Senior Helpers The Top Rated In Home Care In Toms River Nj Talks About The Hospital Discharge Process

Senior Helpers The Top Rated In Home Care In Toms River Nj Talks About The Hospital Discharge Process

By peter porchia. Published 2011-05-16 13:34:09

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Maria Porchai Rn ceo Of Senior Helpers In Home Care Of Ocean County And Burlington County
discusses how to handle and thrive during the discharge process.
If your loved one is hospitalized, the hospital discharge process is a key transition time.  Within 90 days of hospital discharge, as many as 35% of Medicare recipients will be readmitted to the hospital.
Without proper support and resources as well as good understanding of follow up instructions, many individuals will return to the hospital for reasons that could have been avoided.  No one wants this, and it can be especially dangerous for elders and persons with chronic conditions.
If you are a family caregiver and an elderly loved one is hospitalized what can you do to ensure a safe transition after the hospital stay?

• Consider the discharge process from the beginning of the hospital stay.  Find out who is responsible for discharge planning and introduce yourself, explaining that you will be involved and giving relevant information about the patient’s living situation, supports and concerns.  Discharge may not seem like a top concern at the beginning of a hospital stay, but with shorter hospital stay lengths, good groundwork starts as soon as possible.
• Keep good records.  An online personal medical record system is an ideal way to manage your loved one’s health history, medications, and store key contacts as this information can be readily available anywhere.  You can also use a notebook or file to store the information…as long as you have it available so that you can provide good information to new providers.  Some key items to tell the hospital providers: allergies, sensitivities, essential medicines to keep the same (for example, if it has taken your mother’s psychiatrist several months to get her Depression medicine just right for her, you do not want to find the hospital has changed it).
• Get to know the medical staff and check in about what is going on throughout the stay.  Ask questions (and keep records as per above) about procedures, tests, expected outcomes, medications.
• Understand that you or an advocate will need to take charge in being the centralized hub of information and ensuring you understand instructions, what will happen after discharge, the functional status of the person (and therefore what support might be needed).  Ask questions and anticipate concerns that might arise and do not hesitate to voice them.
• Be a good advocate for your loved one, and consider how a professional advocate can help patient and family.  Professional Geriatric Care Managers know the discharge process, use a systemized approach and can help families anticipate needs and find resources to help.  If you are at a distance, this support is vital as it is very difficult to manage the discharge process from afar.
• Plan for the immediate transition time—the first day or two after discharge can be particularly problematic.  Think about practical issues such as getting new medications, food and personal items while needing to attend to a person in a weakened state.  Will you be able to help the patient from bed to bathroom?  Services such as Medicare home health care and medical equipment often begin the day after discharge and are not meant to fulfill “custodial” needs, so you may need additional home caregiver support.
• Find out about the options for services and rehabilitation after the hospital stay.  There are essentially three rehabilitation options: inpatient (i.e. at a skilled nursing facility/rehabilitation center), home health care (for someone who is considered essentially homebound) and outpatient rehabilitation (going to a clinic or center to receive therapy).  Your loved one can benefit from therapy that will allow him/her to return to a maximum functional level.
• Ask for thorough discharge instructions in laymen’s terms and explain that you would like to be there to review them with the medical staff completing them, along with the patient, prior to discharge.  
• Know patient’s rights, including the option to appeal a discharge if additional planning needs to be done to ensure a safe discharge. 

Hospital Discharge: A Checklist for Families
Did I get written discharge instructions (example of a simple discharge form) explained to me with time to ask questions and clarify any concerns? Items that should be included:

• Reason for admission, procedures done, outcome
• Do we know who to contact if we have a problem after discharge?
• What symptoms should we be watching for and what do we do if we have a concern?
• Medication list (and how will I make sure all my doctors & providers are updated with the new list)
• Follow up appointments

Get information about follow up treatment and therapy that might be essential to recuperation. Find out:

• Will I be receiving therapy services at home, inpatient or outpatient? You will need to select a provider and the hospital will generally provide a list of options if you ask, but you should do your research so that you can make an educated choice. There is information online about provider outcomes and you may wish to check with your loved one’s doctor or geriatric care manager for recommendations.
• Does insurance cover these services (your insurance may impact the choice of provider)?
• How long can they be expected to last? What outcome is expected? (Share your goals and concerns as well.)

Find out about the patient’s home care needs and what assistance may be needed in the weeks following the hospitalization. Issues to consider:

• Patient’s functional status: strength, ability to transfer safely, bathing, dressing, weakness, physical limitations.
• Household needs: can the patient take care of the household? Do laundry, clean? Help preparing meals (in compliance with nutritional needs/medical orders)?
• Transportation: will the patient need rides to appointments or help with errands?
• Medication management: consider how the patient will get new medications and discard old ones properly, manage following a new medication routine, communicate changes to all doctors/providers?

*Most times, if a patient is returning home after a hospital stay, they will receive some Skilled Home Health Care services, covered under Medicare or insurance. These services often do not begin on the day of discharge and are not intended to cover custodial needs such as most of those listed above. Medicare may cover support from a home health aide, but only as long as the patient requires skilled services such as physical therapy or a R.N. (for example for dressing changes/wound care). If you have concerns about any of the areas above, you should talk to a licensed, private duty home care provider about affordable home care and transitional packages to fill any gaps.
Ensure the home environment will accommodate post-hospital needs:

• Is any special medical equipment needed? Have arrangements been made? Will equipment be delivered and when? Do I need to pick up equipment and where can I do so? Cost/insurance coverage?
• How safe is the home environment? Have we completed a home safety, falls prevention assessment?
• Does the patient have a Personal Emergency Response System in case he/she falls or needs to call for help?
• for answers to the above questions contact Maria Porchia Rn ceo Of Senior Helpers
• you can contact us at www.seniorhelpersnj.com or call 1-866-306-3615
• Or Email Your questions to mporchia@seniorhelpers.com
• Maria Porchia RN and her Exemplory Staff Can Ensure that your loved one will be 
• Navigated safely through this very stressful and Emotional Period

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