Hospitals, are you elderly-friendly?

Visiting hospitals when sick is a challenge in itself. Booking an appointment, travelling to the hospital, the waiting hours, communicating the problems faced and coming back home with medicines can easily take a day. It is much more challenging when the patient is really old. Undergoing the above process itself can make them weaker, both physically and mentally.

Here, I will share my experiences of taking old people to hospitals. A few things I wish the doctors I met were aware of and about how some doctors helped me.

I have been taking old people in my family to a lot of hospitals in Trichy, India. While some hospitals were really elderly-friendly, I can confidently say some hospitals know nothing about the needs of old people. Or they don’t care.

It starts with how hospitals take appointments. Here are the different ways hospitals responded when I called them for appointments for very old people (80+) who can not sit and wait for long:

We do not take appointments. Those who come first will be served first. If the patient can not wait, someone else come and wait in the queue and right before your turn comes, get the patient from home.

Equality is not justice. This has a lot of logistical difficulties and thus not always a feasible solution.

We will take this as a special appointment. Pay us double.

Hmmm, I’m not really sure how many people can afford this.

If you can not wait for long, please go to emergency ward anytime. Doctor will see immediately and will cost 10x more.

People, when it is not an emergency, kindly stop even suggesting this. This is the worst thing to tell.

We will book the appointment.

And the hospital has a board that calls out,

Senior and very senior citizens will be given preference. Everyone kindly cooperate. Thank you.

This really made my day. I ❤ you people.

The basic expectation while getting very old people to hospital is, do not make them wait for long. Give them preference. Understand their difficulties. They are special.

There are a few basic things a hospital need to do to qualify to be elderly-friendly:

1. Appointments should be taken in prior and hospitals should try their best to stick to the times. If the doctor is late for hours together due to some reasons, patients should be informed. Very old people like other people can not go back to their home and come again later easily. It is a challenge for them to step out of the home once itself and let us not talk about twice or above.
2. Wheel chair support is a must. This is very basic and still some hospitals don’t have it.
3. Having steps in the entrance of hospital is a terrible design. A slope in which a wheel chair can be used is a lot better. It is not right to assume patients can climb as the number of steps is just 2/3.
4. In the waiting area, a sleeping desk is a must. Even well developed hospitals lack this. Some patients are not fit enough to sit and wait and trust me, sleeping desk is the first thing they look for.
5. Old people’s bodies are as tender as new born babies. They are to be handled with a lot of care while taking scans/X-rays/ECG, etc.
6. A portable toilet available at all time is very helpful.

These are all really small things. I believe that with a little effort, every hospital can provide all of these.

Relationship with the doctor

The way the doctor communicates is the most vital part of the overall hospital experience. I’m not sure if all the doctors take the necessary training to communicate things clearly. A doctor once told me that some doctors skip that training and I think I ended up meeting some of them.

Being alive and healthy after 80 years is a blessing. Yet when someone above 80 years falls ill and we take them to hospital, we are genuinely looking for a solution. There can be cases when the patient can not be treated because of the age. They may even be in the last stages of their life. Communicating this in a proper way is really crucial both for the patient and the family.

Some patients can be mentally strong enough to understand the situation and some may not. It is the duty of the doctor to understand the type of patient and behave accordingly.

Patients however old might still want to live. Their families might still want them to be around. So it is unfair to signal anything like it is okay to die because they crossed some age. When there is a life threatening situation, why speak in a way that derails the patient’s or the family’s confidence and add more problems? The point is not to sugar coat everything. But to not over exaggerate or speak like the person’s life no more matters.

When there is a major health issues, deciding treatment for old people is much more complex than choosing for normal aged people. The complexity is due to the age, physical strength, mental strength and the very fact that the person might have lost the ability to decide for oneself and a lot of other people in the family will have to come to a common conclusion. In these situations, relationship with the doctor is very important. Doctors who always helped me in such complex situations did these:

• When there was no emergency, they began the conversation stating that there is nothing to fear of.
• They always explained what is happening in the patient’s body.
• They acted like consultants; gave a list of solutions for a problem and guided us in choosing what is right for the patient.
• They shared a bond with the patient. Understood their mindset and spoke accordingly.
• They understood the difficulty in choosing an option and how much ever questioned, answered patiently.
• They offered their best support for any decision taken.

These doctors are what the world needs more of. You people rock!

Final thoughts

There definitely should be protocols to be followed while building hospitals that make it elderly-friendly. I sincerely hope hospitals adhere to those rules and build accordingly.

Life will be far easier in difficult situations if doctors can communicate clearly and do not hurt/scare those who come to them. To those doctors who help in thinking through and making a choice, a big thanks!

Last but not the least,

Doctors, you mean a lot to old people. You are their ray of hope, confidence and support. They do not google. They only ask you and trust you completely :)