A devastating critique of dismal hospital care for the aged

Ron Schwarz, 79, says he has hardly been able to eat since being admitted to the hospital. (Heidi de Marco/KHN)

Ron Schwarz, 79, says he has hardly been able to eat since being admitted to the hospital. (Heidi de Marco/KHN)

Although America grows grayer by the day, the care that elderly patients get at all too many hospitals after they’re admitted leaves them worse off when they are discharged, the Kaiser Health News service finds in a devastating report.

Kudos to writer Anna Gorman who puts together published studies and tough reporting to detail that, “About one-third of patients over 70 years old and more than half of patients over 85 leave the hospital more disabled than when they arrived. As a result, many seniors are unable to care for themselves after discharge and need assistance with daily activities such as bathing, dressing or even walking.”

Hospitals are so focused on clinical approaches to treating diseases and conditions that they ignore the human needs of their patients, which is particularly destructive to the old, many of whom teeter between independence and institutionalization. As Gorman writes of the treatment given to many of the 13 million seniors hospitalized annually:

Hospital staff often fail to feed older patients properly, get them out of bed enough or control their pain adequately. Providers frequently restrict their movements by tethering them to beds with oxygen tanks and IV poles. Doctors subject them to unnecessary procedures and prescribe redundant or potentially harmful medications. And caregivers deprive them of sleep by placing them in noisy wards or checking vital signs at all hours of the night.

Some of the care is so bad it amounts to medical malpractice. Other times, it’s just indifference. The story humanizes the toll that elderly patients suffer, even when getting acceptable hospital care.  Gorman tells the story of Janet Prochazka, 75. Because of a fall, she goes from independence to living with relatives after her hospitalization and decline. Or there’s 79-year-old Ron Schwarz who finds he can barely eat in the hospital where he’s under care after a fall.

I’ve written recently how traumatizing hospitals can be for patients in general, with medical errors there and overall estimated by some experts as the nation’s No. 3 killer, claiming 250,000 lives annually. The KHN story says the aged, a disproportionate number of the hospitalized, suffer more than many other age groups from problematic hospital care, with a quarter of hospitalized Medicare beneficiaries found to have “suffered an ‘adverse event,’ or harm as a result of medical care. Those events, such as bed sores or oxygen deficiency, cost Medicare about $4.4 billion annually… Physicians who reviewed the incidents determined that 44 percent could have been prevented.”

Some hospitals have created geriatric specialty care units, where seniors get intensive cognitive and other screening that helps to tailor treatment programs that take into consideration not only their diseases and conditions but also how these patients need age-specific attention. That’s a good start but so much more must be done. It won’t be easy, as I have written, because the nation also isn’t turning out the numbers of medical experts in aging that we will need.

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