There’s No Place Like Home

Your Guide to a Stress Free Transition Home

Transitioning a senior home from rehab can cause a lot of fear and anxiety. Not only from a patient’s side but also their caregiver. It’s true what Dorothy said, “There’s no place like home.” If only it were as easy as clicking your ruby slippers. 

The good new is, it can! With a little planning, coming home from a rehab stay can be fairly stress free.

At Beyond Home Care our Transitional Care Program, There’s No Place like Home,  was created for transitioning a senior home from rehab safely and with ease. 

Keys to a Stress Free Transition Home

A patient has been through a lot from the onset of their illness or injury, including a hospital stay, possibly surgery, moving to a rehabilitation facility, and now the transition back home. Most patients will not be 100% back to their previous endurance or mobility when they first discharge home. 

There are some key things you can do to prevent a hospital readmission and to create a much smoother transition back into your home. I’ve compiled my top suggestions in this post, but know this is the tip of the iceberg.

1. Plan Early

We want you to start thinking about what your transition home will look like while you are still in the hospital. The doctor’s and case managers know fairly early on, in most cases, what the recovery period is going to look like because they have worked with patients like you, in the same position many times before. Start thinking and planning for help and home modifications from the beginning so you and your loved ones are not scrambling at the last minute.

2. Utilize your resources

 Ask tons of questions of your nurses, providers, case managers, home health coordinators, and Beyond Home Care admissions, so you can get as much information and detail as possible. No, you may not need all of these resources but its better to know about them and not need them, then to need it and not even know it was an option. You are your loved one’s biggest advocate, which means you will need to ask the questions that they may not want to.

3. Plan for routine care for the first few days of discharge

It’s always better to be more prepared than not prepared enough. If you are the only caregiver helping with mom’s care during discharge, you may need a few extra hands for the first few days.

There will be errands to run, medications to pick up, appointments to schedule, not to mention the one-on-one care your loved one will need. Don’t stretch yourself so thin you can’t manage it all, or worse, your loved one sees how stretched you are and doesn’t want to tell you they need something.

This scenario happens often; a loved one doesn’t want to burden their caregiver more, so they don’t ask for help or they attempt to do things physically but their body is not ready yet resulting in an accident or injury. Those first few weeks home are critical to ensure a client does not reinjury themselves or have an accident causing a new injury. 

20% of Medicare patients are readmitted to the hospital less than 30 days after discharge estimating to cost the American public more than $15 billion per year¹.

Centers for Medicare and Medicaid Services

4. Follow up with your Primary Care Physician ASAP

There are so many moving parts to a discharge from rehab; having medical equipment setup in the home, home health to evaluate and schedule ongoing therapy, medications that need to be filled, supplies to go out and get, friends or family come by to visit and check in. Its easy to put off following up with your loved one’s primary care physician.

But it is crucial!

Chances are, new medications were started in the hospital and/or rehab so the physician needs to see the patient to update the med list, check for interactions, and make sure they are handling the new meds appropriately. Medication errors can contribute to falls in the home. Falls are the leading cause of fatal and nonfatal injuries among older adults², and many falls are preventable. 

Your loved one’s PCP is the quarterback of their care so you should always circle back to the primary care physician when a major medical change occurs. Not only will they ensure that referrals are placed for specialists, and you are seeing who you need to for specific issues. But they help prevent illness and maintain your baseline of health to keep you out of the hospital and rehab.

You Are Not Super Human

It’s worth saying again… you do not need to do this alone.

Whether you are caring for a loved one or transitioning home yourself, you will need some help in the beginning. Home Caregivers are a great solution to help during this transitional stage because they will be able to come in for a short period of time while you gain back your independence.

At Beyond Home Care our goal is to provide our client’s with as much independence as possible in a safe environment. For some of our clients that means simply being in the next room just incase they need help for the first few days. Or making sure they have a meal prepared, medication picked up from the pharmacy and clean sheets on their bed. We have an entire program built around helping clients transition home with care, utilize our services as needed, and then live independently without assistance.

I love telling a client, “In a few week, you can fire us and hopefully never see us again…unless its at the grocery store.”😊

Beyond Home Care provides an affordable and valuable service for transitioning a senior home from rehab so they can regain their independence through our Transitional Care Program, There’s No Place like Home. 

If you would like to learn more about how we can help you or your loved one, call our office today!

Watch our Rehab Q&A with Stephanie Jones- Russell Medical’s Transition Care Unit Coordinator, and learn about the amazing resources they have to offer.

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