Supporting Post-Discharge Recovery with Evidence-Based ADL’s

It’s well-known that hospital stays can have significant downsides for seniors.

The effects are often seen at home, when the just-discharged senior is left to fend for him/herself with limited supports, and expectations to (frequently) self-manage the recovery.  The process takes its toll – both physically, and cognitively, as the senior struggles with ‘getting healthy again’.

But they’ll experience challenges during this time that make recovery expectations often unrealistic, if not unfair.  While not comprehensive, those challenges can include:

  1. Making sense of the hospital-stay experience.  Despite well-meaning care teams, the admitting-to-discharge cycle can be overwhelmingly short – forcing the still-recovering senior to rely on others to ‘listen for them’, or simply rely on the accuracy of the post-discharge instructions, and hope that they are written down.
  2. Making sense of the medication cycle.  If new medications are introduced, this will necessitate a change in the senior’s activities of daily living to assure compliance.
  3. Getting back onto a regular sleep cycle.  Hospitals are notorious for interrupting sleep patterns – either directly via middle-of-the-night care, or indirectly via ambient noise or simply strangeness-of-environment.  A return to home will undoubtedly require a period of getting used to the home again.  Because seniors have fragile sleep patterns – this can be difficult to achieve.
  4. Meal preparation – 40% of seniors are estimated to be at risk of malnutrition – if meals aren’t easily available, nutrition can be a significant issue during the home-recovery period.
  5. Managing mental health – if depression is present, or the senior is socially isolated – or perceives him/herself to be – the recovery can be challenged further.
  6. Support from a caregiver – whether a live-in caregiver or an occasional support – the presence of a caregiver impacts the quality of the at-home recovery process.

From the physician perspective, a post-discharge visit (if successfully navigated by the senior) is often the normal course of benchmarking the recovery.  Family and contracted caregivers touch-base more frequently, but despite good intentions, the periodic ‘touch base’ is little more than a snapshot of how the senior is progressing at the moment – and not over time.

supporting recovery with evidence-based careCompassion helps family members and caregivers bridge the gap between discharge and full-recovery with evidence-based ADL’s that enable near-real-time care interventions.

 

 

Hiyaguha Cohen, Baseline of Health Foundation

  • https://jonbarron.org/article/hospital-stays-trigger-cognitive-decline
  • 1 “Hospitalization May Hasten Seniors’ Memory Decline.” 21 March 2012. Health Day/US News. 22 March 2012.< http://health.usnews.com/health-news/news/articles/2012/03/21/hospitalization-may-hasten-seniors-memory-decline>
  • 2 Jaslow, Ryan. “Study: Seniors may develop memory problems after hospital stay.” 22 March 2012. Health Pop/CBS News. 22 March 2012. <http://www.cbsnews.com/8301-504763_162-57402552-10391704/study-seniors-may-develop-memory-problems-after-hospital-stay/>
  • 3 “Temporary Memory Loss Strikes Hospitalized Seniors.” Zimmet & Quarles. 22 March 2012.  < http://www.zqlawyers.com/library/temporary-memory-loss-strikes-hospitalized-seniors-daytona-beach-nursing-home-injury-lawyer.cfm>

Everink et al, ‘Factors influencing home discharge after inpatient rehabilitation of older patients: a systematic review’, 2016