You're Being Discharged Tomorrow

"You're being discharged tomorrow." That's what they told my Uncle Don two days after his hip replacement. I looked at the doctor and thought, "Are you kidding?" With hospital stays becoming shorter and shorter, did you know that even though your loved one is well enough to be discharged from the hospital, they may have ongoing care needs and/or may not be well enough to safely function on their own at home?

We are blessed to have social workers and discharge planners at the hospitals that help prepare us for this moment. While Uncle Don was excited to be coming home, I was quite worried for both him and my aunt whom I knew, in one quick second, was just promoted to full-time caregiver. Whether we know it or not, discharge planners started our process for us as soon as Uncle Don was admitted to the hospital for the surgery. They were on task to ensure Uncle Don's safety and continued well-being after discharge. The number of options to consider at that moment were overwhelming. As my mouth was still open in amazement, the discharge planner starting reviewing them with my aunt and I.

Any number of arrangements could have been set up and they were based on Uncle Don's medical condition, illness, age, his support system (mainly my aunt's capability, in our case) and much more. We could be looking at one of the five options below:

Go back to his home - With or without family support, home care or outpatient services
Go back to my home - With or without professional home care or outpatient services
Go to a rehabilitation facility for a short while
Go to an assisted-living community for a short while
Go to a nursing for a short while

Our discharge planner discussed all these options with us and identified needs, potential barriers and helped us determine how to best accommodate the needs of Uncle Don. Some needs such as assisting with ambulation, bathing, and dressing were obvious. But when considering Uncle Don's 6'2" frame, it was difficult to imagine my 5"3" aunt who uses a cane herself, would be able to help with that. We knew cooking would not be a problem as my aunt could still easily cook up a mean lasagna. Going to a facility would mean that she would want to go visit him everyday - yes they are inseparable! But while she doesn't drive anymore, that would mean we would need to set her up with transportation everyday, possible 2 times a day so she could get some rest in between. I know I couldn't provide that, so we would have to search outside the family to cover that. If we went to a facility, which one would we go to? Well more than half of that choice is based on bed availability and we would have a strong preference for a facility close to home. In the end we decided to take Uncle Don home and bring in home care, both medical for therapy and non-medical to help with everything else.

The choice is a personal one though and it is important to consider all of the factors involved to make an informed decision. Since hospitals like to move patients out as quickly as possible (or is that the insurance company doing that?) it is important to understand that you could be forced to make quick decisions before really getting a chance to "sleep on it".

Discharge planners can provide checklists to help you make informed decisions when looking for a home care company, skilled nursing facility or rehabilitation center. There will be specific tasks that you will need to make sure get addressed, but don't overlook the relational issues. Kristin Worthington, of Home Helpers, says "It can be helpful to find an appropriate balance between doing and being." Doing refers to support activities such as helping with meals, transfers and personal care. Being refers to companionship."

"For people who are transitioning to their home, with or without home care, family members should consider the following:

Make sure you are aware of your duties as well as your limitations to playing the caregiver role.
Seek training in order to provide the necessary support and be able to do so safely (e.g., transfers, wound care).
Establish a routine and first address known care needs (e.g., meals, meds, laundry, personal care). Then add in companion care to that routine - avoid isolation!.
Discuss and strive to agree on the things that matter most (e.g., safety, dignity, quality of life).
Seek to understand each other's point of view (e.g., caregiver, care receiver). What may seem simple or obvious to one person may seem complex and overwhelming to another (e.g., making a meal, going out for a meal).
Be careful to communicate feelings, fears and frustrations appropriately (e.g., "I'm asking you to please let me talk and just listen").
Know that regular feedback can be helpful (e.g., what's working well, opportunities for improvement). Remember, people can only do or change something if they have the feedback."

If you seek out an agency, like Home Helpers, to help with the care, all of the above should be addressed with that agency as a start. Feel free to contact us to obtain a free report on "Be Prepared When Considering A happinesslifetime.com Home Care Agency" which details 19 questions to ask any agency.

Home Helpers provides non-medical personal care services similar to what is often provided by family members. Our services are designed to help people maintain their independence and avoid isolation. We provide up to 24 hour care to clients in their residential home or in a facility. To learn more about our services or to ask for our free newsletter, call our office at 513-754-1182 or 859-801-1510, or view our website at homehelpers.cc homehelpers.cc