The A.M. Post

Joanie planned her own 82^nd birthday party: her favorite breakfast place would accommodate all 27 members of the family. She bought two kinds of cupcakes, picked up a plant for each family to take home afterward, and told everyone that it was a “no gifts allowed” occasion. At the party she addressed her gathered family about the importance of family and how much she loved spending time with them. With a dry sense of humor, her jokes drew laughter from both her gathered family and neighboring tables.

The following day she felt dizzy and weak, her heartbeat was rapid, and she was having trouble maintaining the thread in conversations. Her daughter called her doctor who suggested she go to the Emergency Room (ER) to have it checked out because he couldn’t get her in right away. After 10 hours of sitting in the waiting room Joanie and her family were finally taken into an exam room. Joanie was eventually admitted to the hospital due to unexplained dehydration which caused a urinary tract infection and kidney stones, all treatable at home.

Joanie’s experience is not unusual. Across Minnesota, seniors wait in ERs experiencing symptoms that may or may not require emergency room care because they are unable to get timely doctor appointments for health issues that arise. They wait in an overcrowded ER for hours — sometimes more than a day — when in many cases it isn’t necessary for the issue they are experiencing.

Using the ER as the default to fill gaps when seniors can’t be seen quickly by their own doctors has other consequences as well. Physically, the toll from interrupted sleep, not moving around and in many cases not eating on your regular routine can be steep. These under acknowledged costs of care are among the many reasons so many leading organizations have started developing  in-home urgent care and hospital at home programs.

Many seniors decline mentally or physically in the hospital, even if they recover from the original illness or injury that brought them there. Research shows that one-third of clients over 70 years old, and more than half of those over 85, leave the hospital more disabled than when they arrived. As a result, many seniors are unable to care for themselves after discharge and need help with daily activities such as bathing, dressing, or even walking.

What if Joanie had been able to stay in the comfort of her own home and the urgent care services came to her?

Urgent health issues do not always require hospitalization or a trip to the ER. In fact, in many cases ERs are an unnecessary layer of complexity for an issue that can be easily treated in the comfort of one’s own home.

The key Dr. Nick Schneeman, Chief Medical Officer at Lifespark, points out is not ER avoidance but addressing urgent needs at home where a senior is most comfortable to avoid long wait times and high costs, and exposure to bacteria, viruses, and overtreatment. Seniors especially benefit from the focused attention at home and even more when the urgent response team is integrated with their primary care.

“Interest in the hospital-at-home model has been taking off,” says Bruce Leff, a geriatrician and professor of medicine at the Johns Hopkins University School of Medicine. “People are starting to see it as part of the bigger solution for overcrowded hospitals, capacity issues, the cost of care, and improving outcomes.” The growing availability of sophisticated technology has been a driving force, too.

A study published in January by researchers at Mass General Brigham showed that for almost 5,900 seniors across the country, who were treated at home saw lower mortality rates, fewer returns to the hospital, and less time spent in skilled nursing facilities.

Multiple studies are showing that treatment at home is not only a viable option but, in some cases, it’s a better option. “People do better; they’re more mobile, they recover faster,” says Michael Maniaci, an internist at the Mayo Clinic. “They use physical therapy or skilled nursing care less. You ask: Why is that? Because there’s something magical about being at home.”

Some innovative programs are now focusing on the gap that often causes unneeded ER visits like Joanie experienced when her own doctor was unable to see her the next day. Called mobile integrated care or urgent care at home, these services respond quickly within hours and provide focused attention by medical professionals to seniors in their living rooms. By filling this important gap, they save people from the array of costs of going to the ER – including the many documented physical and health issues that may occur. At the same time, these options save families from the disruptions of rearranging schedules to accompany older loved ones on lengthy ER trips.

The comfort of the familiar home environment is simply better for seniors regardless of whether they live in a home with others, or alone — and even if they’re acutely ill. If home is where the heart is, it only makes sense that home would also be where our health is best.

Summer is an ideal time to have the grandkids visit. They’re out of school, Minnesota summers are perfect for outdoor fun, and your kids probably need a break from their kids… but sometimes the idea of all that open time with children can be daunting. The memories you get to make during these visits can last a lifetime – it’s all a matter of creativity in your planning.

1. Consider a daily schedule. No need to time things out like a boot camp but building in the downtime that you need to get daily tasks of your life done and some screen time for the kids will help alleviate some of the stressors of routine changes for both you and them. Nonstop bonding is rarely a realistic expectation. Having those allocated periods of personal time will benefit everyone.
2. Consider their ages as you plan activities. Take the competing distractions of phones, video games, and streaming into account when putting ideas together will be helpful for you and them. For example, more complex activities like escape rooms (you can even create one at home), sports activities, or hiking are all things that will engage both mental and physical energy. For younger children, make-believe games, hide and seek (who doesn’t love hide and seek?) and storytelling are all great imagination building pursuits.
3. Spend some time teaching each other activities you enjoy. Whether it’s knitting or woodworking, golfing or tennis – the things you enjoy doing are things your grandkids might just enjoy learning; even if they grumble about having to learn something new when they’re not in school. And then, have them show you some of the things that they love to do. This valuable time together, sharing skills and loved pastimes, will give you even more activities to enjoy together in the days to come and the years beyond.
4. Minnesota summers can be fickle so plan for both inside AND outside activities. From hiking through state parks (you’ll need to buy a day pass, if you don’t have an annual one) to local beaches and neighborhood trails, there’s never a shortage of opportunities for outdoor fun. Chilly, rainy days don’t have to be a drag – and they don’t have to turn into faces staring down at screens either! Devise some rainy-day contingency plans: games tournaments (monopoly is great for older kids, but kids of all ages can play Charades, freeze tag, or build pillow forts. And when it’s time to wind down, movie marathons, where each of you picks a favorite movie that everyone watches together, provides relaxing bonding time.
5. Plan one extravagant activity that you can all do together. An extreme scavenger hunt with riddles and puzzles to solve to find each item, a leaf hunt where you compete to find the most beautiful leaf and then recreate it as a painting, drawing, tracing, or decoupage and then frame them, or an elaborate old-fashioned picnic. Extravagant doesn’t have to be expensive – it’s just that kind of over-the-top event that you and your grandkids will remember long after your visit is over.

Regardless of the things you do, it’s how you do them that builds and strengthens those connections with grandkids. Summertime is a reminder of carefree childhood for most of us. Spending those glorious long days with your grandkids can bring back your memories of lazy, fun days and create the same kind of memories for the next generation.