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On social admissions:
If you are 50 you may not need admission with relatively mild pneumonia. If you are 89 you may find it makes you too breathless to walk to the toilet. You don't need admission for oxygen or iv antibiotics. You need admission for nursing care.
If you are 50 you may not need admission with relatively mild pneumonia. If you are 89 you may find it makes you too breathless to walk to the toilet. You don't need admission for oxygen or iv antibiotics. You need admission for nursing care.
Is this a social admission?
No this is an admission for pneumonia. And for older people often pneumonia that would be mild in younger people is fatal. So they are often soon in need of those IV antibiotics.
No this is an admission for pneumonia. And for older people often pneumonia that would be mild in younger people is fatal. So they are often soon in need of those IV antibiotics.
Also remember that older people often present non-specifically.
So some times the only presenting complaint is that they don't feel well, and can't manage at home.
So some times the only presenting complaint is that they don't feel well, and can't manage at home.
So if someone who can normally walk around their house ok suddenly starts falling over every time they walk. And you examine them and can't find an illness.
Is that a social admission?
No it's an admission because of a non-specific illness you can't identify
Is that a social admission?
No it's an admission because of a non-specific illness you can't identify
What is social admission?
It's an admission where the crises that led to admission is a crisis that is nothing to do with the patient's health.
People don't suddenly stop functioning without a reason.
It's an admission where the crises that led to admission is a crisis that is nothing to do with the patient's health.
People don't suddenly stop functioning without a reason.
Genuine social admissions should be referred to emergency social work.
E.g. Mr Mackay is the main carer for Mrs Mackay, who has advanced dementia.
They have no family. Mr Mackay has been admitted with pneumonia. The ambulance crew bring Mrs Mackay to hospital as well.
E.g. Mr Mackay is the main carer for Mrs Mackay, who has advanced dementia.
They have no family. Mr Mackay has been admitted with pneumonia. The ambulance crew bring Mrs Mackay to hospital as well.
They should (if possible) have organized the duty social worker to arrange emergency care.
Obviously, we can't turn Mrs Mackay out on the street, because she is vulnerable. So we care for her until appropriate care can be arranged.
Obviously, we can't turn Mrs Mackay out on the street, because she is vulnerable. So we care for her until appropriate care can be arranged.
If they brought Mrs Mackay to my house and left her, I wouldn't turn her out on the street either, I would have to care for her until emergency care can be arranged.
But it's not fair on either me, or Mrs Mackay. (Assuming that she is no relation to me!)
But it's not fair on either me, or Mrs Mackay. (Assuming that she is no relation to me!)
For various reasons hospitals do function as emergency respite care for older people. They aren't supposed to, or funded to. And better provision needs to be made.
