All About Estates

It’s Friday afternoon at 4:00 pm and your mom is being discharged home.

This was the frantic call I received from a daughter this past Friday. The hospital was discharging her 90 year old mother but had omitted to confirm that services and follow up medical appointments were in place. Now in many cases, this might not be a problem- depending on the health of the patient. But in this particular case, her mom had high care needs and in addition to 24 hour private pay care (that was in place), public supports including nursing and dietary services were also required. Her mom was returning home after being treated for pneumonia. Prior to this admission she had been home for less than one week, after having spent several months as an inpatient following a severe stroke. She remained immobile and was on a feeding tube.

On this late Friday afternoon, she was sent home with a requisition for blood work to be done the next day; however it was not arranged to be done at her home. She was also sent home with new medications that had to be administered by a feeding tube, yet the community nurse (from the LHIN) was not yet in place. Even with the use of a hoyer (mechanical) lifting device, she required 2 people to transfer her and her 90 something year old husband was not physically able assist the private PSW.

What are families to do who find themselves in this unfortunate situation?

When things are complicated, my advice is not to be discharged home on a Friday and never before a long weekend. If unavoidable, request a discharge meeting so that all team members can provide their recommendations and that any required referrals can be arranged with assurances that the gears are in motion. This is the opportunity for family to ask questions and raise any concerns that they may have. If you are fortunate to have extended family, have one person assigned as the key contact. In many cases with seniors who are in poor health, there simply is no room for error.

In the above situation, this family was fortunate as they were able to get us involved; we made the necessary calls at 7:00 pm on a Friday night to ensure that a nurse was coming to provide the night time medications. This should not have been necessary. For the majority of families that are on their own it really is important to push back, ask questions and sometimes ‘no thank you’ is the right answer.

About Audrey Miller
Email: amiller@eldercaring.ca About: Audrey Miller, Managing Director of Elder Caring Inc. has over 25 years social work and rehabilitation experience working with older individuals and their families. She advises the financial, insurance, legal and business communities regarding elder care issues. Audrey is a recognized expert in her field.

1 Comment

  1. Joan

    October 22, 2018 - 1:56 pm
    Reply

    Well I can comment as I’ve been in that scenario from the health care workers’ side. I was the pharmacist in charge of getting the “discharge medication list” ready and making sure the patient either had the medications already or prescriptions were send to the correct pharmacy then to be delivered. If the doctor forgot to write the prescriptions (not uncommon), it could take 2 hours to sort it out.
    Usually situations like this start with a doctor responsible for the discharge being held up and arrives later than (s)h wanted, and/or got bogged down trying to discharge a whole list of patients because of the ( long) weekend. Some doctors will write “d/c” and very little else, so it’s left up to the support staff to figure out the rest. This is the worst nightmare on a Friday afternoon. The lynch-pin to coordinating all of this is the CCAC coordinator who “coordinates” all these separate services. Their job is really difficult because it demands everyone cooperate with each other and in a timely manner. This includes but is not limited to the discharging doctor, the family doctor, the pharmacist, the social worker, the occupational therapist and the family themselves. Sorry about the client’s situation but as the population ages, this situation, unfortunately will become more common. Also, unfortunately lack of planning on someone’s part, ends up constituting an emergency on everyone else’s part.

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