Reducing chronic hospitalizations

I've worked in nursing homes for many years, so I know that chronic hospitalizations are a reality for those who live in a nursing home as well as for those living in their own home. This is a very big topic in legislation and focus for improvement.

It is obviously costing Medicare a lot of extra dollars as well as causing stress to those who are being hospitalized and their families. One recent study found that 20 percent of hospitalized Medicare beneficiaries are re-admitted within 30 days, with costs accounting for one-sixth of the total Medicare budget.

There are a lot of factors that go into why a person has chronic hospitalizations that include: little social support, unsafe environmental situations, self-care deficits, dementia, poor eating/drinking habits, congestive heart failure (the most common diagnosis for re-admissions) and for some it is not being able to afford necessary medications.

From a legislative standpoint, The Affordable Care Act mandated that starting in October this year, Medicare will begin to penalize hospitals whose patients with heart attacks, heart failure or pneumonia return frequently. By 2014 hospitals with high readmission rates stand to lose up to 3 percent of their regular Medicare reimbursements. Nursing home reimbursement will also be affected by the amount of re-hospitalizations they have. 

So what can be done from a non-legislative standpoint? 

Let’s consider those with little social support, self-care deficits and/or unsafe environmental situations. A recent study in the October-December issue of Advances in Nursing Science shows that the amount of care and assistance received from formal or informal caregivers had an important impact on self-care ability and re-hospitalization risks. Non-medical home care companies that provide help with bathing/dressing, cooking/cleaning, transportation and companionship have been on the rise; though many people may not be aware of such services or cannot afford them. 

These services are going to play a huge role in the strategic answer to preventing chronic hospitalizations. Having a caregiver or companion to oversee that activities of daily living are a success, medication reminders and that the person is eating a balanced diet are all keys to remaining out of the hospital. These services can be the eyes and ears of family members who are not able to be with their aging parent all the time due to their own careers, family or distance. Spouses who are providing the majority of the care giving can also benefit from these services for respite and peace of mind while they are out shopping or running errands. 

For more information on these types of services, call your local senior center.