Transitioning Home from a Hospital or Nursing Facility

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Have you ever have brought a family member home and felt unprepared to care for them? Did you arrive home only to realize that you didn’t have supplies, medications, equipment, or skills to properly care for your loved ones? You are not alone.

Here is the Blue Water Homecare “Home Ready Checklist” to help transition you or your family member home in a seamless fashion.

Supplies

It is important that you take note of the necessary daily supplies. Items such as diapers (briefs), pull-ups, disposable bed pads, fabric bed pads, wipes, gloves, and skincare items all need to be purchased by families unless the person is on hospice. Having the needed supplies on hand before discharge is very helpful. These items can be purchased at a grocery store, pharmacy, or online. Purchase larger size diapers with tabs when caring for someone that is bed-bound or incontinent. Early preparation with supplies will start your family’s transition on a positive path.

Equipment

What equipment is needed in the home? The discharge planner and therapist will make recommendations based on your loved one’s needs. Some examples include a shower chair, wheelchair, hospital bed, raised or bedside commode, or oxygen. Some of these items such as oxygen, wheelchair, bedside commode, and hospital bed are ordered by the case manager or social worker and may be paid for by Medicare or commercial insurance. Shower chairs are typically paid for out of pocket. However, you may want to see if there is a local lending closet to obtain these items free of charge. If your loved one goes home on hospice the cost of equipment will be paid by your hospice company.

Transportation and Home Space Planning

The case manager may arrange transportation home in an ambulance which may or may not be covered by Medicare or insurance. We recommend preparing the space for the arrival by making room for the hospital bed or equipment and removing items such as throw rugs and electric cords. Some hospital beds require an electric cord so you should make sure cords are out of the way for safety.

Care or Skills

While your loved one is receiving the care it is important to learn from the hospital staff how to provide the needed care when your loved one is at home. If you have questions or feel uneasy about your ability to perform certain tasks such as diaper changing or showering you must inform the staff. They may schedule additional training or refer you to an agency that can help provide personal care.

In addition, you will need to know:

  • Symptoms you must report to the physician or that warrant a return to the hospital
  • If there are limitations to lifting, bathing or walking
  • If your loved one be home alone – this may indicate additional services you will require

Special Foods /Diet

Make sure you know if there are any food restrictions or special diets. Shopping and meal planning prior to discharge is helpful and will allow you to transition more easily. We also recommend making meals to cover 2-3 days post-discharge. Be sure to include your loved one’s food preferences in planning.

Safe Storing of Medications

Medications should be picked up prior to your loved one coming home. Many times, the nursing staff will administer pain or anxiety medications before transport arrives. Delays in pick up or long drives home may result in increased pain or anxiety. It is helpful to have medications available when a person arrives home. We recommend identifying a designated area for medications. A medication planner helps caregivers know what medications are given and when they should be administered. The use of multiple caregivers and the use of medication bottles can present challenges and forces additional communication about this critical component of care.

Make sure the designated “med-area” has a current medication list, medication, medication planner, and notebook. Designating one person to fill the medication planner is best practice. You may also have the home health nurse help you with this if they are involved. The notebook is a place to document the time and amount of administered medication. This is also the place to document questions you have for your home health provider or medical professional.

Here are some helpful questions for your healthcare provider regarding medications:

  • What medications should they be taking?
  • How long will he or she be taking them?
  • What are the side effects?
  • Should it be taken with food?
  • Is there a preferred time of day to administer this medication?
  • Does the medication require the need to avoid any foods when taken?
  • Where do we get the medication?
  • Does insurance cover the medications?

Follow up Care

It is important that you maintain a list of healthcare providers with whom your loved one has follow up appointments. This may include follow up with a primary care physician, specialists, or post-acute care providers in the home. Make sure you have a list of these providers including phone numbers and appointment times. It is important to keep these appointments as readmission to the hospital within the first 7 days of discharge poses your highest risk.

It can be overwhelming to care for someone after a hospital or long term care stay. If you need help Blue Water Homecare is a phone call away. We provide in-home care which includes assistance in bathing, dressing, transfers, medication reminders, meal preparation, shopping, and transportation.

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