Discharge planning from a hospital starts upon admission of the patient. This means that as your parent's advocate, you will learn what he or she needs during the hospital stay. Get involved. Observe as much as you can during your parent's hospital stay about the diagnosis, treatment plan, new medications and daily care. There are many resources to help you, but discharging a patient can often be overwhelming and confusing for the caregiver. You might be worried about being able to take care of your parent after leaving the hospital, may feel overwhelmed by the amount of information you have to digest about their daily care and might be concerned about a medical error, like a medication mistake, or relapse that could send your parent back to the hospital, known as a hospital readmission. Relax. Or try to anyway. The hospital will have a discharge planner, hospital social worker, charge nurse or your parent's primary nurse to go over all the discharge planning with you. Here are steps you can take to make sure you understand what’s needed to avoid a hospital readmission:
- Be present at the time of discharge. If the patient is returning home, you'll want to know what kind of care will be needed. Make a list of questions before discharge. Write down the answers in a notebook you'll refer to later.
- Ask the patient's primary nurse to go over daily care of the patient. Take notes in a notebook that you can refer to it later and ask the nurse to show you what needs to be done—watching someone complete tasks is helpful, rather than simply relying on your written notes. Those serve as back-up. Ask the primary nurse these three things:
- What is the main problem?
- What do I need to do?
- Why is it important for me to do this?
- Always involve the patient's primary care physician (PCP) in the process of discharge from the hospital. PCPs can help with transitions to home, give you essential information about the patient's home setting, potential risks at home, and inform you of follow-up appointments with the physician. Write everything down in your notebook. Make sure the patient's PCP has a list of all new medications.
- If your parent speaks another language, ask for discharge planning instructions in the language he or she speaks. Ask if the hospital has an available translator for the patient. If needed, find a family member or good friend who can translate for your parent. Take notes in your parent's language so he or she can refer to them later.
- Write down the patient's diagnosis, list of medications and dosages, dietary needs, any treatment needs, test results and any pending test results.
- If prescriptions for new medications need to be filled, consider filling them before the time of discharge. Ask if there are potential side effects of any new medications. Write them down.
- If your parent cannot afford any new medications, do not be embarrassed to tell the primary physician, primary nurses, discharge planner or social worker. There are options for your parent.
- Ask about any dietary restrictions. Then consider who will do meal preparation if your parent cannot do this for him or herself.
- Make a list of which medical professionals will be helping with the care of your parent. Who will be visiting and how often? What are their names and contact information?
- You'll also want to ask the primary physician or primary nurse for any potential warning signs of a medical emergency or urgent problem that requires medical attention. You'll want to know the signs if your parent is not doing well. Write them down. You might consider making a list for your parent for his or her home that says:
*Call 911 if you experience these symptoms (list them) Create these lists according to the information the patient's primary physician or primary nurse tells you. Place it on your parent's refrigerator or bathroom mirror.
* Call your doctor if you experience these symptoms (list them)
* Go to the hospital ER if you experience these symptoms (list them)
- Ask the patient's primary nurse and primary care physician what the anticipated recovery time will be. Record the information in your notebook.
- If your parent is to be transferred to a rehab facility, nursing home or skilled nursing facility, discuss this with the hospital's discharge planner, hospital social worker, primary nurse and the patient's primary care physician. You'll have a choice, depending on health insurance coverage. Visit the facility. Talk with the facility's manager and medical professionals, and observe the patients there. You can research nursing homes by going to:
Other Resources Before your parent's hospital discharge, ask the patient's primary nurse, primary care physicians, hospital social worker and discharge planner for a list of the following: 1. Community resources of social support for caregivers and patients. 2. Community-based agencies that provide services such as transportation, equipment maintenance, home care and volunteer services. Do your homework. You'll feel better and so will your parent.