What to expect at a hospital discharge

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What to expect at a hospital discharge

For many of us being discharged from the hospital is a pretty normal event under most circumstances. For families caring for an older adult, many times this is not the case. Having our elderly loved in the hospital can be stressful and emotional.

For many adult children, balancing our existing lives, children, jobs, and spouses’ needs with the new reality. The need to now be more involved in our parents’ lives can be overwhelming.  One learns very soon that, one needs an advocate in the hospital.

Patient Advocate

Being an advocate while your loved one is in the hospital, often becomes an added responsibility if you are caring for someone who is aging. While the hospital is striving to provide high levels of patient care, it is best for the patient to have their own spokesperson who is able to communicate their wants and needs during and after their hospital stay.

Hospital staff are busy and they likely won’t be able to adequately prepare the family for what happens next.

It is important, therefore, to be available to speak directly with the staff whether it be the doctor or nurse, or social worker. There are so many patients with their own needs that it is likely that without a family member or other person advocating that the elderly family will get lost in the rush. Mistakes can be made.

In general, the basics of a discharge plan are:

  • Evaluation of the patient by qualified personnel.  Who are the qualified personnel?
  • Discussion.  What is involved in this discussion?
  • Determining caregiver support.  Is caregiver training or other support needed?
  • Follow-up Arrangments.  What will need to be done for follow-up appointments or tests?

The patient might be planning on returning home yet that might be impossible based on the circumstances. Patients might be discharged to a nursing home instead without really understanding the situation. The elderly patient needs to be released into the care of someone else.  Who might that be?

Once discharged, it is important to know what needs to be looked out for. Once we know what to look out for we need to know what to do. Do we need to call 911 or can we visit the doctor? There might be normal issues e.g. headaches or incontinence.  If all goes well we still have to schedule follow-up visits with the doctor. It may require visits with a specialist.

The staff will also address the very important questions regarding the post–discharge process. There will be a discussion about where the patient will stay after the discharge and during recovery. Most people want to return home. Sometimes this is possible but many times not. The medical staff will address the options.

Medication

Keeping an updated medication list can be very helpful if your loved one is ever hospitalized.  If medications are changed during the hospital stay, it is important to be able to identify which medications were adjusted and if those changes have been beneficial to the patient’s health. If medications are changed it is important that the updated list is communicated to the patient’s primary care doctor and other physicians which might be the responsibility of the patient’s family.

Durable Medical Equipment

For those going home, there will be DME’s. DME stands for Durable Medical Equipment which includes wheelchairs, walker, hospital beds, etc. Some of this equipment can be provided for by Medicare.

Many times there will be a need for physical therapy, wound care, occupational therapy, etc. Again this will likely be provided through Medicare. Short-term in-home care may also be added to the mix of services and equipment that will be provided.

If it is at all possible a family should consider hiring a private pay home care company to assist as needed:

  • Personal care: bathing, eating, dressing, toileting
  • Household care: cooking, cleaning, laundry, shopping
  • Healthcare: medication management, transportation to physician’s appointments
  • Emotional care: companionship

Home Care can, oftentimes, be the difference between a successful hospital discharge versus a hospital re-admission.

https://www.caregiver.org/resource/hospital-discharge-planning-guide-families-and-caregivers/