A patient is rarely admitted due to acute Parkinson’s disease. However, Parkinson’s patients are admitted for a number of various reasons. When this occurs, if the comprehensive limitations of that patient are not taken into consideration during discharge planning, readmissions are highly likely.
Consider a patient who is evaluated for discharge postoperatively. If they are only assessed during “on time,” this will not provide a complete evaluation. On one hand, it is good to see how well they are capable of caring for themselves. “On time” will demonstrate this. However, to plan for going home, how a patient responds to “off time” will more accurately predict a successful discharge home.
Assessment concerns that need to be clarified before a patient with Parkinson’s is discharged include:
- What were their pre-admission Parkinson’s symptoms?
- Did those symptoms contribute to the current hospitalization?
- Is the medication routine clearly understood to promote as much “on time” as possible?
- How soon are they to follow-up with their physician, e.g. primary healthcare provider, specialist pertinent to their admission, and the physician managing their Parkinson’s medications?
- Are therapy orders clearly stated to be accomplished at the optimal time for the patient?
- What logistical support do they have in their home to assure they can reach help in the event of “off time?”
- What is there risk for falls?
- What are the questions and concerns stated by their care partner?
A patient with Parkinson’s is at higher risk for falls than most individuals. If they have recently had surgery, balance may be compromised even more. If they have not had a fall prior to a hospitalization it may not be obvious that they are at high risk for an injury and subsequent readmissions.
Healthcare costs can be a factor for a Parkinson’s patient due to lengthier stays or readmissions. Nursing implications need to include careful observation and documentation of what is typical for that individual patient. This includes their preadmission status, current health, and projected post discharge potential complications.
Choosing to advocate for a Parkinson’s patient saves healthcare dollars and promotes patient dignity.