Implementing Preventive Strategies

Some hospitals have developed strategies to prevent problems that can result when older people are hospitalized. These strategies are designed to help older people continue to function as well as they did before they became ill. One such strategy is an interdisciplinary team of health care practitioners who work together to care for an older person. Team members evaluate the person's needs and coordinate the person's hospital care. Team members look for possible problems and correct or prevent them.

Another strategy is a team that focuses on preventing and managing one specific problem, such as undernutrition or pressure sores. Such teams are often led by a nurse, who checks the person for the problem and develops a care plan.

Some hospitals have geriatricians, who are trained specifically to care for older people. These doctors can help prevent problems common among older people. For example, they avoid prescribing drugs that are particularly likely to cause problems. Hospitals may also follow guidelines for care (protocols) developed specifically for older people.

Sometimes a person is assigned to a nurse who has primary responsibility for and monitors that person's care. This nurse makes sure that other staff members understand the treatment plan for the person.

A few hospitals have nursing units that are designed for older people and staffed with people trained in caring for older people. In these units, older people are encouraged to get out of bed as soon and as much as possible. They are encouraged to dress each morning, to follow their usual daily routine as much as possible, and to eat in a group dining room. If older people are going to be in the hospital a long time, they are encouraged to personalize their room with photographs, pillows, and other familiar items. Staff members encourage family members and friends to participate in care.

Even when these strategies are unavailable, hospitals can take general measures to help prevent problems. For example, restraints are used only when absolutely necessary. Bed rails may be used to enable people who are too weak to sit up. Drugs are given in the lowest dose and for the shortest time possible.

Family members can alert doctors and other hospital staff members if the older person has problems that may become worse in the hospital. Family members can also talk with staff members about potential problems related to hospital care.

If family members know that the person may have a problem communicating, they should tell hospital staff members. Communication may be difficult if English is not the person's first language or if hearing is impaired. Staff members can take measures to help. For example, if the person has difficulty communicating in English, they can arrange for someone to translate.