Question 

My 82-year-old father is a very stubborn old man. He does not listen to anyone and must do everything his way. Of course, that does not always go too well. 

Last month he had a minor surgery. A few hours after he was out of the recovery room, he insisted on going home. The hospital staff told him that he needed to stay the night, but he refused. They gave him all the reasons why he should stay, but he insisted on going home. 

Dad did not do well at home and by 1 a.m. I was transporting him back to the hospital. He was dizzy, incoherent, and sweaty. Luckily, I stayed with him, or who knows how I would have found him the next day. 

I don’t know if I will ever be able to convince my father of anything, though I would like to know the best ways to prevent rehospitalization. 

Answer 

Rehospitalization is a problem for hospitals and patients. Everyone involved should do their best to prevent it. The health risk, cost, and drain on human resources is large. 

Not all rehospitalizations are preventable, but a good percentage of them likely are. Every patient, health care professional, and family member can take steps that will decrease the likelihood of a trip back to the hospital because something did not go well. 

Here is a list of things to consider: 

1. While in the hospital, keep a pen and paper or phone on your tray table. Write down your questions so that every time you see your nurse or doctor, you ask those questions. It is okay to ask more than once. Sometimes it takes hearing something a few times for the answer to sink in. 

2. When someone gives you an answer using medical terminology that is foreign to you, stop them and ask them to rephrase or use different words. They are quite capable of using layman terms and will not be annoyed. Every profession has its own language, just like yours did. They do not really expect you to know all their terminology; it is just efficient for them. 

3. If you are advised to stay an extra day, go to rehabilitation, use a walker, sign on to hospice, use a hospital bed, or any other recommendation that is a surprise or outside your original plan, consider what they are saying carefully. A common first reaction is to deny. Know this and allow yourself to feel that way. Then revisit the recommendation and talk it over with a family member and your health team. It is very unlikely that you are the first patient with your set of symptoms or disease that they have treated. They almost always know what they are talking about. 

4. Have a family member or friend serve as your advocate. It is difficult for most of us to process health care information in the moment. It is extremely helpful to have an advocate with you to hear the instructions or advice firsthand. 

5. When receiving discharge information, repeat the key instructions back to the doctor or nurse. Saying them out loud helps you internalize them and reminds you to seek clarification on those that you are not clear about. 

6. If you are planning to return to your home, make sure that you are set up for getting in and out of the house, bathing, sleeping, and meal preparation. Most people need someone to stay with them for the first few days at home, so plan for that. 

7. After discharge, carefully follow the instructions you are given. Every medication and action you are instructed to take is for a reason. The only medications you can alter are the ones that say “as needed”. All other medications are essential. 

8. Call the number provided with any health condition that concerns you. They will provide you with a list of symptoms that you should pay attention to. Heed those instructions. 

Staying out of the hospital once you are discharged is the expectation and with a bit of planning and rule following, your father should have success, if his will does not get in the way. 
I wish you well on this journey together.