Effective Communication is Key in Geriatric Care

A recent presentation highlighted the critical importance of communication during the discharge process in geriatric care. The challenges associated with discharge management often lead to complications in patient treatment, as illustrated by a case presented by a hospital pharmacist from St. Johannes Hospital in Dortmund.

The case involved an 86-year-old female patient who faced numerous medication-related issues, including polypharmacy, adverse drug interactions, and significant fall risks. After an initial hospitalization due to a fall, where she sustained a nasal fracture and pelvic bruising, the pharmacist was able to optimize her medication regimen by discontinuing seven out of eighteen prescribed medications.

Despite the positive adjustments during her hospital stay, the patient was readmitted just four months later. This unfortunate development underscores a severe communication breakdown: her updated medication plan failed to reach her primary care physician, resulting in the reinstatement of her previous, potentially harmful regimen.

The pharmacist emphasized the need for healthcare providers to actively follow up with patients post-discharge to verify that medication plans have been properly implemented. She urged pharmacists to conduct medication reviews, particularly for elderly patients, to prevent similar occurrences.

In this particular case, the patient was previously managing a complex medication schedule that included 21 active ingredients taken at five different times throughout the day, all organized by a home care nurse. Her prior medical history included a range of diagnoses such as hypertension, type 2 diabetes, coronary artery disease, and osteoporosis, all contributing to her frail condition.

The assessment revealed multiple issues, including low sodium levels and impaired renal function, alongside a high risk for falls. The pharmacist's efforts to streamline her medication regimen during hospitalization were commendable; however, the lack of coordination with her outpatient care providers ultimately undermined these efforts.

This scenario illustrates the pressing need for improved communication across various healthcare sectors to ensure that patients receive the appropriate care after leaving the hospital. As the pharmacist prepared for a forthcoming conference where she and her colleagues would present new standards for admission and discharge processes, the case served as a poignant reminder of the real implications of communication failures in patient care.