By Esther Parnes and Michal Naor
Mr. Schwartz’s Cough
Mr. Schwartz celebrated his 85th birthday in the department of internal medicine. It was his second hospitalization in the last month. He started coughing at the beginning of the winter and medical tests showed nothing. After a week’s hospitalization Mr. Schwartz was sent home, though he continued to cough and reduce his varied activities.
Mr. Schwartz has been a pensioner for more than 10 years and his time is dedicated to his many hobbies: photography, crafts, hikes, driving and social gatherings. The CT scan done in the emergency room showed pulmonary embolism in both of his lungs. After another week of hospitalization, Mr. Schwartz went home with a selection of drugs: blood thinners and diuretics with the hope that now he would be able to return to his formerly active lifestyle. However the medicines didn’t help and his condition further deteriorated.
Although Mr. Schwartz was still able to walk on his own when he was admitted for his third hospitalization, after two days in the department of internal medicine he could no longer move his body or breathe independently and was transferred to intensive care. An ultrasound showed that there was serious damage to the right side of the heart, and the words “cardiac insufficiency” (aka heart failure) fell upon Mr. Schwartz, his wife, and his children, completely changing their lives.
Cardiac insufficiency and other typical ailments of the elderly often require repeated hospitalizations, changing the daily routine of the spouse and other family members and necessitating a reorganization of family resources.
Despite the supportive medical care in the hospital, there is a physical and psychological “price” for the hospitalization. Being removed from the home and a familiar environment, dealing with the loss of various physical capabilities, and worrying what the future might bring can sometimes be the cause of confusion, loss of spirits, and even depression.
Here are some tips for handling these issues:
- Notify the medical staff about any changes in the psychological state of the patient in order to get proper treatment in this regard.
- It is important that the family be at the patient’s hospital bedside. Remember that the hospital staff with all its good will is understaffed and unable to attend to all of the patients’ needs. Without someone nearby the patient can feel helpless and requests for assistance may go unanswered.
- Dividing the burden among the family members can help the patient greatly. There is also the possibility of hiring nursing care for various times of day or night when family is unable to be available.
- It is advisable to bring along reading material, magazines, or a laptop computer in order to make the hospital stay more pleasant (but one should also take precautions to prevent possible theft of valuables). It is also possible to rent a television for the patient from hospital services.
- It is important to make contact with the social worker at the beginning of the hospitalization and utilize his/her services. Every department in the hospital has a social worker whose job is to assist the patient while he/she is hospitalized, and also to make certain arrangements upon his/her release.
- Make use of physical therapists and their services, which are available in many hospital departments to help patients regain their physical functioning, including breathing rehabilitation.
Support for the patient’s spouse
The life of the patient’s spouse is fraught with many ups and downs. His/her absence from the home and the frequent visits to the hospital often cause a decline in both physical and emotional states. Worry about the patient can sometimes cause the spouse to neglect his/her own health. In this area, too, the family needs to be on alert to the condition of the spouse.
Release from the hospital to rehabilitative care
Following hospitalization, some patients need continued medical supervision and rehabilitation. The social worker of the hospital department will suggest an appropriate care facility for the patient about to be released and will contact this facility. Families that confer with relevant professionals, such as a gerontological consultant, receive more in depth information and assistance in proper decision making regarding the continued treatment of the patient. These care facilities are paid for by kupat cholim. The staff in these facilities include: doctors, nurses, social workers, occupational therapists, physiotherapists, and orderlies to help with patients’ needs.
Families whose loved one is to be released to rehabilitative care should note the following:
- The family should act as soon as the hospital suggests continued treatment to facilitate the transfer to a suitable care facility. Due to lack of space in rehabilitative facilities in Israel, there is a waiting list.
- It is important to note that the needs of the family (e.g. location of facility and accessibility) do not always match the criteria for the hospital staff recommending a facility.
- Visit the facility in order to choose the one that is most appropriate.
- Proper preparation on the part of the family of the patient and consulting with relevant professionals can ease the stress of the situation and may even be a deciding factor in the healing process.
Mr. Schwartz’s recovery
Mr. Schwartz’s situation continued to improve as a result of the dedicated and professional care that he received in the hospital, and at the continuing care facility to which he was released. Upon arrival at home, special preparations were needed, details of which will be discussed in the next article.
Esther Parnes and Michal Naor are gerontological consultants. They can be reached by calling 054-765-6685 or 050-838-9490, or via the אילת גיל הזהב Facebook page.
Our strict contributed content guidelines ensure useful, informative and non-solicitous submitted content. Opinions expressed in this article are the authors’ own.
For related information check out our “Counseling Service for the Elderly from Bituach Leumi” and “Home Care from the Kupat Cholim” pages.