استعرض مصدر Inpatient Geriatric Consultations — Not What They Used to Be


Inpatient Geriatric Consultations — Not What They Used to Be

By Quratulain Syed, MD

Geriatric Times - 2012 The Cleveland Clinic Foundation 


Those of us who read Dr. Atul Gawande’s article titled “Big Med,” published in the Aug. 13, 2012, edition of The New
Yorker, learned about the shocking experience David Luz had when his 78-year-old mother was admitted
to a hospital after an episode of syncope and a fall.

As Luz recounts, his mother stayed in
the hospital overnight, underwent an
extensive workup and was discharged
home the next day without any clear
explanation or any proper discharge
paperwork or plan. Luz says of the
experience: “We didn’t get to go until
6 p.m., with a tired, disabled lady and
a long drive home.” In addition, Luz
and his mother both struggled to
navigate the post-discharge follow-up.
These sentiments are shared by most
families who have witnessed a loved
one being admitted to a hospital
and undergoing a significant yet
unexplained physical and cognitive
decline in a matter of a few days.
Primary care physicians also go
through a frustrating ordeal when
an older adult patient is admitted to
a hospital. They find frustrating the
lack of communication from the staff
on the inpatient side, especially when
the patient is discharged home or to
a rehabilitation facility with unclear
documentation about the hospital
course and post-discharge plan.
Inpatient teams experience an equally
difficult situation when trying
to communicate with an agitated
or lethargic, delirious older adult
with multiple medical problems,
scant patient history on admission,
unavailable records from primary
care providers and, frequently, few
involved family members. Medical
professionals also struggle with avoiding
frequent readmissions for chronic
diseases, an especially complex and
frustrating situation in a country
such as ours that is facing a significant
shortage of primary care services.
These personal experiences are
supported by national and global
data about higher readmission rates
and the hazards of hospitalizations
for older adults, such as polypharmacy,
instrumentation, malnutrition
and long- term cognitive and functional
decline. 


https://my.clevelandclinic.org/ccf/media/Files/Geriatrics/Geriatric-Times/geriatric-times-fall-2012.pdf?la=en

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