50+ Lifestyles

Your Advocacy

By Julie Arndt
GolderCare Solutions

What to Expect When You Go to the Hospital

It’s been many years since I worked in the acute care setting. When my father-in-law was taken by ambulance last fall to a Des Moines medical center (the same hospital where I worked for many years), I had a suspicion that there was a good chance this would be his final trip to the hospital. It was a grueling six days. In retrospect, it really brought home to me on a personal level so many things that have changed in healthcare as a result of the Affordable Care Act, as well as some of the same things that have existed for decades!

First the care was top notch. I was inspired by the respect that all staff not only gave to my father-in-law and our family, but also to each other. It was impressive to see the nurse who was running wild with multiple critically ill patients, incorporate the words “can you bring me “x” and “thank you” when communicating with her team members. It is not something that you see often and I was impressed.

Some things to be prepared for:

1. Admission. Do you have a Health Care Power of Attorney and Living Will (bring one with you and ask them to make a copy). If you have an IPOST in place, make sure you bring it with you to the hospital so it can be copied into your record AND that you also take it home with you upon discharge.

2. Being asked you name and birth date over and over…every time medication is being administered. You will also see that pesky risk band will be checked over and over.

3. Just because you are physically in the hospital, does not necessarily mean that you have been formally admitted (billed under your part A Medicare) vs. observation (billed under your Part B Medicare). Know what your status is. In our case, Grandpa was clearly admitted and both the nurse and hospitalist confirmed that when I asked. If in doubt, check with medical records or whichever department in the hospital does coding. This is important in the event you need post-acute skilled nursing after your hospital stay. It can make a difference whether your Medicare will pay for post hospital skilled nursing home care.

4. Have someone with you. It’s good to have a family member or friend there to help provide history, ask relevant questions and provide bedside attention. There is nothing worse than being very sick, slightly disoriented and struggling to ask for help.

5. Ask questions. You get to participate in your health care. Ask what medication is being administered and why. Can you have water?

6. Having a test? ASK WHY? Also, follow up and ask for results.

7. Be thinking discharge when you arrive. Be prepared shortly after arrival to answer questions related to your living situation, number of stairs at home, former level of functioning, former ability to bathe and dress self, had you been able to drive before admission, was there any home care in place or if you have a preference for a particular home care service at discharge (perhaps you have used before). It is critical that previous functioning is clarified at admission AND that you remind new clinical staff/hospitalist during your stay. I am fond of posting this critical information in the room – along with any other tips, such as “Dad is hard of hearing in Right Ear”

8. Discharge. It creeps up and you may not even be given a day’s notice. Be sure you review all your choices and discuss with your family/trusted advisor before impulsively making a decision and signing your discharge instruction packet. Know what you are signing and ASK QUESTIONS.

Our medical system(s) are changing rapidly in the U.S. When entering the “system” at any point (primary care physician, specialist, out-patient services, or hospital) be aware of your insurance and how it works with the provider, proactively asking for your options/choices and for an explanation of why and how. Own your health care experience by being proactive.

Join us at one of our Monthly Empowerment Series held the first Wednesday each month 10-11:30 a.m. at our Bettendorf Office location – 1900 State Street, Bettendorf, Iowa. The May 9th discussion will be addressing End of Life – What Advanced Directives Really Mean and June 13th we will explore What to Expect When You Go to the Hospital.

Julie Arndt is a licensed social worker working in the field of geriatrics for over thirty years with expertise in medical case management and community based services. You can reach Julie at GolderCare Solutions Unlimited, LLC 309-764-2273.