EMS Ambulance 21 Apr 2022
Multidisciplinary care for elderly patients: why it’s better to go home for treatment
Although we don’t like contemplate it, at some point in life many of us will see an elderly parent or relative go through a health crisis.
That’s a hard enough experience when they’re based nearby. But if they’re living or holidaying in a foreign country, the difficulties and dilemmas involved can be extremely challenging.
A typical scenario – one we often see here at EMS Ambulance – goes something like this. A customer in England receives a call from his elderly mother in Spain. She has just suffered a bad fall at home; although she’s now in the care of local doctors, they say she has fractured her femur and will need a hip replacement. So now the son is wondering what to do next. Does he encourage her to have the surgery abroad? Or should he bring her home for treatment?
The answer in many cases – perhaps even most – is that it’s better to repatriate an elderly or frail patient so they can benefit from multidisciplinary care, in a hospital or clinic that’s close to their loved ones.
This needs a little unpacking, so here’s the reasoning:
What is “multidisciplinary care”?
It’s a healthcare approach which says patients get a better outcome when they’re treated by an integrated team of specialists. An 85-year-old patient who needs hip surgery, for example, would see a range of consultants and carers before her operation goes ahead – a geriatric specialist, an expert in general surgery, a physiotherapist, and so on. This “team” of experts would have an eye on her full treatment journey, from pre-op preparation to rehab and recovery. Although integrated care is becoming more common in private European hospitals, it’s not always readily available abroad.
What does the science say about multidisciplinary care?
A growing number of studies have found it leads to better outcomes for patients. One 2020 meta-analysis, for example, estimated that eighty percent of older people who undergo surgery develop postoperative delirium (POD) afterwards, a condition that can cause confusion, memory loss, or deteriorating mental function (such as being unable to wash or get dressed). The researchers concluded that “there is a need to implement multidisciplinary interventions, as well as collaboration between clinicians… to more effectively reduce and manage” the condition in these patients.
Another 2018 study carried out research into elderly patients who needed abdominal surgery. It found patients who received “coordinated interdisciplinary [care]” around the time of their operations experienced “shorter lengths of [hospital] stay, had lower readmission rates at 7 days and 30 days, and were more likely to be discharged home with self-care, while experiencing fewer mean number of complications…”
Why else should elderly patients consider going home for treatment?
Getting back home for medical treatment isn’t just about the surgery. Operations – however important – are only one part of a larger journey towards better onward health.
- Rehab High-quality aftercare – particularly physiotherapy and a well-planned exercise programme – makes a huge difference to post-surgery recovery for geriatric patients. These things don’t always happen automatically. They need to be carefully and sensitively coordinated by medics across different disciplines, and will likely involve a number of trips between home and hospitals
- Onward care Post-surgery, there will be a lot of questions to answer. How is the patient recovering? Are the doctors taking sufficient care of her? Have any other medical issues arisen since the original diagnosis? More seriously: will the patient be able to cope at home on their own, or should you be contemplating live-in care or even support within a residential home? Judging these decisions correctly is extremely difficult if they’re several thousand miles away
- Closer to family Ultimately, sick patients are almost always better off being near their loved ones. This isn’t just about human contact (as vital as that is). Family members can also fill in the gaps between clinical care: bringing supplies to hospital, offering help around the home, coordinating lifts and chasing follow-up appointments, and so on. The road to recovery may be tough for many elderly patients – but it’s always better travelled with a loved one alongside.
For further reading: 5 times when it’s better to repatriate a sick patient
Do you need any help or advice about repatriating an elderly family member? We appreciate how confusing the whole process can feel! Just drop our experts a line any time, day or night, and they’ll be happy to answer your questions. You can get in touch with us by phone, email or WhatsApp.
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