
The discharge planner will give you a list of facilities in the
area. They are not ethically allowed to tell you what the best ones
are. Typically, they will ask you to pick three, and then whichever
of those three facilities has a bed on the day Mom or Dad is
discharged from the hospital, that's where they'll go.
BUT HERE'S THE CATCH -- THERE MAY ONLY BE ONE GREAT FACILITY IN
THE AREA. SO HOW TO GET THERE? First, you have to find it. Ask
friends, families, colleagues. If you've hired an advocate, they'll
be able to guide you. If you're on the ground, go visit the
facilities. Ask for a tour of the skilled nursing facility. Talk to
the admissions officer at the facilities you like. If one stands out
above the rest, keep talking
to the Admissions officer at that
facility (you won't know exactly what day your parent will be
discharged) and tell the hospital's discharge planner that you want
your parent to go there.
This is so important and the trickiest part. When you find out
(usually the day before) when Mom or Dad is to be discharged, call
the facility (or facilities if you're blessed to have several you
like) and ask if they will have a bed open the next day. Some
hospital discharge planners are wonderful, others are annoying and
territorial. They may see you as interfering with "their" job. But
put any concerns about that aside, and recognize that they are
treading on YOUR territory, where Mom or Dad goes will make no
difference to them, it will make all the difference to you. If
there's a bed open where you want to go, tell the discharge planner
that day -- tell them you've talked to the admissions representative
at the facility, there's a bed available, and you want Mom or Dad to
go there. DO NOT GIVE IN AT ANY POINT AT THIS STAGE. YOU'VE DONE THE
HARD WORK, IT'S TIME FOR MOM OR DAD (AND YOU) TO REAP THE BENEFITS
OF YOUR INVESTIGATIONS AND ADVOCACY!
Remember, regardless of your past history, fighting for your
parent at this time in his or her life when they may need you most,
can become the most rewarding time of togetherness for both of you
and lead to great healing, if needed, and joy. It won't be easy, but
it will be worth it. Hopefully, with these tips in mind, you can
focus on loving your parent to the best of your ability and not on
the frustrations that come from navigating unknown waters.
