'The older you are, the worse the hospital is for you'

The unique needs of older patients are not a priority for most hospitals, experts say.

Story highlights

  • Interrupted sleep, unappetizing food and days in bed can cause lasting damage to older patients
  • Elderly patients are a growing clientele for hospitals, a trend that will only accelerate

San FranciscoJanet Prochazka was active and outspoken, living by herself and working as a special education tutor. Then, in March, a bad fall landed her in the hospital.

Doctors cared for her wounds and treated her pneumonia. But Prochazka, 75, didn't sleep or eat well at Zuckerberg San Francisco General Hospital and Trauma Center. She became confused and agitated and ultimately contracted a serious stomach infection. After more than three weeks in the hospital and three more in a rehabilitation facility, she emerged far weaker than before, shaky and unable to think clearly.
    She had to stop working and wasn't able to drive for months. And now, she's considering a move to Maine to be closer to relatives for support.
    "It's a big, big change," said her stepdaughter, Kitty Gilbert, soon after Prochazka returned home. "I am hopeful that she will regain a lot of what she lost, but I am not sure."
    Many elderly patients like Prochazka deteriorate mentally or physically in the hospital, even if they recover from the original illness or injury that brought them there. About one-third of patients over 70 years old and more than half of patients over 85 leave the hospital more disabled than when they arrived, research shows.
    As a result, many seniors are unable to care for themselves after discharge and need assistance with daily activities such as bathing, dressing or even walking.
    Nurse specialist Annelie Nilsson checks on Janet Prochazka.
    "The older you are, the worse the hospital is for you," said Ken Covinsky, a physician and researcher at the University of California, San Francisco division of geriatrics. "A lot of the stuff we do in medicine does more harm than good. And sometimes with the care of older people, less is more."
    Hospital staff often fail to feed older patients properly, get them out of bed enough or control their