In a time when hospital readmissions rates are being closely analyzed and hospitals are attempting reforms to improve those rates, it is crucial to take a look at patient populations most frequently readmitted to hospitals and the reasons for readmission. Among those populations of people most frequently readmitted to hospitals, seniors are in great number. Poor discharge policies can be to blame.
When questioned about reasons for high readmission rates for seniors, many doctors cited the high motivation of elderly patients to leave the hospital as a cause for their lack of adequate care. Additionally, it was conjectured that older patients say they understand instructions for care when they do not, or are dishonest about the presence of a caretaker, all with the motivation of being released from the hospital. As a result, these patients do not recover as planned and must be readmitted to the hospital. Additionally, it was stated that many of these patients may choose to go to the emergency room over seeking care from a primary care physician.
However, other factors may be to blame. Various groups of the population require specialized understanding of potential social or personal issues that may prevent them from being able to follow through on care plans after hospitalization. In this situation, it is the responsibility of the healthcare practitioners to assess patients' circumstances and needs and create plans accordingly for these patients. By changing the approach to these patients so as to focus on understanding their needs from a social and personal perspective, the overall care of senior patients can be greatly improved.
One issue that was cited by seniors as a reason for not following through on care plans provided to them is the inability to understand instructions from doctors. Rather than using layperson language, instructions are often written in doctor's jargon and patients are unable to determine what they are supposed to be doing to follow up after hospitalization. By more clearly explaining, both orally and in written form, what the patient should do upon release from the hospital, doctors could greatly reduce the chance of readmission. Using the Teach-Back method is one highly effective way of achieving this goal.
Another issue that is cause for later readmission is the lack of support that many elderly patients have at home. Without a caretaker, many patients feel lost once home from the hospital. Educating these patients prior to discharge on the resources available in the community that may be able to help them would effectively reduce this problem. Additionally, providing a follow up coach that assists seniors in setting up appointments, ensures medication is understood and being taken properly, and who can also help with locating necessary community resources has been proven to improve overall patient care as well as decrease patient readmission.
For many seniors, the pure shock of their diagnosis can prevent them from being able to completely absorb the information given to them during their hospitalization. Again, giving extra care to ensure a patient understands instructions and providing follow up can dramatically improve patients' understanding of how to care for themselves and seek follow up treatment.
Giving more attention to senior patients and to understanding the obstacles they may face in self-care and seeking post-hospitalization treatment has the capacity to greatly reduce the incidences of later readmission.