Did you just get “the call?” Maybe your life was moving along at its usual hectic pace and then the phone rang letting you know your elderly parent is sick or fell or was rushed to the hospital.
Or maybe you are a seasoned caregiver. You’ve been on the receiving end of that call before and now your pulse quickens every time the phone rings. You’re dreading the next call. Either way, if you have aging parents, you need to know what to do when you get the call that your elderly parent is in the hospital.
To Go Or Not To Go:
For many of us, our instinct when we hear someone has been hospitalized is to rush to be with that person. And if your elderly parent lives nearby, it is usually good to act on that instinct. Hospitals can be overwhelming and scary and everyone, especially the elderly, can use support when they are in the ER or admitted as a patient.
But sometimes, it may make sense to wait and see. If you live in another city or state, you may want to wait to determine what the long-term prognosis is before you make plans to travel. If your parent is going to need care after their hospitalization, it may be better to go when they are sent home so you can help them post-hospitalization. It can be tough to stay away in an emergency, but know that professionals are caring for your parent and that you will go when you are most needed.
If you have commitments at work or your employer isn’t sympathetic to family matters, then you need to evaluate the tradeoffs before you rush to the hospital. It can be difficult not to be with your parent, but if their situation isn’t dire, choosing to stay at work and protect your income is a valid reason to wait a few hours before going to see them. At the same time, if you don’t think you will be able to concentrate at work and your job requires accuracy and concentration, it may be better to leave than to stay and risk making a critical mistake. Or maybe your parent is going right into surgery, in which case, they won’t know you are there anyway. Outside of work, you may have children waiting for you at a bus stop or other commitments that you need to honor. Only you can determine the best course of action (Note: There is no right answer) and no matter what you decide, don’t let other people’s judgment get to you. It’s natural for other people to project what they would do onto what they think you should do.
If you choose not to go to the hospital, call and let the medical team know that you are aware of the situation, available via phone, and interested in being involved. If you are the healthcare proxy or your parent has completed an advanced care directive, let the hospital know and ask if you can fax or email the forms to them.
What To Bring To the Hospital:
- Your parent’s health insurance cards
- A copy of the healthcare proxy (assuming your parent named one)
- Copy of any advanced directive form your parent completed instructing the hospital what levels of care and intervention they want
- A copy of the power of attorney (assuming you have that status)
- A list of your parent’s current medication. (If you don’t have this, you may be able to get it from your parent’s primary care provider or their pharmacy.)
What To Bring For Your Parent:
- Hearing aid
- Robe and (skid-free) slippers
- Religious statues, medals or prayer books
You Might Also Want to Bring:
- A sweater. Hospitals are cold!
- Your laptop and a hotspot. There is a lot of sitting around around that happens and you may want to get work done while you wait.
- A basic toiletry kit in case you spend the night. It should include a toothbrush, toothpaste, contact lens supplies, your own medications, and a mouth guard if you use one – caregiver stress can make you grind your teeth!
- Your smartphone so you can keep siblings, relatives and friends updated
- A water bottle
- A good book (Find 5 Good Books to Read at the Hospital)
Bonus Items To Keep In The Trunk Of Your Car:
- A client-ready outfit in the event you need to go directly to the office from the hospital.
- Workout clothes in the event you have the opportunity to get out for a walk or a run.
What To Do At The Hospital:
You have three main jobs at the hospital:
1) Advocate. You are not at the hospital to make friends; you are there to get your parent the best care for them. That means making no assumptions. Don’t assume the hospital will call your parent’s primary care physician. Don’t assume that if they place your elderly parent on an antibiotic they will ask about a history of C diff, a debilitating bacterium that can cause diarrhea or colon inflammation and that can be triggered by the use of antibiotics. I always ask about probiotics when my father is prescribed antibiotics. Don’t assume the social worker will choose a skilled nursing facility post-hospitalization based on what’s right for your parent and you. Ask about their decision-making criteria. Ask what your options are. I am not implying hospital staff are lazy or careless; that is not my experience. I am implying you know your parent best and it’s your job to bridge the gap between what you know about them as a person and what the hospital team knows about care.
Don’t assume treatment is always the best option. You may know through conversations and by completing advanced directives that your parent doesn’t want treatment. Or maybe they do want treatment but palliative care makes more sense than surgery. When my 84 year-old mother was diagnosed with ovarian cancer, a surgeon at the hospital seemed incredulous that my mother didn’t want her to operate. But an oncologist later told me surgery would have been a bad call for someone with her condition and at her age. Don’t be afraid to ask questions.
