Disability After Hospitalization a Reality for Older Adults

Stricter Discharge Planning Rules and Acute Care for Elders May Hold Answers

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Even though a hospital is the best setting to be in when you are acutely ill, a stay in the hospital is a double-edged sword for older adults, particularly the very old or frail. There's a term for what happens to these people after a hospital stay; it's called hospitalization-associated disability.

Hospitalization-Associated Disability

According to the U.S. Department of Health & Human Services , hospitalization-associated disability is "the long-term loss of ability to perform daily living tasks associated with acute hospitalization." Those people who experience this condition have lost abilities basic to everyday living -- independent living -- such as walking, getting themselves to and from the toilet or the ability to dress or bathe themselves.

Hospitalization-associated disability occurs in approximately one-third of those over the age of 70 who are hospitalized, explained The Journal of the American Medical Association in October 2011.

Acute Care for Elders May Offer a Solution

Acute Care for Elders, ACE, is a model of care aimed at providing hospital care for those at-risk for hospitalization-associated disability in a manner that prevents such disability from occurring. San Francisco General Hospital has had an ACE unit for five years, the first hospital in California to implement the approach first developed by Case Western Reserve University in Cleveland, reported the San Francisco Chronicle .

The patient-centered approach involves various members of the health care team, including pharmacists, social workers, therapists and nutritionists who monitor the patient daily and develop a plan of care designed to prevent loss of function.

ACE units employ four basic approaches featuring patient-centered care, providing an environment that is user-friendly for older adults, discharge planning that begins early in hospital stay and review of daily medications and procedures.

Fines Instituted Against Hospitals with too Many Readmissions Due to Complications

As part of the Affordable Healthcare Act, Medicare will begin to levy fines against hospitals who have too many readmissions of patients within 30 days of discharge due to complications, reported NBCNews.com . Initially, these fines will only be instituted for three conditions: pneumonia, heart attacks and heart failure. In time, joint replacements, stroke, heart bypass and stenting will be included in the process.

Such readmissions would often be unnecessary, reasoned health authorities, if proper care was provided during the initial admission and adequate discharge planning was in place for the patient. The Medicare Payment Advisory Commission estimates that 12 percent of hospitalized Medicare recipients are readmitted due to preventable problems.

Bottom Line

Although much of the rationale behind the new fines to be instituted for too many hospital readmissions due to complications is the cost of such care, there is also concern about the continuity of quality care throughout the nation.

The ACE units help to promote independence and quality of life for older adults, which in the long term also lower costs for long-term care and the need for family members to become caregivers.

There is nothing wrong with saving money along the way as long as in doing so the affected people will obtain benefit. There's little doubt that with baby boomers just five years away from their 70s, the importance of saving money spurred these ideas and approaches; baby boomers and their seniors will also benefit from these changes.

Smack dab in the middle of the baby boomer generation, L.L. Woodard is a proud resident of "The Red Man" state. With what he hopes is an everyman's view of life's concerns both in his state and throughout the nation, Woodard presents facts and opinions based on common-sense solutions.

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