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How to Manage a Hospital Discharge

It's hospital discharge day for my dad. Sounds like a day that is all about hustle and bustle. But reality sometimes doesn’t match perception. I learned the hard way that the day consists of long waits and then a short burst of hustle and bustle. Still, you need to be ready for when those bursts arrive. Since my parents' hospitalizations began 2 ½ years ago, I've developed a plan for how to manage discharge day. Hopefully these tips can help you as well when that day comes.
  • As soon as possible, I ask what needs to happen in order for the discharge to take place. During my dad's recent hospitalization, the concern was his low sodium levels. In order to be discharged, his sodium levels needed to rise and level off. During one of my mom's hospitalizations, the focus was her hemoglobin levels, which also were too low. Each hospitalization seems to add a new wrinkle in their care, and each one has a different timeframe. Understanding new information about their current health situation and what it will take become stable helps prepare me for when discharge day may happen.
  • I check the white board in my parent's hospital room for updates. Once I read updates, which can include an anticipated hospital discharge date, I reach out to charge nurses for more details. I've also left notes for the staff on the white board. During one of my mom's hospitalizations, doctors showed up at her bedside with updates at 11 p.m. I wrote a note that doctors needed to update my brother and I (her POAs) and included our cell phone numbers so they could contact us.
  • Note that many states have passed legislation which requires the hospital staff to update you and train you. The Caregiver Advise, Record, Enable (CARE) Act requires hospitals to:
    • Record the name of the family caregiver on the medical record of your loved one.
    • Inform the family caregivers when the patient is to be discharged.
    • Provide the family caregiver with education and instruction of the medical tasks he or she will need to perform for the patient at home.
  • Even though certain levels of updates are required, I never assume a doctor or a nurse will seek me out to provide updates. I ask for updates regularly and am proactive about sharing any concerns. Because each hospitalization brings new information about a new situation, I also ask questions and ask for clarifications. Everything that you can learn will help with preparing for hospital discharges.
  • I've recorded any training I've received in the hospital on my iPad. Receiving training from the hospital staff before we go home is great, but it's different when we get home. We're nervous, tired and worried. Watching training videos specific to my parent's situation helps things go smoothly until I’ve gotten accustomed to what to do.
  • I bring my laptop, tablet and chargers with me because the wait can be long. Each specialist needs to okay the discharge as well as the general practitioner. For my dad's hospitalization, we received quick clearance from the cardiologist and gastroenterologist. The renal doctor, unfortunately, kept us waiting. There’s no sense sitting and doing nothing while waiting for a discharge to be cleared, so during the wait, I found a quiet spot and worked.
  • So far, my parents have returned home after each of their hospitalizations. But the day may come when they will need a short-term stay in a skilled nursing facility. I am aware of the facilities in the community that can accommodate both my parents – the one who needs care and the one who will visit. A facility close to home with easy access is a must for the parent who will visit.
  • Short-term Medicare benefits may cover help at home after a discharge, including a visiting nurse, home health aide, physical therapy and occupational therapy. We now ask if Medicare benefits will cover help at home – we don't wait for the hospital staff to offer the benefit. Your family member may not qualify but it's always good to ask.
  • Ask if new medications can be filled at a pharmacy in the hospital. The convenience of bringing home meds rather than running another errand to the local pharmacy can shorten the already long day.
  • One of the longest waits can be for "transport" – the volunteer with the wheelchair to escort your family member out of the hospital and into your car. I prompt the nurse to order the wheelchair as soon as possible to reduce waiting time. While every hospitalization may be different, you can bring a tool kit of knowledge and resources to the hospital discharge plan. If you do, you’ll be ready when your family member is ready to return home.
  • About Denise Denise launched in 1996, which was the first website to add online caregiving support groups, daily caregiving chats and blogs written by family caregivers. A certified life coach, Denise helps family caregivers and former caregivers find their best selves during one of their life's worst times. Denise also hosts a Twitter chat for family caregivers (#carechat) every Tuesday at 1 p.m. ET. Her books, including "The Caregiving Years", "Six Stages to a Meaningful Journey", and "Take Comfort: Reflections of Hope for Caregivers", provide insights, inspirations and information to those who care for family members.