Being discharged from the hospital can be both an exciting and anxiety-inducing event for clients and their families. On one hand, you finally get to go home. But on the other hand, you’ve been dependent on hospital staff for weeks now. Are you ready?
Patients about to be discharged may find that they are asking themselves questions such as, “Am I able to take care of myself?” “Is my family able to help me?” “What if they can’t? I don’t want to burden them.”
These thoughts are natural for patients being discharged from the hospital, as they process the additional stress that comes with instructions for their post-discharge care plan. When being discharged, you’ll likely even hear that you “need 24-hour care”, or “you’re being sent home with home health”. If you’re confused and left wondering what the right decision is for you or your loved one after all this, you’re far from alone.
Home Health Services
Home health provides skilled nursing care to patients who are homebound. For a client to be considered homebound, they must be unable to leave their home or leaving home has to be a taxing effort for them, and a doctor’s order is needed to start with home health services. It is often covered by Medicare and is used on a short term basis.
Information and Bridging the Gap Between Home and Hospital
A home health nurse can assist patients by educating them and their family on disease processes, such as diabetes or congestive heart failure. They can also assist with wound care for wounds such as pressure ulcers or surgical wounds, and provide intravenous infusions, monthly injections, urinary catheter insertion, and blood draws.
Home health can bridge the gap for many patients who come home from the hospital and need a little extra care. Physical Therapy, Occupational Therapy, and speech therapy can also be provided in the home by a home health agency. Home health staff keep the doctor informed of the patient’s progress and goals eliminating the need for frequent visits with the doctor who ordered the home care.
These patients can stay in their own environment while receiving skilled care. This type of skilled care is often only available for a limited time, and will be dictated by your doctor or insurance company.
Home Care Services: Companion and Personal Care
Home care provides companion or personal care to clients who want to stay in their own environment. It is often paid for out of pocket. However, it can be covered by long term care insurance. For example, Medicare patients who meet certain eligibility requirements can receive home health care to treat certain medical conditions, but homemaker services and custodial care are not covered. So be sure to check eligibility requirements and coverage.
Unlike home health care, home care services do not require an order from the doctor. Services can be long term or short term depending on the needs of the client. However, home care can be provided for the client in conjunction with either home health or hospice care.
Two different types of home care services offered are companion care and personal care. Companion care services can include monitoring for safety, light housekeeping, meal preparation, laundry, transportation, and medication reminders. Personal care services include assistance with bathing, dressing, grooming, transfers, walking, toileting, and all companion care services.
These patients get the help they need, for as long as they need it, in their own environment. Many families find home care services beneficial because they take away potentially burdensome caretaking responsibilities.
Affording Home Care
If you’re considering home care but are worried about affording it, you’re not the only one. First, take a look at our insurance policies. Do you have a rider in your life insurance for long-term care, or long-term care insurance? While some patients may have purchased an insurance policy that covers home care benefits, the premiums can be expensive, and many people are denied coverage as they age.
Other ways to consider paying for home care can include withdrawing from savings or investment accounts, or borrowing in the form of a home equity loan or a federally-approved reverse mortgage product.
Finally, there is government assistance. You don’t have to have lots of money saved up or have purchased a life insurance policy. Instead, check out your local Area Agency on Aging using Eldercare Locator. There is also BenefitsCheckUp, provided by the National Council on Aging, which includes information on benefit eligibility for older people. Home care benefits are also available to service members through the Department of Veterans Affairs, and tax deductions may be available for certain home care services.
Programs of All-Inclusive Care for the Elderly (PACE)
This Medicaid and Medicare initiative can provide coverage for things like:
- In-home care
- Checkups
- Adult day care
- Prescriptions
- Transportation to medical appointments and services
- Home stays at hospitals and nursing homes
- Family caregiver training, support, and respite care
PACE is open to Americans 55 years old or older who are certified as being in need of nursing home care through their state, who live in areas with a PACE organization. Learn more about PACE services and eligibility here.
Hospital Discharge Planning and Setting Up Home Care
Families may be surprised to learn that it is during the hospital stay, not as a patient returns home, that discharge preparation should begin. While you or your loved one is still in the hospital, patients and their families should plan to stay in touch with the hospital case manager, so that they know what the needs are going to be after leaving the hospital.
All too often, if families don’t get the information they need about recovery outside of the hospital. “They just told us mom was going to be discharged,” families will say, “We had no idea what she was going to need to come to a skilled nursing facility.”
Early and frequent communication with the hospital or rehab staff will help to guide you in the direction that is best for you or your loved one, and to help come up with a strategy ahead of time.
Questions to Ask When Being Discharged
Whether it’s you or your loved one preparing to leave the hospital, here are some prudent questions to ask to make sure that you’re ready to go:
Your Prognosis
Ask whether your health situation or diagnosis has changed since you’ve been in the hospital.
How You Can Get Help at Home
Find out if your hospital has a social worker or case manager who can help you as you navigate finding help with things that may be difficult when you get home. Whether it’s help getting around your home, assistance with hot meals, groceries, or something else, they can help you get answers.
Insurance Assistance
Once you’re discharged, your focus should be on taking care of yourself and establishing your new routine. In order to do that, tap into the resources at your hospital before you leave so that you aren’t left to make sense of your insurance paperwork once you’re back home.
What Are the Signs of Something Going Wrong
Be sure to ask your provider and other medical staff about any indications you may receive that something is going wrong, and how you should address them, such as whether you should try to treat them at home first or seek treatment immediately.
Medication Management
Avoid any mishaps at home by learning about how to manage your medications. Get your questions answered about what time to take your medications, how frequently, and how they may interact with each other or your diet.
Exercise, Activity, and Therapy
Drill down to ask about what type of exercise and activity you should take. Perhaps you are limited as to how much activity or exercise you can do at first, before increasing gradually. Ask about how much exercise and activity you can engage in as you continue to heal and recover, and whether that amount will change, by how much, and when.
Also take the opportunity to find out more about which therapies might help you in that process.
Your Medical Record
Be sure to ask about how to procure a copy of your medical record. You should also find out about medication lists and test results.
Know the Facts
When you leave the hospital or go through a traumatic event, finding the right care for your loved one or family member shouldn’t be a burden. Hopefully, the information in this article helps make the decisions a little easier.
