The Insiders as Outsiders: Professionals Caring for an Aging Parent

Area of Science:

• Geriatric Medicine
• Social Work
• Healthcare Systems Analysis

Background:

• Aging parents with neurocognitive disorder and multiple conditions present unique care challenges.
• Repeated problematic healthcare encounters highlight systemic issues in geriatric care.
• Effective care requires understanding the patient's medical, psychological, functional status, social support, and goals of care.

Purpose of the Study:

• To recount experiences of a hospitalization for a 90-year-old parent with neurocognitive disorder.
• To identify and address recurring obstacles in healthcare system interactions.
• To propose solutions for improving care for elderly patients and their families.

Main Methods:

• Personal narrative of a hospitalization experience.
• Application of geriatric medicine and social work expertise.
• Identification of system failures and successful interventions by family caregivers.

Main Results:

• Major medical errors were identified and corrected, including missed follow-ups, medication errors, undertreated pain, poor fall prevention, and inappropriate rehabilitation placement.
• The family acted as a critical fail-safe mechanism within a dysfunctional healthcare system.
• Active caregiver presence, engagement, and vigilance were crucial for patient safety.

Conclusions:

• Patient and family-centered care, especially dementia-sensitive approaches, is vital.
• Improved communication, information management, and streamlined processes are necessary.
• Systemic changes in reimbursement, regulation, discharge planning, and placement are recommended to support geriatric patients and their families.