Hospitalized: Take 2

I’ve continued to hear from people about what to do when a friend or family member is hospitalized. There is no doubt that patient advocacy is critical. As for supporting patients in the hospital, I'm for the 24/7 approach. I can't imagine leaving loved one in the hospital alone.

One person wrote of their experience with a family member who has Parkinson’s Disease as well as her own issues following surgery. Sometimes a particular diagnosis requires some extra special attention, and so I have included the comments, eliminating identifying information.

When J was in hospital for extended stays, I found that monitoring his PD (Parkinson’s Disease) medications was extremely important. Often meds are given at the convenience of the pharmacy and the nursing staff, and PD meds in particular have to be administered according to the patient's schedule. The problem is often that every change of nursing staff ( 2 - 3 times a day, and especially on weekends or holidays when there may be brand new people with no experience with this whatsoever) requires constant monitoring. I once gave J his meds from my own supply in the ICU when no one could tell me whether or when he last had his meds, and I knew he had been in the ICU through a complete meds time schedule, not a good situation at all.

Be aware of cognitive changes, changes in behavior, attitude, etc. J experienced severe depression and suicidal behavior in reaction to a new prescription (this was at home) and a severe psychotic reaction to a morphine-derivative painkiller given while he was in the hospital after surgery. No one on the staff seemed to be aware that he was acting very strangely. This is an important point, as you will know what’s normal for the patient and staff wont necessary know.

Be there to help the patient with getting comfortable, changing the bed position, moving pillows, tightening or loosening top sheets, helping with drinking, using the nurse call button. The patient may not be able to do these things or even be aware that there is a problem. When I was recovering from my surgery and was alone, I wanted a walker and was told by the nurse that it would take three days to get a PT evaluation to even discuss getting the walker. I enlisted the aid of a young med student to get the walker, and was out of the hospital two days later, a full day before the scheduled PT evaluation. Help the patient to order food and to eat if necessary. Eating in bed is not easy.

The bottom line is that your patient is one of many to the staff; he is your one responsibility and you are his advocate.