How Nurses can Help Older Patients Stay Out of the Hospital

Written by: 
Daymar College

As people are living longer, the elderly population is increasing in society today. This means there are more people living with one or more chronic conditions. To avoid expenditure on the healthcare system, it is important for people to be mindful of their wellness. Nurses have a vital role in helping older patients to stay healthy and can use a variety of methods to support them in staying healthier longer. By doing this, it helps avoid exacerbations of chronic illness, hospital admissions and allows older patients to be independent.

Reducing Social Isolation

Some real issues for the elderly include feeling lonely and being socially isolated. Many older people live alone because their families are more dispersed than they were several years ago. Some older people spend days alone without speaking to anyone. This can lead to depression and has even been seen to lead to heart problems. Nurses can assess the situation by evaluating the patients’ social interactions when they come for treatment or a clinic appointment. Urging (or encouraging) patients to join walking groups, peer support organizations and other activities can reduce the hours spent alone. There are lots of groups and organizations aiming to support older people, but often the elderly person is unaware they exist or unwilling to ask. Having some local knowledge of what is available is vital for nurses working with older patients as they can bridge the gap and make things happen in a proactive way.

Preparation for Winter

Cold weather increases the likelihood of older people being admitted to hospital because of exposure to lower temperatures. For people with chronic diseases the temperature only needs to drop a few degrees to cause problems. Nurses can help older people prepare for the winter months by giving advice on heating the home, storing food in their home, and staying warm with heating blankets. Encouraging older people to get a flu vaccination helps them avoid influenza and pneumonia.

Exercise Programs

It is essential for older people to keep as active a lifestyle as possible. Nurses can advise patients where to find exercise programs and talk to them about the benefits of attending a structured program. Nurses can also assist patients by showing them simple seated exercises and other movements to aid with circulation and blood flow.  Suggesting Tai Chi or Pilates has been shown to increase balance and maintain muscle mass, which can help prevent falls. Informing patients about the benefits of attending these specialized programs should impact their wellness decisions. Each individual is at a different level, so it is imperative to recommend something that suits their tolerance. Even if it is just encouraging elderly patients to walk to the grocery store or around the block, it helps them to stay active.

Healthy Eating

It is very important for older people to eat healthy, so they retain the vitamins and energy necessary for daily tasks. Some people find it hard to cook a hot meal. Nurses can help older patients find solutions to this. Older patients can join lunch clubs, get meal deliveries, and have prepared meals in the freezer. Teaching an older person how to make an online order with their computer or phone is another way of regulating their diet. Nurses need to be aware of people who are losing weight and not eating because they are too tired to use the oven or microwave. This is when nurses can intervene with some social support.

Self-Management of Chronic Disease

One of the most significant things a nurse can do for older people with chronic condition(s) is to give them a management plan. This includes lifestyle advice and what to do if they feel unwell. It also ensures they know how to take their medication properly and how to live with their condition. This allows people to be independent and at home instead of becoming an emergency admission at the hospital. Many emergency admissions occur simply because the patient did not know what to do when they began to feel unwell.

Mental Agility

Loss of memory and even dementia is a fear held by many older people. Exercising the brain is just as important as doing exercises with the body. Older people can do a brain workout to help stimulate the cells and keep them as active as possible. Nurses are ideal at promoting mental agility exercises to keep people healthy in mind, body and spirit. Examples are crossword puzzles, sudoku, playing chess, and even learning another language. Other ways of exercising the brain include visiting a new place, learning a new song or trying a new recipe.  An older person can get into a daily routine of doing something to keep their memory active. Nurses working with older people in care homes should recognize the importance of mental stimulation and have a range of activities for the residents every day.

Staying healthy in all aspects of life helps older people maintain independence. Nurses are the vital link in helping to support older people and keeping them healthier over time. By helping people to remain self-sufficient, mentally and physically agile, and less socially isolated, nurses are influencing older people to want to stay healthier.

