How to Ensure a Smooth Transition Home from the Hospital


It is always great news when an older loved one is discharged from the hospital. But that puts into motion yet another phase of care—the one that takes place at home.

Older adults released from the hospital may still be recovering from their surgery, illness, or injury and remain frail and in pain. It is important that you have the full spectrum of support services necessary to guarantee a safe and appropriate recovery.

Here are three ways in which you can line up support for you and your loved one before he or she comes home.

1. Work with the hospital’s discharge planner.

Discharge planners are responsible for making sure that you have the support you need at home. This can include everything from professional home care to special devices such as wheelchairs and walkers. Make sure that you have all the care instructions you need including a complete list of medications. If there are gaps in care at home caused by work or daily responsibilities like picking up children from school, discuss these with the discharge planner. It is his or her responsibility to connect you with professional home care services and other types of support. The goal of the release plan is to ensure a smooth transition from hospital to home.

2. Become familiar with support services in your community.

Most every community has senior support services that can help you when your loved one comes home. They range from professional home care agencies to councils on aging. Before you engage a home care agency, make sure they are certified in senior care. Use a checklist to understand the in-home care services they offer. Know what payments the home care agency accepts and if their services are covered by Medicare and/or Medicaid. Plan ahead in case you have to enroll and wait for payments to be processed. Councils on aging often have numerous programs for seniors ranging from advocacy to companionship services. In most states councils on aging operate on the county level. To find the one near you simply conduct a quick web search for “councils on aging” and the name of your county.

3. Plan for good nutrition.

Returning home from the hospital doesn’t mean that one’s appetite returns. Exhaustion may interfere and medications can alter taste buds. However, good nutrition is extremely important for a good recovery. Fill the refrigerator with foods that are appetizing, yet easy to eat. Yogurt and pudding are easy to eat. Applesauce is packed with vitamins and whole grain toast is healthy as well. Peanut butter and hummus can be spread on toast to increase its flavor and nutrition. Homemade soups are always great. Pasta can be a warm and hearty meal, too.

4. Consider Hiring In-Home Care

In the critical days and weeks following a hospital discharge, professional caregivers can provide that crucial extra layer of support. They can provide coordination with the many providers and instructions your loved one may have received upon discharge and work with your loved one each day to support their recovery and rehabilitation process. In-home care services include:

  • Assisting with walking and transferring from bed to wheelchair,
  • Bathing, dressing and grooming assistance
  • Medication reminders
  • Toileting and incontinence care
  • Status reporting to family
  • Safety and fall prevention

If you can plan ahead for your loved one’s discharge, you make the transition easy on them and you as the caregiver. Rely on the experts to support you during this time. Care is apt to be more intense and you both deserve the support.

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