Planning For Hospitalization During COVID-19

Planning for hospitalization is something we do continuously, especially with our most vulnerable clients — those that are older, living without family members close by, or living with multiple, chronic conditions and/or alone.

But COVID-19 has exacerbated an already difficult situation: First, because those who are ill must now enter the hospital alone, without a family member or healthcare advocate by their side.

In addition, and due to potential overcrowding at some hospital Emergency Departments, we can no longer assume that emergency personnel will transport us to a facility that we know or that has easy access to our medical records.

As a result, different steps must be taken in order to facilitate communication and allay some of the anxiety and fear we hear from our clients.

(For more information on Covid-19, check out this blog post .)

The “Grab-n-Go Kit”

When entering a hospital, it’s important to share as much information as possible with medical professionals regarding both health status and how physically active one was before they became sick.

But, if you arrive alone without someone to assist in this communication and/or at a hospital that does not have immediate access to your medical records, the medical staff is at a disadvantage.

The Grab-n-Go Kit is intended to close this gap.

Simply put, it’s a packet of information — preassembled and ready to go at a moment’s notice — that contains the vital details emergency room staff will need. It need not be fancy or perfect. It is simply a start for EMT’s evaluating and treating in the home and for emergency personnel treating in an Emergency Room.

Contents of a Grab-n-Go Kit

Ideally, the contents are kept in a plastic sleeve, hung in a visible place, such as a refrigerator or a cabinet. They contain the following:

• “Face Sheet” with:
• Name, address, phone number, date of birth, allergies
• Emergency contact with name, phone number, email and text information
• “What you should know about Sam or Mary” (explained below)
• Medication list, both prescribed and over the counter, including dosage and how often taken (more details here)
• Medical Conditions, Past Surgeries, Past Hospitalizations (more details here)
• Copy of front and back of insurance cards
• Signed HIPAA release forms, authorizing someone to speak on behalf of the person
• Healthcare proxy, executed and witnessed
• Healthcare advance directive
• MOLST / POLST forms, if available
• Power of Attorney

If you do not have current access to Patient Portals for you and your loved ones, now is the time to set them up. In addition to their many communication benefits, these are a convenient way to access your list of Medications, Allergies, and Medical Conditions. Just print them and add them to your Grab-n-Go Kit.

In addition, you may want to prepare a small overnight bag, cell phone with charger, 24 hours’ worth of needed medications, hearing aid case, glasses, notebook and pen, and a few toiletries.

(for more tips on coping with COVID-19, check out this blog .)

“What you should know about Sam or Mary”

This is simply a short note that includes specifics that are important for emergency and hospital personnel to know. For example:

• Mary has Parkinson’s disease and needs her medicine every 2–2½ hours or she will not be able to move. Her Sinemet is in her bag. She walks long distances with a rolling walker.
• Please follow hip precautions for Sam, for a frequently dislocated left hip. He is not to bend at the hip past 90 degrees, twist his leg in or out, or cross his legs. He uses a cane to walk.
• Jane is extremely hard of hearing and must have her hearing aids in to hear you. Otherwise, please stand directly in front of her when you speak to allow her to read your lips. She does not have cognitive issues. She walks three miles, unassisted, every day.

Communication with Hospital Personnel

If a loved one is hospitalized, it is important to develop the best telephonic relationships you can with all appropriate caregivers. Ideally, this is done in person. But it’s possible to do it and do it well over the phone, provided you are organized, supportive and kind in your approach.

Call the emergency department about half an hour after your loved one leaves the home and say something like:

Hi, my name is Dianne and I am Mary Smith’s daughter. May I speak to the nurse caring for my mother?

Thank you so much for taking my call as I am sure you are incredibly, busy.

I am calling to check in on my mom’s status, but primarily to let you know I am her emergency contact and to share my contact information with you so you can keep me informed. I sent it with her in a Grab-n-Go Kit, but I want to be sure you have it. Is this a good time for an update or should I call back a little later?

To whom am I speaking? The best phone number for me is 978-555-5555. You can text or call me at that number.

You may need to do this numerous times and through multiple shift changes. I usually start with the nurse and ask who the responsible physician is. When appropriate, I ask if I might speak to her/him.

If your loved one is transferred to an In-Patient Unit, or an Intensive Care Unit, you have to “relationship build” all over again.

You may need to email or fax the documents that you sent in the Grab-n-Go Kit, so be sure to have easily accessible copies of your own.

(For more information on COVID-19 hospitalizations, check out this blog .)

Final Thoughts

Whew, I know. It’s a lot!

But there is much to be thankful for as well. In the face of this pandemic, so many hospital-based professional caregivers have stepped up beautifully to also fulfill the role of being a “loved one/family member.” Further, they recognize the strain being placed on the people left behind and understand the frustration of not being there in person to offer support and to get first-hand information.

I have heard incredible stories about creative ways hospital personnel are using technology to bridge the gap. As a former nurse myself, I know that they will do all they can to keep family and loved ones on the outside informed and ever-present.

Your efforts to work together, even from afar, will result in the best experience you can have in the face of this very difficult time.

(For more information on advocacy changes due to COVID-19, check out this blog .)