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September 18, 2018

Post-Hospital Syndrome: How it Affects Older Adults & What to Know

By all accounts, Bernadine Lewandowski was an independent, healthy older adult. She had minor illnesses, and minor cognitive impairment, but always functioned well. Until she suffered a compression fracture of her vertebra, which had her admitted to the hospital for pain relief. 

Bernadine was in the hospital for four days, but the implications from her stay—sleep deprivation, weakness from being bedridden and delirium—had an effect.

She developed a blood clot in her lung that could have formed as a result of the inactivity from her time in the hospital, and was readmitted three weeks after being discharged for treatment for her fracture. Bernadine suffered what researchers are calling “post-hospital syndrome,” which they say accounts for the high hospital readmission rates among older adults.

What is post-hospital syndrome?

Post-hospital syndrome is a period of vulnerability following a hospital stay. Dr. Harlan M. Krumholz described it this way: “At the time of discharge, physiological systems are impaired, reserves are depleted, and the body cannot effectively defend against health threats.”

And for many older adults, it’s common. According to the Centers for Medicare and Medicaid Services, about 18 percent of Medicare patients returned to the hospital within 30 days of discharge in 2016.

What causes post-hospital syndrome?

If you’ve ever been hospitalized or have visited someone who was, you know how jarring the experience can be: Blood draws and vital sign checks at all hours of the day and night, difficulty sleeping because of interruptions, noises and a less than comfortable bed, restricted food choices, limited mobility.

All of these things can add up.

Dr. Krumholz notes that when you’re hospitalized, you’re not only dealing with the condition that sent you to the hospital, you’re also undergoing a considerable amount of stress in the form of sleep disruption, circadian rhythm changes, pain and discomfort and are maybe even poorly nourished and deconditioned by prolonged bed rest.

“Each of these perturbations can adversely affect health and contribute to substantial impairments during the early recovery period, an inability to fend off disease, and susceptibility to mental error,” he writes.

How to avoid post-hospital syndrome

While we wait for hospitals to employ more comprehensive strategies to combat post-hospital syndrome, making little changes to the hospital stay can help you or a loved one avoid or reduce the severity of post-hospital syndrome.

Always check with medical staff before implementing any of the following suggestions:

Bringing in outside food: Hospital food isn’t always the most delicious and can be served at inopportune times. Try to bring in or have someone bring you a favorite food, if it’s approved by your doctor. This can help ensure you get adequate nutrition and maybe even boost your mood.

Making sure you have your hearing aids, dentures, cane etc.: If you regularly use them and with a physician’s okay, these items can help you stay oriented and mobile.

Having a family member or friend walk with you: If you are able, ask a family member or friend to accompany you for a short walk through the hall.

Asking for a change: You can ask for your blood or vital signs to be taken at a time when you’re awake.

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