How Nurses Can Prevent Readmission of Older Patients to the Hospital

When a patient is readmitted to hospital within 30 days of being discharged home, it is distressing for them and can lead to further deterioration in their condition. It also costs the health economy money and in some cases, a hospital can be fined for having too many readmissions. Nurses have a major role to play in preventing readmissions to the hospital, particularly with older people. Here's how a nurse can make a big difference in prevention of readmissions with a few simple actions.

Think Holistically

When a patient is admitted to hospital with one problem there are often other underlying medical conditions. In the over 70 age group, people are now likely to have more than 2 chronic conditions such as hypertension, asthma, diabetes, dementia, and or depression. A patient admitted to hospital for a hip replacement could have diabetes too, or several problems including frailty. That's why it is vital to take a holistic approach when treating patients. Many readmissions to the hospital are caused because only one problem was solved, when there are many others in need of attention. Ensuring the other conditions are assessed and managed while in the hospital the first time will help avoid a readmission later.

Self-Care Plans

When patients have knowledge about how to manage their condition, they are more empowered. Understanding their medication, knowing what to do if they have an asthma attack, or chest pain, and being able to get advice can all contribute to keeping that person out of the hospital. Nurses can help here by ensuring their older patient with a long-term condition has a self-management plan and knows how to take action if their illness flares up. Rehabilitation programs are another effective way of giving the patient confidence to manage a medical problem and coping methods. Programs like this introduce patients to others with a similar problem, giving them peer support and encouragement. This helps them move on and they are less likely to be readmitted after discharge from the hospital.

Planning a Discharge Home

Discharge planning should ideally begin when the patient is admitted to the hospital. This includes finding out the type of accommodations the patient lives in and whether something needs to be modified before they go home. An increasing number of elderly people live alone, and today many of their families live hundreds of miles away from them. This means that support may be required when a patient goes home to prevent them falling ill again and needing to be readmitted. Nurses need to record the patient's social details in the notes so that once a patient is ready to be discharged the support they need can be organized. Heating and cooling in the home is also very important. The temperature only needs to fall or rise a couple of degrees in homes of people with chronic conditions before it affects them and places them at risk of being readmitted.

Communicating the Plans

Once a patient has a date to return home it is vital the nursing staff communicate this to the family and the local doctor's office. If there is a family member nearby, they could heat or cool the home in preparation for the patient coming home and also ensure there is food in the house. This communication is vital to prevent a patient going home to an extremely cold or excessively hot house with no support, and then finding themselves back in the emergency room.
 

Support Phone Lines

Some hospitals have phone lines that patients can call to speak to a nurse if they have any worries or questions once they are home. This connection helps people who are unsure about how to do something or are less confident about their medication. Having a qualified nurse talk to patients helps people manage their illness. It is more convenient sometimes for both the nurse and the patient to handle the inquiry over the phone. Some nurses also take the initiative to use the phone in order to check on how the patient is a few days after sending them home.

Another effective way of supporting patients after discharge from the hospital is connecting with them virtually. This is where patients are sent home as normal but have the added support of a nurse contacting them by phone or online each day to check on how their progress. Systems and protocol like this help people manage independently and stay out of the hospital and in the comfort of their own home.

Nurses have a critical role to play in preventing readmissions to the hospital. This includes effective discharge planning, providing self-management tips, rehabilitation programs, and communicating effectively to the multi-disciplinary team. By planning ahead and using support networks, patients can avoid the revolving door of readmission and live healthy and happy life.

Interested in learning more about becoming a nurse? Ready to learn about pharmacokinetics and the rate of drug elimination in the body? As a successful graduate with a nursing degree, you may be prepared to work as a beginning professional nurse in hospitals, physicians' offices, nursing and residential facilities, and home health care centers. If you're interested in pursuing a career in nursing, we have the degree program for you. Daymar College’s Associate of Science degree in Nursing is designed to provide the foundation for beginning the practice of professional nursing.