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Tips for Choosing Where to Recover After a Hospital Stay


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senior-caregiver-recover-home.jpgBringing a loved one home from the hospital can be a potentially precarious situation and the worldwide pandemic could complicate hospital processes and procedures even more. Rules are ever-changing as the virus ebbs and flows throughout communities. Knowing what to do when an older adult is leaving the hospital can be a challenge, especially if a loved one has contracted the coronavirus.

In some places, the Centers for Disease Control and Prevention (CDC) has clarified that patients with COVID-19 can be discharged from a health care facility to either home or long-term care facilities when needed. The decision to discharge patients should be made in collaboration with the patient’s clinical care team and the state health department, the CDC notes.

This document guides health care regarding the decision to discontinue transmission-based precautions and discharging hospitalized patients with COVID-19.

For loved ones who are being released from the hospital under other circumstances, the following information may help.

Hospital Discharge Planning Starts Early

A good place to start as a family caregiver 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 aftercare 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
  • An explanation of the skill level required to provide the necessary level of care
  • Staff recommendations for discharge options
  • List of providers for aftercare
  • 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, which may also have changed during the pandemic.

1. Inpatient: Nursing facility/rehabilitation hospital
An inpatient option can be 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 rehabilitation center typically lasts for weeks not months, and if continued assistance is required beyond the inpatient stay, it usually takes place at home or an outpatient center.

2. Home: Certified home health care agency or in-home health care services
If your family member only needs part-time or intermittent rehabilitation 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.

Making the decision to use outside help to care for an elderly loved one isn't always easy, but there are a wealth of senior care resources for you to consider. Often, depending upon your family member's needs, a trained home care companion could assist with mobility, medication reminders and special dietary issues. In addition, these caregivers will be able to provide you the peace of mind of knowing that your loved one is safely at home. You can find more information about the different types of home care from the Home Care Solution Guide (PDF). Make sure that you ask whether the company provides their workers PPE (Personal Protective Equipment) and if they are trained in safety and hygiene practices.

3. Outpatient: Rehabilitation center or adult day health center
If your family member's rehabilitation needs are not acute and do not require inpatient services then he or she may be able to take advantage of outpatient services. An individual recovering must be able to travel for his or her after care needs to be met by an outpatient rehabilitation center or an adult day health center. Typically outpatient rehabilitation centers provide physical, occupational and speech and language therapy.

A senior might require additional services beyond those provided at the rehabilitation center. Often, a combination of outpatient rehabilitation services and in-home care services work 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 care 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. Here are just a few to consider:

  • 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 fulltime/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, including:

  • 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?

We encourage you to work with your loved one's medical providers to determine which post-discharge care option is best. 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. Check out the resources at www.homeinstead.com/covid19 for more information about how to keep an older adult safe at home.

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