When Your Loved One Comes Home From the Hospital
Mom tripped on the garden hose while walking to get the mail. She had surgery to repair a torn shoulder. The surgery went fine and now she's coming home. But with her arm out of commission and a long sheet of post-op instructions, she can't manage on her own.
Maybe you've heard the term "quicker and sicker"? It’s true that patients are discharged from the hospital sooner these days after surgery or an illness.
For older adults, this isn't necessarily a bad thing! The hospital isn't the best place for a restful recovery, with the bright lights and noisy corridors. The Centers for Disease Control and Prevention (CDC) says that 700,000 American patients each year contract an infection during hospitalization, and seniors are at higher risk. Many senior patients also develop hospitalization delirium, a state of confusion and disorientation that sometimes occurs after surgery or a serious illness. While delirium is temporary, researchers now believe that the condition raises the risk of dementia.
Hospital care also is very expensive, both for patients and for Medicare and insurance companies. There are incentives to move patients into a less acute care setting as soon as possible, and to avoid unnecessary return trips to the hospital. Yet one in five hospitalized Medicare patients is readmitted within a month of discharge, costing Medicare $26 billion annually. Medicare has begun penalizing hospitals whose readmission rates are too high.
After discharge, some seniors go to a nursing home, rehabilitation facility or similar care setting. Others are discharged directly to their own house or apartment, or come home after a short rehab stay. Can they recover successfully at home? In the absence of nursing and support staff, who assists these patients during their recovery?
The answer, as many Caring Right at Home readers know, is that family caregivers step in to help. Are these family members ready for the challenge? Many times, their loved one not only is suffering from the effects of a major health event such as a stroke, heart attack or hip fracture—but also is experiencing post-hospital surgical pain, grogginess and weakness. This puts them at higher risk of infection and falls. The AARP says that many caregiver relatives today are called upon to perform medical and nursing tasks, such as medication management, wound care, using meters and monitors and more—and they don’t feel qualified.
"Many hospitals treat family members as visitors rather than members of the healthcare team," cautions Dr. Alexia Torke, a professor at the University of Indiana Center for Aging Research. Fortunately, there is a growing understanding that family caregivers are central members of the care team and should be more involved in discharge planning. Many hospitals are providing caregiver education, helplines and other caregiver support services. "As the population ages, family members of older adults should prepare for the crucial role they may play when their loved ones are hospitalized," says Dr. Torke.
Once a patient is discharged, skilled nursing services can be provided in the home. In some regions, the house call is even making a comeback, with doctors visiting senior patients in the less disruptive home environment.
Much of the care is more routine. The patient may need help with the activities of daily living and with managing post-discharge recovery instructions—to say nothing of cooking, cleaning and the other usual household tasks. Family caregivers quickly find that caring for their loved one is a full-time job!
This is where professional in-home care can make all the difference, both in the patient's optimal recovery and in the well-being of family caregivers. In-home care can be provided for a few hours a week up to 24/7. After a patient is discharged, trained in-home caregivers can:
Support the patient's follow-up care. Compliance with the doctor's instructions promotes the best possible outcome. But managing appointments, instructions and care tasks can be overwhelming! In-home caregivers help coordinate medical appointments, pick up prescriptions and provide medication reminders, and transport patients to doctor appointments, outpatient rehabilitation sessions and other follow-up care.
Supervision and confidence. The old days of prolonged bed rest after surgery or an illness are over! In most cases, healthcare providers recommend a prompt return to physical activity. Trained in-home caregivers assist patients as they return to exercising, walking and getting around the home. They also provide a steady hand and encouragement while patients adjust to using a walker, crutches or other assistive devices.
Personal care and hygiene. Many times patients are challenged by bathing, dressing, grooming, going to the toilet, oral care and so forth. Trained caregivers provide skilled assistance with sensitivity to preserve the patient's dignity.
Housekeeping, laundry and meal preparation. In-home caregivers keep the house clean to lower the risk of infection, and remove hazards that could cause a fall. They grocery shop and prepare appetizing meals and snacks that meet the healthcare provider's dietary recommendations.
Respite for family members. Caregiving is hard work. It can be emotionally difficult and exhausting. With a trained in-home caregiver filling in, families can get some rest and take time for their work and other responsibilities, lowering the stress that jeopardizes their own health. In-home care also is a great option for long-distance caregivers who feel torn between their loved one’s care needs and their responsibilities back home.
The Eldercare Locator offers a free booklet, Hospital to Home: Plan for a Smooth Transition.
Families whose hospitalized loved one has Alzheimer's disease or a related disorder can find specialized information from the National Institute on Aging's Hospitalization Happens: A Guide to Hospital Visits for Individuals with Memory Loss.
For information on topics related to home care and healthcare, visit our Home Care and Healthcare Advocacy group on LinkedIn.
|Do you know a senior who needs help transitioning home from the hospital? Right at Home’s RightTransitions® program can help make that transition easier. Visit the Right at Home Care Transitions information page to learn more.||