April 20, 2012
What do you do when your loved one is discharged from the hospital and needs continuing health care? Deciding upon the best course for care isn't always easy to do so it is important to understand what options are available and what issues need to be considered before making this important decision.
Discharge Planning Starts Early
As the family caregiver your first step is to have a meeting with the appropriate hospital staff—often a case manager or discharge planner—and let them know you would like to be involved in after care planning, including where your loved one will go upon discharge from the hospital.
Key issues to discuss with the discharge planner include:
- Expected date of discharge,
- Type of aftercare required along with an explanation of the level of skilled care or services required to provide the necessary care,
- Staff recommendations for discharge options,
- List of providers for aftercare, and
- List of resources for additional information and support.
Options for Services and Rehabilitation After a Hospital Stay
There are three primary aftercare or rehabilitation options available and each has its own rules, regulations, and entrance requirements.
Inpatient—Nursing facility/rehabilitation hospital—An inpatient option is typically necessary if your loved one's doctor orders inpatient services or if your family member will benefit from specialist treatment following the hospital stay, such as intensive physical or speech therapy.
Time spent in a skilled nursing facility or rehab center typically lasts for weeks not months, and if continued rehab is required beyond the inpatient stay it usually takes place at home or an outpatient center.
Home—Certified home health care agency or in-home health care services—If your family member only needs part-time or intermittent rehab or skilled health care services such as wound care or monitoring of medications and equipment, then home health care may be the right option for them. Depending upon need, care can be provided by nurses, nurse practitioners and physician assistants or certified home health aides.
We understand that making the decision to use outside help for caring for an elderly loved one is difficult but there are a wealth of senior care resources and Alzheimer's and dementia care resources for you to consider. Often, depending upon your family member's needs, a non-medical but trained home companion will be able to assist with mobility, medication reminders and special dietary issues. In addition, they will be able to provide caregivers the peace of mind knowing that their loved one is safely at home. You can find more information about the differences between medical and non-medical in-home care on HomeInstead.com.
- Outpatient—Rehabilitation center or adult day health center—If your family member's rehabilation needs are not acute and don't require inpatient services then he or she may be able to take advantage of outpatient services. Your senior loved one must be able to travel in order for his or her after care needs to be met by an outpatient rehab center or an adult day health center. Typically outpatient rehabilitation centers provide physical, occupational and speech and language therapy.
Your senior loved one might require additional services beyond those provided at the rehabilitation center. Often, a combination of outpatient rehabilitation services and in-home care services works well in this scenario. For example, caregivers provided by an in-home senior care agency like your local Home Instead Senior Care® office could assist with transportation to rehabilitation and other home health needs such as dressing, meal preparation, and medication monitoring. Also keep in mind that it is common for top rehabilitation facilities to have waiting lists so it is important to start early to find a center that will accept your loved one when he or she is ready to be discharged.
Guidelines: Family Caregivers and Post-Discharge Issues
There are many important factors and issues to consider before your loved one is discharged from the hospital:
- What level of skilled nursing care or specialist rehabilitation services are required and for how long?
- Are these after care services covered by Medicare or other insurers and if so, for how long?
- Does your loved one need full-time/around the clock, daily or intermittent care?
- Will transportation be a factor for both inpatient and outpatient options? Consider issues such as the location of the center, length of travel time, parking, stairs and if travelling tends to cause your loved one to experience confusion or anxiety.
- Does the facility (outpatient or inpatient) have extended hours of operation, convenient visiting hours and are meals/snacks provided?
As the primary family caregiver there are also many personal factors for you to consider as well:
- How much time do you have to help out?
- Will you need to take time off from work?
- Do you have a back-up caregiver in the event of an emergency?
- Are you physically able to lift or move your family member?
- Can you handle additional tasks such as picking up medicine and taking care of your loved one's home?
Once you have answered these questions your loved one's medical providers and you can decide which post-discharge care option is best for your loved one. Knowing what options are available and weighing each against your loved one's desires and needs can help you make a well-informed decision that will help to ensure a successful recovery.
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