Of the people annually admitted
to hospitals, a large proportion
consists of older patients
with declining health due to
concurrent chronic, often debilitating,
diseases.
These patients are referred to as ‘frail’ elders.
Researchers in Sweden have found that although frail elders are extremely fragile and vulnerable, they have clear views about what makes for a good hospital experience. And – just like any other patient – they do expect to be treated by doctors and nurses in a certain way.
So, what are their wishes and expectations? Dr. Anne Ekdahl, of Linkoping University, Norrkoping, and colleagues asked the elders themselves. In a study, published November 30, 2009, in Patients Education and Counseling, they looked at the preferences of 15 hospitalized elders aged 75 to 96 with three or more medical conditions, and who had already been in hospital at least three times in the previous year.
Here is what they found.
• The elders felt it was very important to be kept informed about their condition, planned treatments, and tests results. Staff should proactively provide such information without waiting for the patient to ask, as some are too ill, tired, confused, or in too much pain to do so. Participants in the study were particularly dissatisfied with this aspect of care. One said: “It should be a natural thing that patients are informed without having to ask — that they sit down and tell me what they have done; what they had found.”
• Also important was to have a nurse or doctor explaining what was going to happen during a medical procedure. The elders wished to understand what was happening to them.
• They wanted staff to take some time to sit down with them, and listen to how they felt and what they thought about their illness.
• They had trouble dealing with continually changing doctors often giving different advice. In some cases, this occurred several times in the same day. “This,” say the researchers, “made it difficult for the patient to feel confident in treatment strategies and to follow the thoughts and plans made by the doctors.”
• Several elders also mentioned the problem of staff members speaking with a foreign accent, which they couldn’t understand, and of stressed personnel.
These findings are of particular importance. Knowing how frail elders wish to be treated helps meet their needs, allows for better treatment choices, and increases the likelihood of patients following the doctor’s instructions. All of which results in improved quality of care and higher chances of a full recovery.