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Common Senior Conditions that Contribute to Hospitalization and Readmissions

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Discharge from the hospital is a critical transition point in your loved one’s care especially if she has multiple comorbidities.

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June 21, 2012

While a number of factors can contribute to a senior's readmission to a hospital after being transitioned home, there are six common conditions that are the most prevalent causes:

  1. Arthritis
  2. Congestive Heart Failure
  3. Diabetes
  4. Myocardial Infarction (Heart Attack)
  5. Pneumonia
  6. Comorbidity

Arthritis

Arthritis is a chronic disease, which is characterized by more than 100 conditions that primarily affect a body's joints. Some of the most common forms are osteoarthritis, rheumatoid arthritis, fibromyalgia and gout. The chances of getting arthritis, especially osteoarthritis, which is caused by the deterioration of a joint's cartilage, increases with age, making it likely that a senior may suffer from the disease's effects.

Some with osteoarthritis have knee or hip replacement surgery to help relieve the pain in their joints. Others use medication and lifestyle changes such as exercise and a proper diet to ease their symptoms.

But seniors with arthritis who have just completed a hospital stay and who live alone may have difficulty caring for themselves, particularly in areas of medication and nutrition management, as well as getting the exercise they need to ease their symptoms. If a senior misses needed doses of medications and becomes weak from poor nutrition, he could end up with setbacks and be readmitted to the hospital.

Congestive Heart Failure

Congestive heart failure occurs when the heart is no longer able to pump blood throughout the body. It can be caused by narrowed arteries, high blood pressure, problems stemming from a heart attack, stroke, infection of the heart, and other factors. The symptoms of congestive heart failure generally include fatigue, weakness, shortness of breath, swollen legs and ankles, reduced appetite, nausea and weight gain. Congestive heart failure is a progressive disorder that affects the heart, lungs and kidneys.

Aging plays a large role in the risk of congestive heart failure, and the prevalence of heart failure approximately doubles with each decade of life. Congestive heart failure is one of the most common reasons for hospital readmissions. If you notice any of the symptoms mentioned above, you should contact your loved one's doctor right away.

Diabetes

Diabetes is a group of diseases characterized by high blood glucose levels due to a lack of insulin. Diabetes is present in over one quarter of seniors age 65 and older, according to the Centers for Disease Control and Prevention's National Diabetes Fact Sheet. People who are over age 45, overweight or obese and physically inactive also increase their chances of getting diabetes. Diabetes can cause sight and hearing loss, nerve damage, and high blood pressure.

According to the article “Diabetic Foot Ulcers: Prevention, Diagnosis and Classification” in American Family Physician, foot complications are the most frequent reason for hospitalization in people with diabetes, accounting for up to 25 percent of all diabetic admissions in the United States and Great Britain.

Making sure that your senior loved one leads a lifestyle that includes a healthy diet, exercise and strength training, and proper medication and insulin routines may help to limit complications from diabetes. Research presented in the Lower Extremity Review article “Exercise and Neuropathy: Not mutually exclusive” also shows that weight-bearing exercise does not increase the risk for foot ulcers, and that those people who were the most active actually reduced their risk for ulceration.

If you need some help, senior care agencies can provide assistance with making sure you senior gets exercise and proper nutrition. Many also provide transportation to activities and can help with grocery shopping.

Myocardial Infarction (Heart Attack)

If your senior loved one suffered a myocardial infarction – also called a heart attack – she has much to consider when returning home from the hospital including: keeping and getting to follow-up doctors' appointments and medical tests; properly taking medications; eating a healthy diet; getting to a rehabilitation program and more. Sadly, according to the US National Library of Medicine, having one heart attack increases one's likelihood of having another episode.

The US National Library of Medicine suggests to prevent another heart attack, and thus readmission to the hospital, a senior needs to do the following:

  • Keep blood pressure, blood sugar, and cholesterol under control
  • Don't smoke
  • Eat a heart-healthy diet rich in fruits, vegetables, and whole grains, and low in animal fat
  • Get plenty of exercise, at least 30 minutes a day, at least 5 days a week (talk to the doctor first)
  • Get checked and treated for depression
  • Limit alcohol intake to no more than one drink a day for women, and no more than two drinks a day for men
  • Stay at a healthy weight

All of this might seem like a lot of work, but it is vital to maintaining a senior's good health and staying out of the hospital. As a caregiver you can help in many ways, but be sure to inquire with the senior's doctors or discharge coordinators if you have questions about getting some outside assistance.

Pneumonia

Pneumonia is a serious condition that occurs when fluids accumulate in the air sacs causing irritation and inflammation in the lungs. As this occurs, blood and cells do not receive the oxygen required for proper function. Pneumonia can affect one or both lungs and can be caused by exposure to bacteria, viruses, irritants or exposure to chemicals. Since the elderly can often have chronic lung problems, the condition may be harder to detect, especially if a senior is already weakened from a previous hospital stay.

Seniors don't always exhibit classic pneumonia symptoms such as chills, shortness of breath and chest pain. In fact, many elderly sufferers, particularly those just released from the hospital, often show no symptoms because their immune response may already be in a somewhat weakened state. Seniors may also have a lower than normal temperature versus a high temperature. Other signs of pneumonia in seniors include confusion, disorientation, severe weakness and bleeding or discoloration of the lips and nail beds.

According to the National Institutes of Health, pneumonia is one of the ten leading causes of death for persons over the age of 65. It is vital that you monitor your loved one for pneumonia symptoms and call the doctor if you suspect a senior's health is off. Doing so can keep a senior healthy and risk free.

Comorbidity

Comorbidity is the simultaneous presence of two or more conditions or diseases in the same person, which may complicate her situation. For example, if a senior has congestive heart failure she is particularly vulnerable to infection, especially pneumonia and influenza. An infection can aggravate the underlying heart disease and could lead to rapid, frequent recurrences of the congestive heart failure, which could then result in readmission back to the hospital.

Discharge from the hospital is a critical transition point in your loved one's care especially if he has multiple comorbidities. Be sure to ask several questions of the senior's discharge coordinator so that you can make sure to be watch for warning signs and be ready to help manage them.

It may seem a daunting task to have to watch for all of these conditions and their various warning signs but doing so can mean the difference between a senior's full recovery, a setback or worse. And always remember to take good care of yourself. Be sure to eat right, rest and engage in activities that you enjoy. Being a healthy caregiver is good for you and an even greater gift to your loved one.

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