For older adults the transition home from the hospital is usually a welcome one. However, many older adults end up right back in the hospital, and as many as 2/3rd’s of these re-admissions are medication-related. This post highlights some key advice that can guide you, or your loved one, when experiencing the usual hospital-induced confusion and stress when returning from the hospital, especially when involving the addition of newer medications that can either help you, or harm you.
There is a sizable body of evidence that suggests there are key areas where subtle improvements can make the difference between a rapid recovery, or that of a relapse and a medication-related complication that sends you right back to the hospital. Here is that list of key points to consider when leaving the hospital.
- Make sure you know what each medication is for and how to take it.
- Make sure you know what side-effects to look for.
- Make sure you know what symptoms might reappear that suggest you may be having an aggravation of your condition.
- Make sure you have a routine that helps you adhere to taking your medications as prescribed.
- Make sure you and your pharmacist have checked for drug interactions
- Make sure your new list has all discrepancies explained and corrected, as compared to your medication list prior to entering the hospital.
By engaging in your medication plan and ensuring there are no errors, or inappropriate prescribing, you can have a better chance of recovering without another trip to the hospital.
Some examples of mix-ups that occur all too commonly are:
- Not continuing a critical drug during the hospital stay and upon discharge back home. One person had her heart medication mistakenly left off her medication list when entering the hospital, which continued onto her trip back home, and she subsequently had an aggravation of her heart condition. As a result, she had to go back to the hospital. Advice: Make sure someone, preferably your pharmacist, is reconciling your medications.
- Many adverse effects from medications can start two, or three, weeks after getting home. This is because the interaction of medications can take time to build up to the point of causing noticeable symptoms. This is why checking for appropriate doses and screening for drug interactions with your pharmacist is an important step when getting home. No one can assume that the hospital staff don’t make mistakes. If that was the case we wouldn’t have adverse drug events and medication errors a leading cause of harm in older adults. Advice: Know what symptoms to look for that suggest a serious side-effect (adverse effect) from your medication.
- A person was found to have a low blood level of her seizure medication while in the hospital, so her dose was increased. She was discharged, and a short time later was found unresponsive at home. The level of the seizure drug in her body was toxic. No one followed up to re-check the level of drug by doing a routine lab test. Advice: Know what needs monitoring and hold people accountable.
- In another case a person was prescribed a drug that worsened her asthma and had to go to the emergency room. Advice: Make sure the drug is appropriate for your conditions, otherwise known as drug-disease interactions.
- A person with congestive heart failure was readmitted to the hospital because they did not get their new medications filled after discharge to home. Advice: Plan in advance to have all medications available upon discharge so they can either be delivered, or picked up at the drive through.
- Lastly, a person could not adhere to her heart medications and ended up not taking them properly and being readmitted to the hospital. Advice: Review your new medications and plan a routine of how you will take them, at what times, with or without food, etc. I also recommend using a pill box, or “4×7” medication reminder, since even the brightest of people have a hard time time remembering when to take their medications. Note: Albert Einstein developed the theories of relativity, but would forget to tie his shoes or match his socks before leaving home. Thanks, Al.
So once again, I recommend these simple steps listed above, and also recommend engaging in your health and, stay at home!