When an accident, fall or other event causes the need for an elderly loved one to be admitted to the hospital, it can be a stressful, worrisome time for the family. In addition to concerns about their recovery from primary injuries or illnesses, research has shown there are also concerns over deteriorating mental health and cognitive ability brought on by the hospital stay itself. Though the cause is unclear and there are many potential factors, recent studies have concluded that hospitalization causes a much higher risk of developing or increasing cognitive problems in elderly patients.

One specific study published in 2012 examined the data of more than 1300 individuals age 65 and older of various backgrounds and ethnicities. Each of these individuals had experienced a hospital stay and had been interviewed at least once before the stay, and at least twice afterwards at 3-year intervals.

Researchers discovered that the rate of cognitive decline more than doubled for these patients after their stay in a hospital. Thinking and memory were found to have declined dramatically across the board.

The lead researcher on the project, Dr. Robert Wilson, said “it’s as if people became 10-years older, from a cognitive standpoint, than they actually were before hospitalization.”

The individuals at the highest risk for rapid cognitive decline were those who started experiencing worsening memory or thinking problems before their hospital stay. The length of their stay in the hospital also made an impact as those with more serious health issues who were admitted for longer stays were also more likely to exhibit cognitive decline.

While not every elderly patient leaves the hospital with previously unidentified cognitive problems, for many, a hospital stay serves to “unmask and accelerate” these issues.

Previous research had already revealed that hospital stays interfere with physical functioning for the elderly. Daily activities like bathing, toileting and dressing have all been impaired for many older patients after leaving the hospital.

One potential cause of both physical and mental changes brought about by a hospital stay is delirium, which is estimated to occur in one in five hospital patients. Rather than a transient, temporary condition, delirium is now regarded more as a brain injury, which can produce fast manifestation of symptoms like confusion, disorientation, agitation and unresponsiveness, and can forever alter mental health and have residual effects well after a supposed recovery.

Another potential mechanism is the medication given to acutely ill patients in intensive care. The long-lasting effects of these medications, specifically on mental health, is severely lacking in research.

Finally, the environment of the hospital itself may be to blame. Because cognitive ability in seniors greatly relies on physical exercise and mental stimulation, being stuck in a bed in a room with little to no stimulation can greatly influence mental health.

All of these potential issues can be addressed and avoided, but families should be aware of potential problems when a loved one is admitted to the hospital. Understand that increased care and support may be necessary after a hospital stay and a rapid cognitive decline could occur.

For alternatives to traditional hospital stays, contact us at Cura-HPC. We offer hospice and palliative care to a variety of patients to provide them a more comfortable, caring environment. 

At some point in our lives, almost all of us would benefit from hospice care. But how do you decide which hospice provider to choose when they all seem so similar? The American Hospice Foundation put together a list of questions you can use to find out if your needs and situation match-up with the capabilities and services provided by a specific hospice provider. Here’s what to ask in order to make an informed decision.

How long have they been in operation?

The takeaway from this question is to find out if the hospice provider is relatively new to your area. If this is the case, they lack the stability of other providers who have years of proven service. New providers also introduce the possibility that they won’t still be around when you need them, or that they’ll halt operations while your loved one is still under their care. Be wary of hospice providers with less than 6-months of history.

What are their references?

Another reason newer hospice providers are risky is because it’s more difficult to talk to physicians and families who have worked with them in the past. Without these references, it’s extremely difficult to rely on these providers with confidence. Before you make a decision, be sure to ask around and find out what others’ impressions are.

What is a typical response time for nights and weekends?

Illness doesn’t work a typical work schedule so it’s important for your provider to be available and respond quickly any time you might need them. A qualified hospice will ask their clients about response times and whether their staff was adequately available to the family and patient. That means the provider you’re speaking with should already know what their response is like. For many, this can be a make or break question so be sure you have a quoted response time for any provider you’re considering.

What are treatment limitations?

Depending on the hospice provider being considered and a patient’s illness, there may be a disconnect between the treatments currently being done for a patient that could not be considered by the hospice team. In many cases, the patient can simply continue seeing their own doctor, but it’s important to understand these limitations before making any changes in care.

What are their accreditations and certifications?

If the patient considering hospice care is a Medicare beneficiary, it’s essential that the provider they choose is Medicare-certified in order to permit reimbursement. For many patients, this consideration alone can help to narrow the list of provider options. Additionally, some states require their own licensure for hospice providers, so if you live in one of these states, be sure a provider is compliant. JCAHO or CHAP accreditations are not required, however they could give you peace of mind. Knowing that a provider has an accreditation lets you know that they’ve been reviewed and determined to provide a reasonable standard of care.

