Be Prepared for Your Hospital Stay

12/28/2009

Be Prepared for Your Hospital Stay.

Preparing the information you need before an emergency or hospital admission will help you and your hospital team take the best care of you. This and other worksheets to help you stay organized will be available to you under My Medical Chart in the My Wellness Section of this website. Print this worksheet for your reference and use.

You may also want to review the companion article Be Prepared for Your Medical Visits to optimize your outpatient care.

Record the information you need in one convenient space.

Being prepared for a hospital stay means you must have important medical information available and recorded in a convenient form to help your hospital team. Complete and update your 'Parkinson's Care Questionnaire', Medication Log, Doctor Contact Information, and Symptom Summary to have available for medical visits and hospital stays. By doing this you will have a complete list of your medications, dosing and time of day, medical diagnoses, allergies, and list of your treating doctors or other health care providers important to your care. See the article Reduce Medical Errors While in the Hospital for more helpful tips.

Educate your hospital team about you and Parkinson’s disease.

Discuss your medicine needs with your nurses. Bring a complete list of your medicines, dosage and the time of day that you take them. Be sure your hospital care team understands that Sinemet, Stalevo or carbidopa/levodopa must be given at the exact time that it is ordered. Ask if you or your family can keep this medicine at your bedside if you are not getting it on time. Parcopa or dissolvable carbidopa/levodopa can be used if you are not able to swallow or eat.

Describe your symptoms to your care team as they may not be familiar with such problems as dyskinesia, On-off motor fluctuations and freezing of gait. Be sure to let your care team know how your movement and abilities change in the medicine on or medicine off state. This also helps them understand why it is so important for you to get your medicines on time.

Advocate for the services you need.

Your motor symptoms can worsen in the setting of a medical illness so you may not be able to move as well and may find some symptoms such as tremor, dyskinesia, and freezing increase in the hospital. In a similar fashion, confusion and hallucinations can occur or worsen in the setting of medical stress or as a result of new medicines such as narcotics for pain, or sedatives for sleep and anxiety or agitation.

Ask for physical therapy, occupational therapy, swallowing evaluation or speech therapy consult as your illness and prolonged bed rest can weaken your movements and affect daily activities. Ask to see a social worker especially if you have questions about community resources, special needs after discharge or changes in living arrangement. Chaplain services are available in most hospitals and available to support you no matter what your spiritual needs or belief.

Ask your doctor for rehabilitation after discharge as you may be weaker due to your illness. If you have had a serious illness or surgery, ask your Neurologist and doctor about inpatient (hospital based) rehabilitation or home health services that may include social work, nursing, dietary or rehabilitation services.

Log on to the Davis Phinney Foundation, www.davisphinneyfoundation.org to find out how you can order the book, “Essential Information and Inspiration for a Lifetime of Wellness With Parkinson’s Disease- Every Victory Counts”. This book includes worksheets that you can complete to aid you in collecting the information needed for a safe and successful hospital stay.

Review the following questions with your discharge nurse and be sure you understand the answers before you leave the hospital.

Get the answers before discharge!

When should you next see your physician?
Should you get additional rehabilitation such as physical therapy?
What important tests, procedures, or new diagnosis have you had?
What medicines have been changed and why?
How do I get a copy of the hospital records sent to me and my doctor?

Medications to avoid

Some medications can worsen movement symptoms of PD, including slowness, stiffness, tremor and dyskinesia. These drugs, listed below, are used to treat psychiatric problems such as hallucinations, confusion or gastrointestinal problems, such as nausea. The stress of your illness, hospital stay or new medicines can increase your risk of hallucinations while hospitalized. Common anti-hallucination medicines to be avoided are listed by generic or chemical name followed by the trade name.

Anti-hallucination medicines to avoid

Note: the anti-hallucination medicines Quetiapine (Seroquel) or Clozapine (Clozaril) can be used. The following should be avoided:

aripiprazole (Abilify)
chlorpromazine (Thorazine)
flufenazine (Prolixin)
haloperidol (Haldol)
molindone (Moban)
perphenazine (Trilafon)
perphenazine and amitriptyline (Triavil)
risperidone (Risperdol)
thioridazine (Mellaril)
thiothixene (Navane)

Anti-nausea medicines to avoid

metoclopramide (Reglan)
phenothiazine (Compazine)
promethazine (Phenergan)

Medicines to avoid if you are on Rasagiline (Azilect) or Selegiline (Eldepryl)

Pain medicines - Meperidine (Demerol), Tramadol (Ultram)
Antispasmodic medicine Flexeril
Stimulants - Certain cold medicines

This is not a complete list of medicines to avoid. If you have questions about other medications, ask your pharmacist or doctor.

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