Care transitions — those times when someone enters a hospital, transfers from one department to another, gets discharged to a rehabilitation center or goes home — are risky times.
Moving between hospitals or into rehabilitation and other care centers can be a stressful time, especially for an elderly loved one. Unfortunately, too, these “care transitions” can create far greater problems than stress, as they also are prone to creating problems with the patient’s care. Potentially, these problems can have long-term affects.
Care transitions are not a recent concern of health professionals, but have been on their radar screen for some time. In fact, a recent study is the subject of a recent post on the New York Times’s blog series, “The New Old Age.”
According to the study, a very large Canadian study of older adults recently published in the Journal of the American Medical Association found that the main problem is with essential medications. It seems these meds can be accidentally stopped by healthcare professionals when the patient is in transition. And, older persons can be on many medications at once, often with little understanding of each drug and with complete faith in the multiple doctors prescribing them.
For example, what happens if an elderly loved one (who may be on as many as 10 medications) has an “episode” requiring a trip to the emergency room? The emergency room staff may have to take them off some of those medications to administer needed care. Unfortunately, thereafter the doctors may forget to have those medications started up again once they are stabilized, moved to regular care or even transferred out to a rehabilitation center. In turn, your loved one might not notice any changes without the meds, or simply might assume the doctors know what’s best. Ultimately, this lack of communication and coordination in transition care can be life threatening.
It’s something that happens all too often, particularly with medications for cardiac and blood conditions, such as statins (e.g., Lipitor) and blood thinners (e.g., Plavix).
All of this gives family caregivers one more thing to bear in mind when tending to an elderly loved one, but it can also be an important one. It’s important to ask questions and be aware of all medications an elderly loved one is taking, and if these meds change (or stop) after a hospital visit… find out why.
Reference: The New York Times Blogs (September 8, 2011) “A Big Risk in the Health Care Handoff”