Hospital stays can be incredibly disorienting for the elderly. If your parent is acting more confused than normal, be sure to tell the medical team your experience of him or her. Don’t assume they are factoring in the impact of the hospital experience on your parent’s personality. When my father was transferred from an ER where he was given a powerful anti-psych drug (too powerful in fact for an octogenarian with his diagnosis) it made him incoherent and belligerent. The new medical team assumed that was his baseline personality pre-hospitalization. I told every single nurse and doctor who entered his room that was not the case. When one of the doctors said, “I know, you told me already,” I responded, “Yes, but I don’t know if you really heard me.”
Speaking of belligerence, if your parent has a difficult personality, your job is to humanize them. During that same hospitalization my father attempted to escape and knocked over a nurse in the process. I could tell the staff was frustrated and impatient with him, understandably. I stayed with my father overnight after that so the staff could see he was more than the mean, old man they experienced. He was someone who was loved by his family.
2) Listen. Be the extra set of ears for your parent. Take notes when you talk to the doctors, nurses, and social workers. Ask questions when you don’t understand something. Repeat what you heard so you can be sure you heard information and instructions accurately. Sometimes that means asking a doctor to wait and listen to you. That’s okay.
Also, understand if your parent is indeed an inpatient that has been admitted to the hospital. Sometimes hospitals keep patients for observation but don’t actually admit them. This makes a difference in what benefits Medicare will pay for post-hospitalization.
3) Support. And of course, you are there to support and comfort your sick or injured parent. You can best support them by advocating and listening.
How to handle your job:
If “the call” comes in and you need to get to your parent immediately or risk never seeing them again, go! Unless you’re flying an airplane full of passengers or operating on a patient, just go! Call your manager when you get to the hospital* and tell them you had to leave. Some day, when you are on your deathbed, where will you have wanted to be?
If you need or choose to leave but you have some time, let your manager know you have a family emergency, tell her what work and deadlines you have, recommend a way to pass that work to someone else, and offer to pull together the necessary information to transition the work, like contact information, phone numbers, drafts of documents. Tell your manager when they can expect you to check in again, and then, go!
If you choose to stay at work, do everyone a favor and underestimate your ability to focus. Go ahead and work guilt free, we all handle crises differently and some of us need a good distraction in the form or our jobs, but you are be foolish to think you can operate at your normal level of productivity. Have someone check your work. Avoid difficult conversations. Put off major projects if you can. And under no circumstances should you unload your personal woes on your customers.
How to Handle Your Spouse And Children:
If you were planning to pick up a child at the schoolyard or bus stop, make alternative plans before you head to the hospital.* Ask a neighbor or family member to step in and then let the school know someone else will be meeting your child. Schools will not release children to anyone except the pre-approved adults they have on file. Even if the person picking up your child is on the approved list, let the school know. They can tell your child so he or she isn’t surprised or scared when they see someone who isn’t you.
When you get to the hospital and assess the situation, call your spouse and let them know what has happened and what if anything you need from them. A word about spouses: we often take our stress out on the person closest to us. Partner with your partner to figure out how all of your combined priorities can best be handled.
What To Do About Pets:
If you have pets, make sure a family member, friend or neighbor can feed or walk your pet if necessary. If you have no one nearby to call, try the vet. The office may be able to recommend a shelter or pet care service.
Taking Care Of The Rest Of Your Life:
When your elderly parent is hospitalized, their situation often becomes your whole focus. Make sure your major responsibilities, like family and work, are covered and don’t sweat the rest. However, if you have the capacity to think about anything else, here’s a checklist of things that might need your attention:
- Appointments that might need rescheduling (friends, doctor, beauty, etc.)
- Volunteering shifts/commitments you need to change
- Plants that need watering
- Food that might spoil
- Deliveries you are expecting
Finally, remember you cannot take care of anyone if you are not well yourself. Hospitals are notorious for bad food and lots of germs. So drink lots of water, get some sleep, wash your hands frequently and pick the healthy choices in the hospital cafeteria – occasionally.
*Don’t use your phone while driving. You will be tempted to make calls on the move in order to save time. But you will be distracted thinking about your parent. Stay off the phone while you are on the road.