Avoid Post-Hospital Syndrome During Mesothelioma Treatment
When you have mesothelioma, it’s obvious that the more attention you get from your doctors, the better. But did you know that spending more time in a hospital bed can actually lead to worse outcomes?
In 2013, a National Cancer Institute study explored why Medicare cancer treatment costs were higher in some regions than in others. The researchers found longer and more frequent hospitalizations were common in some areas, which substantially drove up costs.
Yet the increased time in the hospital was not associated with improved survival rates.
A New England Journal of Medicine article published that same year revealed risks of hospitalization beyond higher costs. For several weeks after hospitalization, elderly patients typically experience a period of fragile health. This condition is known as “post-hospital syndrome.”
Awareness of the problem has grown since this syndrome was first named. An August 2018 New York Times article highlights the issue in a disturbing statistic: Almost 1 in 5 Medicare beneficiaries discharged from a hospital in 2016 were re-admitted less than a month later.
In many cases, it was not because of the original illness. They returned because the experience of hospitalization, in part, caused a new health problem.
Fortunately, there are ways to minimize post-hospital syndrome during mesothelioma treatment.
What Causes Post-Hospital Syndrome?
Hospitals can provide lifesaving care, but it’s often at the expense of a healthy lifestyle. Post-hospital syndrome arises because hospitalization typically comes with many negative health effects.
Sleep-cycle disruption: In a windowless hospital room, it’s difficult to tell daytime from nighttime. Patients may also be awoken at odd hours when nurses have to administer medication or draw blood for tests.
Poor nutrition: While recovering from a medical procedure, patients may not be able to eat, or they may have no appetite. Their hospital food also may not appear appetizing.
Lack of exercise: Being confined to a hospital bed can cause muscles to atrophy and energy levels to drop.
Medication side effects: Strong sedatives and other hospital drugs throw the body’s chemistry off balance.
Pain, discomfort and stress: Isolation in an institutional environment can lead to feelings of depression, confusion and frustration, especially when patients are in pain.
These factors impair the body’s ability to heal and protect itself from infection. Most important, muscle weakness caused by a long hospital stay increases the risk of getting injured in a fall.
Minimizing Your Hospital Stays
Doctors can provide many mesothelioma therapies on an outpatient basis, avoiding the need for hospitalization. All patients, even those who elect surgery, can take steps to spend as little time in the hospital as possible.
Get an Expert Opinion
Every patient should consult an experienced mesothelioma specialist before making treatment decisions.
There are a range of surgical options available for mesothelioma. Major surgeries typically involve hospital stays of two weeks or more, but they offer some patients the best chance of living longer with mesothelioma.
On the other hand, the most appropriate surgical procedure for many patients may require only an overnight stay.
Start Palliative Care Early
Include palliative care in your treatment plan from the beginning.
Many people think palliative care means the same thing as hospice or end-of-life care, but that’s a common misconception. Palliative care is for anyone who has symptoms to manage.
A 2014 Cancer study associated early palliative care referrals with fewer hospitalizations for patients. Mesothelioma treatment works best when the medical team treats the whole patient, not just the cancer.
Get Home Medical Equipment
Home medical equipment can make living at home safer and easier for mesothelioma patients.
Shower chairs, walkers and other simple aides can help patients avoid dangerous falls. Home hospital beds can allow patients to stay comfortable in their own surroundings.
An indwelling catheter is an at-home device that drains a patient’s fluid buildup around their lungs. Some patients choose this option because they want to avoid a more invasive surgery or repeated trips to the hospital.
Mesothelioma patients should be careful to avoid harmful bacteria, viruses and fungi.
Patients undergoing chemotherapy are especially vulnerable because the drugs suppress the immune system. Getting an infection while on chemotherapy is a ticket straight to the hospital.
Tips for preventing infection include staying away from crowded areas and practicing good hygiene at home.
To avoid food poisoning, practice good food safety by cleaning and cooking ingredients thoroughly.
Making the Most of Time in the Hospital
Ultimately, some hospitalizations are unavoidable. You should always seek medical care during an emergency, and recovering in a hospital after surgery is a normal part of some mesothelioma treatment plans.
But, of course, all hospitals are not created equal. Seeking treatment at a specialized cancer center often leads to shorter and fewer hospital stays.
Multidisciplinary cancer care teams are better at preventing complications that could put you back in the hospital after being discharged. Surgeons at specialized cancer centers are trained in minimally invasive technologies, which can shorten recovery times.
There is plenty loved ones can do for patients, too.
They can work with the medical team to minimize post-hospital syndrome and keep patients active by walking with them or joining them in activities.
Loved ones can also bring patients their favorite foods, as long as it meets their dietary needs during treatment.
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4 Cited Article Sources
Span, P. (2018, Aug. 3). The Illness Is Bad Enough. The Hospital May Be Even Worse.
Retrieved from: https://www.nytimes.com/2018/08/03/health/post-hospital-syndrome-elderly.html
Hui, D. et al. (2014, Feb. 22). Impact of timing and setting of palliative care referral on quality of end‐of‐life care in cancer patients.
Retrieved from: https://onlinelibrary.wiley.com/doi/abs/10.1002/cncr.28628
Krumholz, H. (2013, Jan. 10). Post-Hospital Syndrome — An Acquired, Transient Condition of Generalized Risk.
Retrieved from: https://www.nejm.org/doi/full/10.1056/NEJMp1212324
- National Cancer Institute. (2013, Mar. 8). Medicare Spending for Advanced Cancer Not Linked To Survival Differences. Retrieved from: https://academic.oup.com/jnci/article/105/9/1/987357