|Written by Amy S. Griggs
Trips to the hospital for any reason during this time of rampant COVID-19 spread are extremely stressful, but there are steps to take before seeking medical care to be sure your family is as prepared as possible. These tips can be applied under any circumstances, but they become more important as the country faces rapid increases in illness and hospitalizations. It is particularly critical to look out for the elderly and vulnerable populations and find ways to help and set their minds at ease. Taking actionable steps like those listed below can help to ease anxiety.
Select a family member, friend, caregiver, professional health advisor to be your primary contact person. Choose someone who is assertive and comfortable speaking with healthcare providers and someone whom you trust with your confidential health information. Your Patient Advocate should be someone with the organizational skills to assist with notes, paperwork, insurance forms, etc. This should be someone nearby and able to take you to appointments and for treatment. This should also be someone in a lower-risk category than the patient.
Gather your medical history and medical records in a secure electronic format. Have a list of preexisting or underlying health conditions available for your doctor. Make sure the Patient Advocate knows the medical conditions for which the patient is under active, current treatment and monitoring. Have a list of critical dates like recent surgeries or hospitalizations. Have a list of your current providers: internist, cardiologist, neurologist, etc. Know your blood type.
Be ready to describe your current symptoms, time of onset, and details quickly. Have a list of medications you are taking, doses, brand/generic, and a list of medication allergies. Have a contact list ready for family member, work or other important contacts. Have a copy of your identification (i.e. driver’s license) and insurance cards.
Know your medical directives, power of attorney, and religious preferences. For your Patient Advocate to be effective in the event of a hospital visit, have a medical Power of Attorney and a signed HIPAA authorization allowing the Advocate to speak with the medical providers on the patient’s behalf. This may not be required for a spouse to get basic medical information after a surgery or during hospitalization, but it is something to consider otherwise.
Have a copy of all Medicare and Medicaid information and know what is covered. Have a copy of all insurance cards to provide at the hospital and to leave with the Patient Advocate. Know the general insurance plans available and whether pre-authorizations for treatment are required, as well as general deductible information.
Research where to get testing and treatment. Arrange transportation. You will likely have to go into the hospital alone without an attendant, which is a very disconcerting event for most people and is something to discuss in advance. Check the hospital’s website for those restrictions and any possible exclusions (ex. parent may attend a minor).
Pack a to-go bag with must-have medications, a change of clothes, eye-glasses, cell-phone and charger, basic toiletries like a toothbrush/toothpaste, important phone numbers, and any other critical items from your health/medical history list. Take your to-go bag even if you are unsure whether you will be admitted to the hospital.
Either you or your Patient Advocate should document as much information as possible about the interactions with health care providers and the treatment. Take notes about health care provider names (i.e. which doctors, nurses, specialists are seeing you). Take notes about as much of the conversations with health care providers as possible, noting the date/time of each interaction. If the Patient Advocate can accompany the patient, try to be present during physician rounds each morning for the best access to providers; if the patient is alone in the hospital, the Patient Advocate should try to listen to doctor check-ins in by phone. Physician rounds are likely to occur very early in the morning or at shift change, so be prepared.
The Patient Advocate should confirm the telephone number for the nurse’s station nearest the patient room and call for updates if the patient is unable to be a reliable historian. The Patient Advocate should call the patient to stay in touch as much as possible. Send photos back and forth to monitor the patient and to help cheer up the patient.
Write down any instructions. Ask questions about dosing instructions for medications. Confirm all health information is accurately conveyed, especially if the patient is medicated and not a reliable source. Confirm side-effects for medications or treatments. Make sure the Patient Advocate’s contact information is stored in the patient’s chart, or on the white-board in the room. Monitor food intake and know what is permitted in terms of food. Monitor mobility restrictions. Ask what the “treatment goals” are to monitor benchmarks and discharge date.
Confirm health preferences are respected like use of ventilator, feeding tube, do-not-resuscitate order (DNR), if in place.
If needed, the advocate can ask the nurse for help. If additional resources are needed at the hospital, a charge nurse can be a point person, or a patient resource nurse within the hospital system. Ask what resources are available at the hospital.
At discharge, the Patient Advocate can coordinate follow-up care and will be a vital resource to help the patient moving forward during recovery. Ask for the warning signs, symptoms, drug reactions to watch out for and know when to call the doctor or go to the emergency room. Update all medication lists and relevant health history after the hospitalization. Note any medical instructions and numbers to call for test results. Confirm the purpose for each new medication, dosage frequency and duration. Schedule future treatment and therapies. If needed, research new providers and referrals. Obtain additional referrals, if needed. Request and obtain copies of medical records for each medical visit, treatment or hospitalization.