If You Are Hospitalized During the State of Emergency

by Janet Simpson Benvenuti

The COVID-19 virus has upended all of our lives, none more so than infected family members who need hospitalization. Recently, I asked attorney Alexis Levitt if I could circulate her advice to clients about being hospitalized during this state of emergency. As you know, visitors are not allowed to accompany patients into hospital settings.

Here are her suggestions in how to prepare for that possibility. I’ve added a couple of notations in italics and wrote a separate post about how I prepared my family. As we know, it’s not sufficient to follow this advice; we also need to talk with our family, especially our healthcare agent and financial power of attorney.

From Attorney Levitt,

I hope you are all staying home (unless you are an essential worker). I want to share some important points to keep in mind if you are hospitalized during the state of emergency. These apply whether you are hospitalized for COVID-19 specifically, or for any other reason.

1. Keep your Health Care Proxy, HIPAA Statement, and Medication List at your fingertips.

(a) If you are a client of ours, then we enrolled you in DocuBank. Take five minutes now to update your medication list. (Really. Five minutes. I updated mine recently, it was very easy.) If you do not use DocuBank, print out hard copies and put them into a plastic sleeve or envelope.

(b) Keep copies on your phone. You can save the documents to your Google Drive, you can simply keep them attached to an email, whatever you like, so long as they are accessible to you on your phone.

(c) Keep copies on the back of your front door or on your refrigerator. Many first responders will look in these places for emergency medical papers.

2. Advocate to be coded as “inpatient” rather than “under observation.” If you are in the hospital and then transferred to a rehab, how you were coded at the hospital will make a big difference in payment source for the rehab stay.

3. If you are transferred to rehab and told that you will be paying privately, call us (your attorney). Under the State of Emergency, some of the usual coverage triggers for payment for rehab have changed. Nursing home billing offices could be – quite understandably – overwhelmed and perhaps not updated on the temporary changes. We can help.

4. Call us (your attorney) if you need a guardianship or conservatorship. For anyone who has not signed a health care proxy or a power of attorney, the hospital (or rehab) may tell you that you need a guardian or conservator. This is a court proceeding handled by an attorney.

(a) It’s possible that the hospital or rehab attorney will handle the guardianship and/or conservatorship for you, for free. If that is the case, be sure to check in with them as to who they are naming to act as the guardian or conservator, and, if you are not happy with their choice, advocate for naming someone you prefer.

(b) If the hospital or rehab tells you that you need to find your own attorney (or if you are not comfortable using their attorney), then please call our office. This is something that we can handle for you.

Reprinted with permission.

Healthcare Advocates: The Campaign for Better Care

by Jan Simpson

I felt uncomfortable the first time I sat in on my parents’ medical appointment with their family physician instead of waiting in the reception area. The doctor greeted my parents warmly and shook my hand before he sat behind his desk. My father joked, “We brought our mother with us today.”

For decades, my parents’ primary care physician had managed their care, coordinating testing, surgeries, and specialists as their ailments became more severe. Our family had confidence in his medical knowledge and my parents shared that confidence. Yet when my parents were 78 and 77, our family assumed a greater role in their care. When my father was too ill to drive my mother to her medical appointments, a sibling or I did so, sitting next to her and taking notes so she could follow her physician’s guidance at home. After a prescribed drug caused my father to hallucinate, I attended his next appointment to advocate for a change in the medication. My siblings and I visited during hospital stays and used those visits to seek advice from physicians, nurses, social workers, and other health care providers at every encounter. We learned about the progression of our parents’ ailments and we tried to anticipate their needs. Above all, we tried to maintain their strength and vitality through good nutrition, mobility, and the simple joy of being surrounded by loving grandchildren.

Dr. Madeleine Biondolillo recently wrote an oped article in the Boston Globe, “A Deadly Information Gap.” She describes the chilling experience of her 84-year-old mother’s recent brush with death caused by a lack of communication among physicians, noting that “hospital doctors often don’t communicate with office doctors, leaving the patient to fend for herself, just when most vulnerable.” She continues “my mother survived her near fatal illness because she had knowledgeable, relentless insiders to advocate and communicate for her.”

And that was a surprise?

Hospitals can be minefields for elders, yet you don’t have to be a physician to get competent care for your older loved one. The challenge isn’t the hospital care they receive, it’s of being left alone to navigate the system. Would you leave your young child alone in the hospital to communicate with the physicians? Would you expect him or her to track medications, understand the diagnoses, remember the details of the last visit with the pediatrician? Why would you expect an ill elderly parent to coordinate care with specialists and their primary care physician? And why would you expect health care as delivered today to be coordinated?

Not long ago I participated in a focus group organized by the Campaign for Better Care, an effort led by the National Partnership for Women & Families. Calling themselves ‘lobbyists for the patients,’ they are pressing for legislation to improve the way health care is delivered. I applaud their effort, yet my father had it right. All elders need a “mother,” a tireless advocate who will pay attention to their care.

Does your parent or older loved one have a health care advocate? If that advocate is you, have you experienced what Dr. Biondolillo described?

©2011 Circle of Life Partners™