Aging Parents: "In Patient" vs "Under Observation" --- How Being in a Hospital Bed can Fool You

 

Does being in a hospital bed
qualify Medicare-eligible seniors as In-Patient?

   
For some time now, we've been hearing about Medicare-eligible seniors who've been given "Under Observation" status when admitted to hospitals--for what any intelligent person would assume should be "In-Patient" status. "Under Observation" status is not "In-Patient."

If parents need to enter a skilled nursing facility or a nursing home after the required three days of hospitalization, Medicare will not pay and the family will be required to pay all of the bills, including the hospital costs, if hospital status was "Under Observation."

We might also assume that those in a bed in a hospital are automatically considered "In-Patients." Not true.

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Medical Emergencies, Emergency Rooms, Hospitals: Getting Optimal Care

CBS News presented a segment about the “Best Hospitals” issue. It’s the video’s specific information, imparted by Dr. Jon Pook in the interview, that I found most instructive. Dr. Pook is a doctor at at NY-Presbyterian/Columbia U. Medical Center and chief medical correspondent for CBS news.

He discusses measures to insure getting optimal hospital care. For example, he stresses the importance of communication needing to be “a good hand-off” between the patient’s regular doctor and the hospital’s doctor or the hospitalist, comparing it to the passing of the baton in a relay. He calls attention to basic, but critical, things........

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Help Aging Parents: Avoiding the Accidental "Bad Things"

"EACH YEAR, half-a-million injuries occur in the United States because of medication errors," according to a 2009 U Magazine (UCLA health) article.

We live in an imperfect world. The older we get the more we're aware. With a better understanding of "best practices" are we better equipped to help hospitalized aging parents avoid accidental bad things because we know what to look for and thus, know what questions to ask? How can we know and ask pertinent questions if we're clueless about it in the first place?

The following excerpted information from U Magazine's 2009 article, "Do No Harm," illuminates measures the UCLA hospital system began implementing to reduce the potential for accidental "bad things" (my words for the overarching concept). Having this knowledge helps us know what to look for. Hopefully our hospitals have implemented some of these measures so we and our aging parents can take advantage--now 4 years later.








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Aging Parents, Best Hospitals, 16 Specialties: 5 Reasons to Use Them

 Mt. Sinai Hospital Ranked #1 in Geriatrics--2010-2011

Mt. Sinai Hospital's Geriatrics Department, started by Dr. Robert Butler in 1982, (last Tuesday's post) was ranked #1 this week in the latest US News & World Report's "Best Hospitals" issue (August 2010). An additional 49 hospitals' geriatric departments complete the list. 

Fifteen other specialty departments are also ranked. And Johns Hopkins Hospital ranks #1 as the top hospital in the country--having 15 of the 16 specialties ranking at or near the top. US News & World Report compiles this list every year (and has done so for over 20 years) "to guide patients who need an unusually high level of hospital care" (which includes high-risk patients).  Isn't this of enormous benefit to help aging parents?

Life takes on a more delicate balance as people age.  Making well-informed decisions ups the odds in our efforts to help parents age well. 

5 reasons to consider the best hospitals' specialties to help aging parents

1. Approximately the same time is involved, be it for procedures done in excellent hospitals or less than excellent hospitals; with excellent doctors or less excellent doctors. Only the outcomes may be different.   
2. Quality of life is at risk; the more experienced the hospital and medical professionals are (the more times they've done your parents' needed procedure) the better the odds to have encountered  and handled well unexpected problems.
3. Older people don't bounce back so quickly. Patients lose independence in hospitals. It's important they gain the confidence to feel some control. Ideally professionals working in the best hospitals' specialties departments should have done "it" (what ever your parents' medical situation is), worked with "it," handled "it"--over and over and over. Thus, they instill confidence in you and your parents based on countless experiences with the expected and unexpected.
4. It takes hard work to recover well from certain procedures.  The skill of the professionals following a procedure is a significant factor; it helps aging parents in their recovery and in regaining a positive outlook. And it's so important for these senior citizens to push themselves to move forward so they can get back to normal--so the hospital experience doesn't take them down a notch.
5. And yet--there are emergencies when we do what we must in a hurry. And there are times when we know the decisions we make are crucial and we may get only one chance to do it right. But even then, the professionals in the best hospitals can come to the rescue.  
   

Have you had this experience? 

Two true stories will bring the "best hospitals" theme to life in this coming Tuesday's post. One an emergency (stroke); the other a well-thought out (after arguments and pressure) plan to treat advanced colon cancer. While not planned at the outset of the each health crisis, the best hospitals figured prominently in both. In the meantime, US News & World Report is at your newsstand now.


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