If you’re a family caregiver and feel something isn’t quite right and have questions about your loved one’s medical care, you can and should speak up and ask questions. This is especially important if the person you care for has dementia or doesn’t always communicate directly with their health care providers on their own.
In a survey of people with Medicare, one in four people who had been hospitalized (25%) reported being harmed – and 43% of those harms were preventable. The most common harms are due to medication errors, hospital-acquired infections, misdiagnoses, falls, and bedsores from not being moved enough.
Reducing harm in health care settings is part of what we call “age-friendly” care, or care that’s evidence-based and prioritizes what matters most to older adults and their family caregivers. Hospitals, medical practices, nursing homes, and other organizations that take part in the Age-Friendly Health Systems initiative focus specifically on reducing harms. But as we all know, hospitals and health systems can’t provide care in a vacuum. They need the support of the whole caregiving team – including family caregivers – to provide the best care possible for older adults.
What Caregivers Can Do
If you’re taking care of an older adult, take these steps to help ensure their safety.
Be on the lookout for medication problems.
Medication problems in older adults can happen for many reasons, including fragmentation of care, meaning multiple health care professionals providing care that isn’t well communicated or organized. That fragmentation may lead to duplicating medications or prescribing medications that dangerously interact with each other. In fact, as many as 750 older adults are hospitalized daily in the United States due to complications from one or more medications. To best protect against medication problems, family caregivers can join the office visit and give the provider:
- A list of all medications being taken at home, including supplements
- Any new medications being prescribed by all health care providers; for example, optometrists, podiatrists, and nurse practitioners
- Information about any allergies or known reactions to drugs.
- Your questions about potential side effects and symptoms to look for
Be alert to the potential for diagnostic errors.
Older adults are misdiagnosed more often than younger people due to the complexities of caring for their range of conditions. To avoid overdiagnosis, where someone is treated for a condition they don’t have, or underdiagnosis, where a person isn’t treated for a condition they do have, family caregivers can:
- Make sure the entire care team understands an older adult’s current symptoms and full medical history.
- Review the older adult’s electronic health records to ensure the information is accurate (especially important as one in five patients had incorrect information in their medical records, according to a recent study).
- Speak up when you think there’s a problem.
Seek help when using medical devices.
Family caregivers often carry out complex medical tasks to support the person they care for. They may need to use complicated or intimidating medical devices to complete those tasks, like feeding tubes or oxygen tanks, without formal training or supervision. To best protect against medical device errors, family caregivers can:
- Seek resources like these videos on proper medical device use.
- Ask a member of the care team to demonstrate proper use.
Family caregivers know the people they care for better than almost anyone else. While ensuring patient safety ultimately rests with health care providers, family caregivers’ opinions and knowledge can help prevent mistakes and ensure age-friendly care. Every caregiver should speak up when something does not seem right, and health care providers should encourage caregivers to contribute their insights to paint the fullest, most accurate picture of the older person’s health.
Ultimately, supporting family caregivers by ensuring that medical staff treats them as valuable members of the care team – training them to use medical devices properly and bringing in professional help when they need a break – helps increase safety and reduce harm.
For more resources on age-friendly care, visit johnahartford.org/agefriendly.
(A version of this article, by Terry Fulmer, PhD, RN, FAAN, president of The John A. Hartford Foundation, originally appeared on Next Avenue.)
Show Sources
Photo Credit: E+/Getty Images
SOURCES:
Office of Inspector General: “Adverse Events in Hospitals: A Quarter of Medicare Patients Experienced Harm in October 2018.”
Lown Institute: “Medication overload and older Americans.”
Society to Improve Diagnosis in Medicine: “How Seniors Can Avoid Misdiagnosis.”
JAMA Network Open: “Frequency and Types of Patient-Reported Errors in Electronic Health Record Ambulatory Care Notes.”
