Be Prepared for Your Hospital Stay

12/28/2009

Don't wait for an emergency to get the information together you need for your care. These helpful tips and our Hospital Worksheet will help you stay safe and get the best care.

get the most out of your. 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

1. Record the information you need in one convenient space.

The first step is to have your important medical information available and recorded in a convenient form to help your hospital team.

Print and complete the Hospital Worksheet. Not only will not you summarize the information most helpful to your medical team you will also provide your doctors, nurses and therapists crucial information about your PD and its treatment. have helpful tips for your doctors, nurses and therapists. information Hospital . 2. Educate your hospital team about you and Parkinson’s disease.

2. 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.

3. Educate your medical team about your symptoms. 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. The hospital worksheet will also help you with this goal.

4. 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.

5. Appoint someone to be your advocate while in the hospital.

6. Understand your next steps after discharge. Review the following questions with your discharge nurse and be sure you understand the answers before you leave the hospital.

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?

7. Other Helpful tips

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.

[See My Medical Chart for more worksheets and handouts you can print.]
[See companion article Be Prepared for Your Medical Visits .]

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