May 5, 2005

Aging Connection

Hospital to home transition

By Vivian I. Silva,
Gerontologist/MSW
Special to the Times

Family and friends often step in when difficult situations occur during hospitalization to home transitions; however, I’ve worked with many elders with no one to serve as an advocate.

I received an invitation two weeks ago from the American Society on Aging to participate in a focus group regarding the hospital to home transition. With little time to prepare, I agreed to participate and I would like to ask any reader willing to share their “hospital to home transition” story with me to contact me. If you would like to participate, May 16 is the deadline for calls (975-2988) or e-mails (vivsilva@aol.com).

I recall a situation where an older woman weighing less than 100 pounds called frantic that she wouldn’t be able to give her husband the proper care needed when he came home from the hospital. She received a phone call that evening that the hospital was sending him home in a taxi. He weighed over 200 pounds and she didn’t know what to do. She didn’t know where to get a home health aide so she called the senior center. For this couple, I will attend the focus group.

Costs keep rising, but the hospital stays seem to get shorter. A daughter relieved to see her elder mother finally hospitalized for testing, called me very upset. After an overnight stay due to chest pains, the mother was released but then couldn’t stand on her feet due to excruciating pain. The daughter took her to emergency, but the hospital didn’t want to admit her. Granted we don’t always know the medical why’s and why not’s but for this family, I will speak up at the focus group.

Families complain they try to understand all that the doctor tells them before they have had a chance to digest the information, the discharge planner comes into the room to talk about the release. Once at home, the family member looks over the paperwork and referrals but often doesn’t have a clear care plan. For these families, I will share their complaints at the focus group.

An 80-year-old widower lived alone. During his hospitalization he became very anxious about going home because he didn’t have grab bars set up in his bathroom and he worried about climbing stairs. Overwhelmed with the details of getting his home ready for his discharge, he wasn’t sure he’d be safe. At risk for depression, for this man I will discuss mental health screenings at the focus group.

My first job after graduate school was in a hospital setting. I remember being told patients may experience depression up to a year after a hospitalization. Patients face life and death issues even if going in for a simple procedure. Just being in the hospital triggers thoughts of mortality. But are the families and patients educated about possible depression and emotions? Male elders told me the only time they’d been to the hospital was when their parents died. Perhaps grief surfaced for them during this transition. For these men, I will share my experiences with the focus group.

Now is a good time to share your stories whether similar to the above situations or unique. May is Older Americans Month. This year’s theme is “Celebrate Long-Term Living!” The U. S. Administration on Aging chose the theme to celebrate and acknowledge that Americans are living longer and healthier than in any other time in our history; and, most older Americans live independently in their homes. Join me in advocating for a smooth transition from hospital to home.

Vivian I. Silva, Gerontologist/ MSW is the director of Geriatric Advisory Program at Almaden Valley Counseling Service. The service educates and advises adult children and elders on aging issues and provides individual and family consultation. For more information call (408) 975-2988 or e-mail vivsilva@aol.com.