I recently visited a friend who is in his 80s and was hospitalized after a fall. He did not know where he was, was convinced lawyers had come to visit him in the night (a truly horrifying thought), and was extremely agitated. While it still is not clear what happened, he may have been experiencing delirium, which happens to as [...]
I’ve recently spent more time as a hospital visitor than at any time since the pandemic began. A lot has changed since Covid-19, but my experiences confirm some good advice for older patients, their families, and the medical staff that cares for them. Here are a few ideas for patients and staff. While they focus on hospitals, many apply to [...]
Two of the greatest sources of frustration for Medicare recipients and their families are observation status and the government’s incredibly complex appeals process. On Monday, a federal judge in Hartford CT, certified a class action lawsuit aimed at addressing both. The judge’s eventual decision in the case (Alexander v. Price) could have far-reaching effects on both the burgeoning use of [...]
One-third of nursing homes residents are admitted to the hospital at least once each year, and half of those admissions could be avoided. Preventing them could protect hundreds of thousands of older adults from potential harm and save Medicare billions of dollars. The problem is neither new nor surprising. But it is tough to fix. Last week, the federal Centers [...]
Of all the complex rules that plague fee-for-service Medicare, few are harder to understand and potentially more important for seniors than observation status. By now, many older adults have heard the phrase. But they are still not clear what it means. A new study by AARP sheds some light on the consequences for seniors of hospital observation stays. But they [...]
When we think about the health of frail older adults, severe, high-profile illnesses such as dementia, heart disease, cancer, and debilitating arthritis come to mind. But for many seniors, small things can turn a manageable chronic condition into an acute medical crisis. One is malnutrition. Spend a little time in a hospital emergency department and you’ll be shocked at how [...]
Medicare has a huge and growing problem caring for patients after they have been discharged from the hospital. After years of talk, Congress may be about to take a modest but important first step toward cleaning up the mess, and making sure that patients get care that gives them the best chance to live a healthy and active life after a [...]
You are caring for a parent or spouse who is in the hospital. At 9:00 AM, your loved is told she’s being discharged by Noon. You had no idea this was coming. Worse, she’s going to have complex care needs—maybe wound care after surgery, or lots of medications to take on a complicated schedule. You have no idea what to [...]
Almost one of every five patients in the intensive care units of a major teaching hospital got treatment that was futile or “probably” futile, according to the doctors who treated them. And older patients—especially those admitted from a nursing facility—were most likely to get care that does nothing to improve their quality of life, or even keep them alive for [...]
Seniors continue to be readmitted to the hospital too frequently. But when it comes to explaining why, patients and providers are on Mars and Venus. The patients blame doctors and nurses. Doctors and nurses blame patients. And everybody blames the hospitals. The problem, everyone seems to agree, is that hospital discharges are a mess. Patients don’t understand what they need [...]