by Dr. Menachem Meller and Lisa Tavares, Director of Case Management
While eldercare has always been challenging, the coronavirus pandemic has made it even more difficult, especially for patients requiring follow-up care after hospitalization for an acute condition.
In the early days of the pandemic, rehabilitation facilities closed their doors due to rampant COVID-19 infections and deaths. Once the doors reopened, patients elected not to consider this treatment alternative.
But patients who are used to living independently are poorly prepared for a permanent dependent lifestyle change that follows a major injury. The same is true for family members who may have to care for the patient.
While it may seem intuitive as to how to provide healthcare for the elderly, in practice, the full extent of what is required is often not thought through. There is often one family member who seems more capable or willing to take on the task. But placing the entire responsibility on one family member is not realistic.
There are also financial considerations. While caring for a healthy elderly relative may incur much cost, caring for one who may require round-the-clock care can cost as much as half a million dollars a year.
Although, in hospitals, case management is happy to provide support for these decisions, there are crucial things to be considered before making the decision to bring your loved one home to ensure a safe transition in lieu of a short facility stay.
First is transportation. How will the patient travel and is there a comfortable vehicle to accommodate the patient’s physical abilities? Many families have some type of SUV, however, can someone who needs an assistive device be able to make the climb into that vehicle safely? Once the patient arrives at the residence where they will be staying, steps need to be considered, both steps to enter the home as well as being able to freely move to other levels of the home where bathroom, food, and sleeping quarters are located. It is important to evaluate the need for assistive devices and having ample room to navigate those devices such as a walker or a wheelchair.
Follow up care is also an important consideration. Plans should be made to have prescriptions ready to be picked up prior to discharge. The patient may not be able to walk into the pharmacy or wait in the car to have their prescriptions filled. The patient and/or family should also understand what medications should be taken and when. Making sure that patients make their follow up appointments is paramount to ensure that they are progressing back to health and if there is an issue post discharge, it is quickly identified. Transportation again needs to be considered for these trips out, particularly if physical therapy is involved, as that can be several visits in a week.
We should consider the pandemic as an opportunity for families to have discussions and commitments regarding possible outcomes and individual contributions. Having a long-term plan may diminish some of the stress of being forced to make these difficult decisions at the spur of the moment. This will not only benefit the elderly recipient, but also family members who are enriched by providing care and spending time with an esteemed, wise and special member of the family.
To schedule an appointment, call one of our convenient locations or visit us online.
Lower Bucks Hospital, Bristol
Town Center Drive, Langhorne
PHOTO CAP: Dr. Menachem M. Meller, M.D., Ph.D., FAAOS