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At the Hospital

The sights, the sounds, the smells . . . a hospital seems like a different world to most of us who aren't in the medical field. It's a foreign place where we don't know the language, the rules, the customs. So when your loved one must enter one, often it's not just a time of worry and fear, but also a time of confusion, both for your care-receiver and for you.

These are some suggestions for making the experience easier:

--Be sure that all paperwork regarding legal, financial, and end-of-life wishes is completed, signed, and filed with your loved one's records.

--Keep in mind that you're entitled to ask questions. If your loved one has OK'd it with his or her doctor, it's perfectly all right for you to call your care-receiver's physician, identify yourself, and find out what's happening now and what's being planned. In most cases, a physician will be very willing to discuss your loved one's condition with you. Of course, this is only with your care-receiver's permission.

--If your care-receiver is being seen by more than one doctor, you may need to plan a phone consultation with any specialists who are also treating him or her.

--Once your care-receiver has been admitted to the hospital, introduce yourself to the staff on the floor where he or she has been assigned. (This can be done over the phone if you don't live near him or her.) Find out what the typical daily schedule is on that floor so you'll know the best times to call or visit.

--Ask when your care-receiver's doctor makes rounds. Usually this is done early in the morning and again in the evening. These are the best times to see the doctor and ask questions. The doctor may have a great deal of important information to share, so much that a patient of any age can feel overwhelmed. It helps to have two people hearing that information and asking questions.

--If you or your loved one thinks of questions when the doctor is not around, jot them down so you'll remember to ask. And jot down the doctor's answers, too. Sometimes it may seem as if there are so many health-care professionals seeing your care-receiver that it's hard to remember who's who and who said what. Make a note of those things as well.

--Ask about social services at the hospital and if a visiting chaplain or extraordinary minister of the Eucharistic is available. Find out if the hospital has a chapel and visit it often. You'll find support there and the comfort you need.

--Make use of the discharge planner. Often this person is contacted through the social services department. He or she is usually a medical social worker or a care manager who coordinates the discharge of patients. The discharge planner looks at what is happening now -- based on information from doctors, nurses, occupational and physical therapists, and others -- and what will happen when your loved one goes back home or on to a nursing home or assisted-living facility.

The discharge planner is the one who lines up visiting nurses and therapists and has referral information about non-medical assistance, such as housekeeping. Patients are discharged sooner now than they were in the past and may need special instructions for continuing care at home. The discharge planner can arrange for the physical or occupational therapist to teach you about the devices your loved one may need. Watch for subtle, and not so subtle, pressure for you to accept more responsibility than you are able to handle.

He or she can also line up equipment for home use, perhaps through Medicare. Don't be shy about asking for items for your loved one; red tape and regulations can make it much more difficult and expensive to obtain that same equipment after he or she is back home.

--Meet with the discharge planner early, before you receive word that your loved one is going to be discharged. Often a patient is given less than 24 hours' notice of a discharge, and while it's going to be great to have your care-receiver back home again so soon, this may not be enough time to get everything set up so that the homecoming is a safe and successful one.