Often when older people end up the hospital, even for a few days, the focus is on fixing the medical issue—in Betty’s case, out-of-control diabetes, and bladder and blood infections. Little attention is paid to what illness and a few days in bed can do to the person, and too often people who didn’t know a frail older person before their hospitalization will assume they couldn’t walk or think clearly in the first place. And sometimes they couldn’t, but everyone has a functional baseline. It’s hard for hospital doctors and nurses to assess whether someone is back to a baseline they’ve never seen. In the days when the same doctor took care of a patient in clinic and in the hospital, that doctor would know. Now hospital staff must rely on family or caregiver reports, but what two different people mean by “He walks normally” or “She’s totally with it” can differ dramatically

Often when older people end up the hospital, even for a few days, the focus is on fixing the medical issue—in Betty’s case, out-of-control diabetes, and bladder and blood infections. Little attention is paid to what illness and a few days in bed can do to the person, and too often people who didn’t know a frail older person before their hospitalization will assume they couldn’t walk or think clearly in the first place. And sometimes they couldn’t, but everyone has a functional baseline. It’s hard for hospital doctors and nurses to assess whether someone is back to a baseline they’ve never seen. In the days when the same doctor took care of a patient in clinic and in the hospital, that doctor would know. Now hospital staff must rely on family or caregiver reports, but what two different people mean by “He walks normally” or “She’s totally with it” can differ dramatically