Dear Betty: How to avoid rehospitalization

By Betty Beverly - 11/21/2009

Dear Betty, As if I weren't nervous enough about my upcoming major surgery, I just read an article that said one out of five Medicare patients end up back in the hospital after discharge. My daughter will be coming to stay with me for a while, but I worry about her missing work — and her family. I want to do everything I can to get on my feet and get better fast. Any tips?

— One time is enough Dear One Time, I asked some medical professionals at Mountain-Pacific, and they assured me there's a lot you can do to increase your chances of successful surgery and successful recovery. The key is getting good information right now and learning who to contact for questions you haven't thought of yet.

First, be sure you understand how your surgery will work to correct your medical problem, and importantly, how you can expect to feel in the days and weeks following your operation. Ask what assistance, if any, you will need and about symptoms that might indicate problems and who you should call if they occur. You'll also need to know how soon you'll need to be checked to assess your progress and how frequently. Be sure your doctor knows all the medicines you take (including vitamins and herbs) and ask whether you should discontinue these before or after surgery.

You'll probably be offered this information at a visit before surgery, but if not, ask for it, and if possible, bring your daughter or someone else along. Your listening "partner" can help you remember better. If you both are confused about a point, call and ask for clarification.

If you'll need help beyond the time of your daughter's stay, you can explore options ranging from home-delivered meals and rides to appointments to actually using a home health agency for services, an option sometimes paid for by Medicare. Your hospital's discharge planner can tell you if you qualify. Your Area Agency on Aging (find it at www.eldercare.gov) is a good resource for services like Meals on Wheels and transportation issues. Your daughter will probably be pleased to help with this aspect of planning, since it will ease her mind as well as yours.

Fill a small notebook or folder with all this information, including phone contacts, and keep it handy for both of you. You can also download "Planning for Your Discharge," (www.medicare.gov/publications/pubs/pdf/11376.pdf), a checklist of questions to ask before surgery. It includes questions for family members or other caretakers too.

A few other tips: At Hospital Compare (www.hospitalcompare.hhs.gov) you can search for your hospital (or several hospitals if you haven't decided) and get information on quality of surgical (and other) care provided, on readmission rates, and even on consumer satisfaction.

Don't forget hospital-acquired infections are a problem nowadays, especially methicillin-resistant staph infections (MRSA). Your best defense against this infection is to be sure anyone who comes to your room — medical staff and visitors alike — washes his or her hands. Don't be embarrassed to ask. Most hospitals have already implemented hand-washing campaigns because they know this is one of the best ways to keep patients safe from infection and happily recuperating. Good luck.

Dear Betty is a biweekly question-and-answer column. Please mail your questions on senior issues to Betty at Mountain-Pacific Quality Health, 3404 Cooney Drive, Helena MT 59602 or e-mail them to dearbetty@mpqhf.org.