1008 – Alone and Impaired: Collaborative Strategies for Safe Discharge of Cognitively Impaired Elder Orphans
In an era of short-stay hospitalizations and increasing numbers of “elder orphans” who lack significant family connections or other forms of informal support in the community, practitioners are frequently confronted with discharging patients who may not be able to safely manage their own care at home. Explored in this presentation are the difficulties in detecting impairments during short-stay contact with patients and the critical indicators to watch for in assessing their ability to discharge to a home environment. Also examined are the community resources available for collaborative and successful discharges of impaired elder orphans when the discharge process is obstructed by concerns about decisional capacity. Guardianship, a solution widely regarded as the last resort for those experiencing cognitive impairment, will be thoroughly explained, inclusive of the initiation process, the timeline, and the multidisciplinary team necessary to establish guardianship.
1. Describe subtle indicators of cognitive decline that are particularly difficult to detect during short hospital stays.
2. Name community resources that are available when discharge planning is obstructed by a patient’s cognitive limitations and lack of informal support.
3. Summarize guardianship, including determination of appropriateness, initiating the process, necessary components and both the limitations and protections that come along with a guardianship.