Hospital stays can be a tense and uncertain experience for patients and families alike. But a family caregiver who can act as a thoughtful patient advocate—asking the right questions, keeping track of hospital personnel and their directives, monitoring medications—can make all the difference and ensure a comfortable, safe, and hopefully brief hospital stay.
The concept of family advocacy is something more and more hospitals are becoming receptive to. Under financial pressure to keep stays short and staff lean, hospitals are seeing the primary family member or caregiver as a valuable resource who can have a positive effect on the level of care and help prevent potential problems—and, in turn, more family members and caregivers are thinking of themselves less as visitors and more as patient guardians and advocates.
How best to shift into advocate mode when your family member takes a trip to a hospital? Here are some tips:
“The number one thing is to ask questions and find the people who can answer them,” says family caregiving expert Judy Santamaria, MSPH. “If you are intimidated by the doctors or the health care process, start with the nurses on duty. They have the most vested interest in keeping the patient comfortable and safe.”
So when hospital staff use acronyms or terms you don’t understand, ask them to explain. Try to determine the pros and cons of tests and treatments and whether they are truly necessary. If you are uneasy about speaking up, bring in another family member or friend to serve as an intermediary. Don’t feel as though you must do it alone.
“So many people come in and out of a hospital room, and it can be hard to keep track of who’s who and what each one says,” says Santamaria. Ask for business cards and write down identifying details on the back of each. A notebook will help you keep track of important information, such as the names of the attending doctors, nurses, and any specialists, as well as medications (see the next point). Note the date and, if necessary, the time of your entries and use it as a reference when asking questions. Tip: A journal can be especially handy at discharge, when you want to be clear on directives for home care.
Errors regarding medication can occur in hospitals. Be sure all medical personnel are aware of any allergies or side effects your family member has experienced to common drugs. Make a list of your loved one’s medications, as well as dosing information and schedules, and be aware of any changes while in the hospital. Note any new medication and don’t be afraid to ask what each is for, how long the patient will need to take them, and what sort of side effects to look for. If necessary, ask nurses to read the drug orders aloud.
“A hospital stay can lead to disorientation and in some cases delirium, especially in the elderly,” says Santamaria. “Keep your family member grounded and comfortable by letting them know what day it is and showing them the newspaper.” Read and talk to them in reassuring tones, and bring in their eyeglasses, hearing aids, dentures and familiar objects from home. Be aware of the signs of delirium. Some medications, especially narcotics (such as Haldol), can make elderly patients more prone to confusion. A10sk if medications that do not pose this sort of risk are appropriate.
If you have any serious concerns about your family member’s care and feel that his or her needs are not being addressed by hospital staff, reach out to the hospital ombudsman or patient advocacy department.