Facing
the Unknown After Discharge
Submitted
by Kimberly Perkins-Akers, Amada Senior Care
Anne left their breakfast table to get
George’s cane from the living room when she caught her foot on the rug and
fell on the tile floor, breaking her hip. Luckily George was there to call for
help. The next week was a whirlwind for George and Anne; ambulance ride, hip
replacement surgery and begin the rehabilitation and recovery process.
When Anne was well enough to go home,
doctors instructed she would need physical therapy, medication, a wheelchair,
check-ups and constant monitoring to continue her recovery.
Senior citizen families and patients like
George and Anne persevere through illness or injury only to find themselves
facing the unknown after discharge. It is enough of a struggle to make it
through emergencies, hospital procedures and anxiety hanging on hopes for good
recovery. But after leaving the hospital, senior patients are just beginning
their journey towards restored health.
What should you do when facing
the unknown after discharge?
Who is Involved in
Hospital Discharge?
·
Patient – The patient succumbs to illness
or injury and receives treatment from the hospital. He or she has the right to
discharge into any post-treatment situation, so long as they are mentally
capable. The patient can also discharge themselves against medical advice. Most
patients want to come to the safest and healthiest solution possible.
·
Family Member / Caregiver –
George is the family member involved in this story. His role is vital to Anne’s
discharge planning because he knows Anne’s needs and preferences intimately. He
is also the one who will most likely manage Anne’s care after leaving the
hospital.
·
Doctor / Physician –
Provides a significant amount of input into the patient’s discharge planning,
making recommendations for continuing the patient’s physical and mental well-being.
They have the authority to finalize discharge plans, prescribe medication and
order further treatment, if necessary. The doctor or physician in the hospital
is usually not the patient’s family physician; therefore, relaying
accurate information between the two is critical.
·
Nurse – While a patient is in the
hospital, multiple nurses take care at all times of the day. Observations are
made of mental status, stamina, ability and willingness to follow directions.
These observations are communicated to the discharge planner.
·
Discharge Planner –
The hospital discharge planner is usually a nurse or social worker. It is their
job to coordinate what happens during and after discharge. They also advocate
for both the hospital and the patient. They juggle factors like cost-effective
insurance coverage, doctors’ orders and patient preferences to plan the best
follow-up care after hospital treatment.
Before Discharge
Spouses, siblings, children or caregivers
have necessary input when it comes to the care of elderly loved ones. It is
essential that all people involved are on the same page when planning what to
do when a loved one is in the hospital. The patient, family members and
caregivers should be informed enough to plan for the length and depth of
hospital treatment and coverage of outpatient care. The patient’s needs
and preferences, who they are comfortable receiving care from, where they are
safe and how they will continue to function must be communicated.
Helping the
Discharge Planner Help You
The discharge planner wears several hats,
balancing what is cost-effective for the hospital with the patient’s wishes and
wellbeing. They have established relationships with community agencies outside
the hospital, such as rehabilitation centers, nursing facilities, hospices and
home health companies.
One issue for discharge planners is the
dilemma patients face if their insurance no longer covers hospital treatment,
but they need more care. The discharge planner does their best to secure a
fluid transition from hospital to home so that recovering patients do not have
to be readmitted to the hospital. When discharge planners ask questions, be
honest and request anything you need. The more a discharge planner knows about
all aspects involved in your in-home recovery, the better. It is the discharge
planner’s job to consider your needs and preferences to secure the services
necessary for full recovery.
After Discharge
The discharge planner coordinates all the
needed services, round-the-clock caregivers, physical therapists, nurses and
specialist to visit the patient.
Being transparent about your needs and
preferences, the discharge planner can work with you to find the best solution to
grow stronger and recover from your illness or injury without being re-admitted
to the hospital.
Amada Senior Care offers three types of
services for seniors and their families including in-home private care, senior
housing advisement, and financial care coordination with long-term care
insurance or Veterans’ aid. Call Amada Senior Care at 480-999-5250 or visit
www.AmadaMesa.com.
Contributing Author: Michelle Mendoza
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