Your Senior Mom is in a NYC hospital, What Should You Do?

Mother in a NYC hospital Portrait of a mature woman comforting senior man while sitting on sofaFirst, let me extend my sympathies and encourage you to channel all your patience because this journey will most likely be a bumpy one.  Keep reminding yourself that it is not the staff’s fault for the inefficiencies, the patient to staff ratio, the terrible food, the lack of coordination among doctors, the waiting, the list is endless but it simply is the way it is.

Some NYC facilities (hospitals, emergency rooms, etc.) will be better than others and, hopefully, every healthcare professional you encounter is trying their level best to keep your senior parent safe and onto the road of recovery as quickly as possible.  The reality of the situation is you are not in a hotel, you are in a HOSPITAL.

There are three main ways your elderly mom could have been admitted into a NYC hospital: planned admission, direct admission or emergency room admission.

TYPES of Hospital Admissions

Planned Admission

Planned admission refers to a pre-planned, or “scheduled” in-hospital stay, after you and your doctor decide that you need hospital-based treatment.  Examples of planned admissions are scheduled child births (like a scheduled caesarian section), scheduled elective surgeries, etc.

If your admission was prescheduled, normally NYC hospitals will proactively reach out to you from the Admissions or Patient Services Department (or a similarly named department).  During that call, a hospital representative will ask you to provide personal and insurance information. Most likely they will also tell you what you should expect when you arrive, what to bring, where to go and answer any questions you might have.  This type of admission typically does not apply to seniors in NYC.

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Direct Admission

A senior in NYC can get directly admitted into a hospital without going to the emergency room when your elderly loved one is sent directly by their physician or primary care physician who has admitting privileges at the hospital.

Most NYC based hospitals have doctors who work for the hospital (i.e., employee of the hospital) and also have a private practice.  These physicians most likely have admitting privileges at the hospital they also work for.  Typically, if your physician or primary care provider admits you to the hospital, you should report to wherever they tell you to go.  Sometimes they will send you to the emergency room and other times they will send you to the information desk.  Every hospital in NYC is different so be sure to ask specifically to the admitting doctor where you elderly loved one should go.

Hopefully your admitting doctor will call the hospital ahead of time so they will be expecting you.  The doctor will provide the hospital with your medical information, reason for admitting and this should (in theory) speed up the process.

Worth noting is more often than not your admitting doctor (even if they are your primary care doctor) will NOT follow you in the hospital,.  The hospital employs doctors called “hospitalists” and they will follow you. On rare occasions the hospitalist might consult with your primary care physician or specialists but typically in NYC hospitals you will be seen by hospitalist and hospital specialists.  Upon discharge you will be told to follow up with your community doctor and specialist for follow up which we will discuss in more detail later.

This type of admission is an excellent example of why it is critical that your elderly parent has a primary care doctor with admitting privileges to a NYC hospital.  Your elderly parent’s doctor can circumvent the stress and drama otherwise known as an emergency room.

Emergency Admission

Emergency room admission occurs when life-threatening illness or injury requires an immediate hospital care.  Typically the admission decision is made by an emergency department doctor or a hospitalist and usually elderly patients are admitted.  If your doctors decide you should stay in the hospital after emergency care, we will admit you to the hospital as an in-patient.  You can be admitted to a specific floor (usually specializing in a department like intensive care unit or medical floor) or transferred to an observation unit.  On observation unit is NOT a hospital admission.  This is an important distinction if you are trying to gain admission to an acute or sub-acute facility.  Typically a NYC hospital will hold a patient in an observation unit for 24 hours to do what it says – observe the patient.

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A Deeper Look at Emergency Rooms

For the elderly, a hospitalization usually begins in the Emergency room.  Once the medical team decides that you need to stay in the hospital for one night (or more) you are admitted into the hospital.

Why are Emergency rooms so slow?

Usually if you are in the emergency room, you are waiting (sometimes more than 12 hours) because the emergency room is out of beds and/or treatment room.It is important to realize that emergency rooms do not see patients based on arrival time but based on seriousness of the condition they present with.  In NYC hospitals, it is not an uncommon sight to see gurneys lined up head to toe in the hallways of emergency rooms.  Further, you will see the emergency medical team treating patients in the hallways.  The few emergency rooms the hospital has are saved for true medical emergencies.  In emergency medicine the name of the game is triage:  they will assess who is able to wait and who isn’t.  Generally speaking if you not the sickest or the oldest, you wait so being in the NYC emergency room with your elderly parent does have an advantage as you will probably not wait as long.

Tip: If you have any control over when you go to the emergency rooms the busiest time starts around 6pm and continues until midnight.  Mondays and holidays are the worst days of the week and the mornings, early morning (3 am – 9am) are the slowest.

Preparation for the emergency room or NYC hospitalization

As a senior or a loved one to a senior, you can make life a little easier in the hospital by being prepared.  In the emergency room during thepre-admission process the information they will ask is always the same.  Demographic information (name, address, date of birth) are the obvious questions but beyond that you will needto know:

  • List of medications currently being taken, the dosages, how often they are taken and the reason for taking them
  • List of over the counter medication
  • List of doctors currently been treated by, last visit and reason why
  • Allergies to food and/or medication
  • Medical insurance information

Also, if your elderly parent is admitted you will want to bring a small bag with a change of clothes and personal items like tooth brush, comb, etc.  Also, if your parent wants their cell phone bring a charger!