Don’t wait until a crisis to begin researching and interviewing hospice providers. If care needs to begin immediately, it can be difficult to properly assess your options. If possible, start your research at the first signs of a serious illness, or when a loved one reaches a certain age. Even if you don’t need a hospice providers for another few years, the information you gathered will come in handy.

To learn more about Cura-HPC, our services, philosophy and capabilities, don’t hesitate to contact us at (800)797-3839. 

While hospice care has been adopted by more and more individuals, there remain a number of myths and misconceptions about the hospice philosophy and the facts about palliative care. Unfortunately, these misconceptions can lead to patients and their families missing out on beneficial services. As with any type of medical treatment and care, education is important in order to allow patients to make the best decisions for them. With that in mind, here are three of the most common and detrimental myths about hospice care and the truth behind them.

Time limits

Medicare uses benefit periods, which last 90 days. This practice has led to the belief that hospice care has a time limit and is only for patience with 6-months or less left to live. This time frame comes from a typical Medicare estimate that hospice patience only need two benefit periods. What many people don’t know, however, is that Medicare allows you to receive an unlimited amount of 60-day benefit periods after that initial 6-months should you need it. Palliative care isn’t designed to shorten or lengthn life, but the reduction of stress and increase in comfort often affects health in a positive way. It’s even an option to go off hospice care and come back when it’s needed. At no point would a patient be refused care, however, due to the length of time they’ve received hospice.

Hospice centers

No one is quite sure where this myth comes from, but it states that hospice care is administered at a specific facility and patients are required to go there to receive care. This is completely untrue. Rather than a physical location, hospice is a philosophy that allows patients to make choices for their end of life. That means a patient could be in a hospital, nursing home, or in their own home and still be a candidate for hospice care. Services are provided 24/7 and are even available when the patient’s finances are depleted. The idea of hospice is to make patients more comfortable and to work with their needs, so requiring them to visit a specific facility or make a specific choice is outside the philosophy.

No medications

While it’s already been mentioned that hospice is a relief-based approach, rather than a curative one, the decision to go off medications is left up to the patient. Some medications can be a cause of discomfort and it may be the recommendation of the hospice provider that the patient discontinue use of it, but to say that hospice requires patients to stop taking medications is inaccurate. In order to receive the maximum benefit from palliative care, recommendations are made to increase comfort and reduce stress. Sometimes that coincides with going off medication, but sometimes the patient prefers to continue medications and other recommendations and considerations are made.

Once you understand that hospice care is a philosophy focused on making patients more comfortable, many of the myths associated with hospice are easy to discern.

To learn more about hospice care or to find out if you or a loved one is right for it, contact us at Cura-HPC. 

Building a strong relationship with your physician is important for any individual. Within the context of hospice, it becomes particularly important, and not just for the patient but also for the family. Your physician will be having difficult conversations with you and making recommendations. Taking the time to build that relationship helps them know you better, which allows them to make more meaningful recommendations. For a better overall experience with your physician, here are a few tips for how to effectively build a stronger relationship.

Be prepared

Before your appointment, you likely already have a good idea of what will be asked. Take a few minutes to prepare by listing your symptoms and how long each has been present. Or list exactly what’s been troubling you and make sure that each reason for the visit is addressed. Knowing each prescription and non-prescription medication you’re taking is also extremely helpful.

Be honest

Without full disclosure, your physician can’t be expected to effectively treat you. It’s important that you are completely honest about your lifestyle, symptoms and needs. Many patients feel embarrassed or self-conscious during doctor visits, but holding back can lead to dangerous situations. Let your physician help you to the best of their abilities by telling them everything.

Understand your care plan and follow it

Don’t leave your doctor’s office if you have any questions or uncertainties about the care plan they’ve outlined. Understanding exactly what is expected of you is important for the plan to be successful and ensure maximum comfort and healing. Once the care plan is explained satisfactorily, follow it exactly. Failure to take medications on time or in the correct dosage, or not monitoring blood sugar and other aspects causes the plan to fail. This can lead to changes in the plan that aren’t necessary. Eventually, this is a great deal of time lost.

Bring a companion

Researchers have found that those that see their physician along with a friend or family member are significantly more satisfied with their visit. Having a trusted individual in the room with you helps put you at ease. It also means there’s an extra set of ears there to absorb the doctor’s information. If possible, enlist one individual to attend physician’s appointments with you and rely on them to help keep you organized and on-track.

Additionally, communication with your physician is key. Your doctor is here to help, but they need your help to know exactly how to treat you. The more you know and can tell them about your situation, the better they’ll be able to help you.

At Cura-HPC, we work closely with a number of amazing physicians and medical professionals. We are dedicated to providing hospice care to patients who need it and provide services to their families as well. Contact us to learn more about our hospice and palliative care capabilities.