A trip to the hospital, whether expected or not, can be overwhelming. Your attention is likely focused on the medical care your loved one is receiving, but it's crucial to consider what will happen once they come home.
This is where discharge planning comes in—determining the type of care your loved one will need after leaving the hospital. You might get help from a hospital social worker, nurse, or case manager, but remember, as a family caregiver, you know your loved one’s history best and are key to ensuring a safe return home. It's a good idea to ask the hospital to connect you with the discharge planner as soon as your loved one is admitted, allowing time for a thorough evaluation and planning process.
Rehabilitation at Home or a Facility?
Many people assume they'll go to a rehab facility after a hospital stay, but that's not always the case. Often, patients are discharged home after an overnight stay. If you feel your loved one needs more support, you may need to advocate for a transfer to a rehab facility. The hospital team might not fully understand your home situation, and if your loved one is eager to go home, that can make things more complicated.
Make sure the discharge team is aware of any unsafe conditions at home, such as the need for significant repairs, excessive clutter, multiple stairs, or the presence of someone else in the home who may not be able to provide support due to cognitive or physical limitations. Additionally, note that Medicare typically covers short-term rehab stays only if the patient was hospitalized for at least three days.
If your loved one is going home, ask for a home health care referral. Home health care can include skilled nursing, physical therapy, occupational therapy and speech-language therapy provided at home. This option allows your loved one to receive rehab services in a familiar setting, possibly including a home safety assessment and other recommendations. Medicare covers home health, so be sure the referral is in place before discharge.
Remember - if you don’t think your loved one is medically ready to leave the hospital, you have the right to appeal the discharge.
Considerations
Medications: Before surgery, ask about any new medications and whether they can be filled in advance or picked up at the hospital pharmacy. This can save you a trip to the pharmacy and ensure that necessary medications are ready when needed.
Medical Equipment: Ask if any special equipment is needed or recommended for recovery, such as oxygen or a wheelchair, which may require a medical order. Don’t forget about items like canes, walkers, shower chairs, toilet risers, or bedside commodes that can make recovery easier.
Specialized Care: If you or your loved one will need to provide specialized care, such as wound care, ask for clear instructions on how to do it properly. Be sure to know what symptoms or signs to watch for and when to contact the medical team if concerns arise.
Follow-Up Appointments: Schedule any necessary follow-up appointments before leaving the hospital. If you have trouble getting an appointment within the recommended time frame, ask the medical team for help.
Meals: Even a smooth recovery can leave someone feeling tired and not up to preparing meals, yet good nutrition is key to healing. Consider prepared meal delivery services or grocery delivery, and stock the refrigerator before your loved one comes home.
Transportation: Ask the doctor if your loved one will be able to drive during recovery and if there are any transportation services available for medical appointments through the health provider or insurance. If family or friends can’t assist with driving, explore other options like community agencies, taxis, or ride-hailing services.
Personal Care and Household Chores: Depending on the nature of the hospitalization and recovery, your loved one may need help with tasks like bathing, dressing, or laundry, even if only for a short time. If possible, arrange this ahead of time and meet with the agency or individual before they start providing care. This person can often help with meals and transportation too. This may be covered by Medicaid or in some cases, a Medicare Advantage plan.
Hospitalization can be stressful, and a little planning can help ease the process. Visit Mellie to learn how we can help lessen your burden by creating a plan and connecting you with local resources. With the right support in place, you can focus on what truly matters—your loved one's recovery and well-being.
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