Give home care agency a list of medical history

After a successful stay at a rehabilitation hospital - the latest stop in a medical saga that had lasted nearly six weeks and had also involved two hospital visits as well as time in a skilled nursing facility - Joan was grateful to be back home. She had made a lot of progress, but she was still weak and needed help with both medical issues and non-medical ones such as bathing.

Mountain Valley Rehab an option for complex cases

Last week's column de-scribed inpatient rehabilitation facilities, IRFs, also called rehabilitation hospitals. These facilities treat patients with severe problems typically following a hospital stay for a major illness, injury or surgery with complicating factors. Mountain Valley Regional Rehabilitation Hospital in Prescott Valley (, with 40 beds, is the only freestanding IRF in north central Arizona.

Rehab hospital an option after serious illness or injury

About seven weeks after Joan had a medical procedure followed by a variety of complications, she was once again preparing to leave the hospital. Experience had shown that a skilled nursing facility wasn't necessarily going to be able to meet her very extensive needs. But where else could she go? To get the care she needed, Joan was sent to a rehabilitation hospital.

Clarify expectations for short-term rehab stays

A typical stay in a non-hospital short-term rehabilitation facility is three or four weeks. It helps to know what to expect during that time. One significant issue that is important to understand early in your stay concerns how long you can remain there. Facilities certified by Medicare typically follow Medicare rules regarding when to discharge you. Even if you have private insurance and are not relying on Medicare, other insurance programs often follow Medicare's lead on this point.

Find the right short-term rehab facility for your needs

Last week's column described life-threatening issues that one patient, Joan, experienced in a short-term rehabilitation facility.

How can you select a short-term non-hospital rehabilitation facility to get better results? In the hospital, discharge planners will provide a list of all licensed facilities in the area. Typically, they are not permitted to steer you towards or away from any specific site, so you will need to get more information.

Act quickly if care facility doesn't meet your needs

Joan had a bad experience at a short-term rehabilitation facility that I will call by the fictitious name Sandalwood. Shortly after Joan arrived, the facility's doctor implied that it would cost Sandalwood more to take care of her than he had expected. He seemed annoyed about this issue. The rest of Joan's stay reflected a similar lack of focus on helping her recover.

Don't leave the hospital before you're ready

Joan was settled into the intensive care unit (ICU) after she had emergency surgery to deal with a staph infection in her knee. She was also being treated aggressively for the sepsis that had developed, since it can easily progress to septic shock and lead to death.

Many days later, she was transferred to a regular hospital room. She was still very sick, though, and soon she was startled to be told, "You can't stay in the hospital. You've got to go to a nursing home."

Get help fast if problems arise after treatment

Joan, 68, got an injection to treat knee pain due to osteoarthritis. She had gotten such injections in the past, and the experience hadn't made much of an impression on her. This time was different. Nine days later, she landed in the emergency room because her knee now hurt so much that the pain was unbearable. They sent her home, saying that it was just a reaction to the shot.

The next day, she went to see her doctor, saying, "I can't take this pain anymore." It was Friday, and he told her to wait and see if the knee calmed down over the weekend.

Useful strategies help prevent accidental falls

Have you ever fallen? If so, and if you are age 65-plus, you have plenty of company. The typical adult aged 65 or older has a one-in-three chance of falling in any given year. Roughly one fall out of four results in a serious problem such as a hip fracture or a head injury.

Avoid being snared by the most common medical error

What would you guess is the most common mistake doctors make? Operating on the wrong arm or leg? Prescribing the wrong drug because they mix up two drugs with similar names? Accidentally nicking one organ while operating on another?

No, no and no.

The most common medical error, according to a recent study, is misdiagnosis. Researchers came to this conclusion by studying more than 350,000 medical malpractice cases in the U.S. that patients won, spanning 25 years.


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