Hospital discharge planning for a parent should be an opportunity to craft the best possible therapeutic solution to an ongoing health issue. The reality is that arranging care for a parent is often aggravating with time pressures and fear of failure punctuating the entire experience.
Bringing a parent home to recuperate, receive physical and occupational therapy as well as assistance with activities of daily living is a worthwhile goal. The familiarity and comforts of home may provide a calming effect for the parent. Calm is something adult children thrust into the role of decisionmaker probably will not feel. Hospital stays are structured under the payment guidelines set by Medicare and other health insurance plans. Timetables and coding set the trajectories for a patient’s treatment and stay up until discharge. Discharge does not mean that a patient is recovered, only that the acute phase of the treatment has run its course. Hospitalizations with periods of immobility, nutritional inconsistency and lack of sleep will weaken a patient requiring some form of rehabilitation. Medicare will cover short term stays in rehabilitation facilities as well as therapeutic services at home
Preferential discharge planning for Rehabilitation and Nursing facilities is common. It is easy. A few phone calls, an assessment and your mom can go from hospital bed to rehabilitation bed. The rehabilitation facility will provide a bed, closet, and usually a nightstand. Laundry and meals are included. Physical therapy may be conducted in a special room or in the patient’s room. Discharge planners can make the arrangements faster than with alternative options. Families will have more time to work on long term care planning while Medicare is the primary pay source. While all of these features seem advantageous, adult children who have dealt with these situations know that there are plenty of drawbacks to institutional recuperation including: food taste, staff to patient ratio issues, roommate issues and defining what is a productive physical therapy session.
For home discharges, there has to be a safe environment and enough care to support the patient’s return. Setting up home care and readying the home takes time and there will be pressure from the hospital to move faster. Do not let that pressure deter your efforts. An adult child decisionmaker should reach out the parent’s primary care doctor, a Physical Therapist offering home services, a licensed home care agency and a vendor for any necessary durable medical equipment as well as a hospital bed. If your parent has a specific diagnosis then there are organizations that understand the needs of that population which can guide your efforts. More work needs to get done, but there will be more family oversight and control over this very important recuperative stage. There are experienced social workers and long-term care professionals who have set up home discharges for other families and can help you too.
Talk to the professionals at Sloan and Feller today for guidance on home care planning.