It isn’t easy being a family caregiver. Your caree has been acutely ill, requiring a hospital stay. Now it’s time to transition back home. The day of discharge is finally here and yet you feel unprepared. The level of care has changed and you are unsure if you can still manage all of the caregiving needs.
A good transition home has to start long before the discharge date. As soon as a caree’s hospital stay begins, you should start thinking about what will be different when they return home. These suggestions may make this hospital to home transition easier.
- Be present for personal care A lot of care is given throughout the day at a hospital. Personal care is something that you may not see at different times during your visits. If caregiving is new to you, or if your caree requires a change in the amount of care needed, then it may be a good idea to be present during times of personal care such as bathing or assisting to the bathroom. Being there will give you a better idea of what to expect for care when your caree returns home. Does your caree have new drains or tubes that you will be responsible for emptying? Will they require additional assistance getting into or out of the tub? When caregiving is new, frequently the hospital will attempt to educate the family caregiver. However sometimes education comes in the form of a written instruction sheet. This may not be enough. When caregiving is hands-on the education should be as well. Ask for demonstrations or if you can perform certain tasks before discharge.
- Keep track of physicians and schedule follow-up appointments It’s a good idea to write down the names of every doctor that comes in to see your caree during their hospital stay. Note whether they are Specialists or hospitalists. Ask which specialists you should schedule follow-ups with. As more and more hospitals move towards using hospitalists you’ll rarely see your caree’s primary physician in the hospital. As soon as possible following discharge, you should also call the primary physician and schedule a follow-up appointment. Many people are under the misconception that their primary physician will know they have been in the hospital and have been included in every decision made along the way. This is not true. While some hospitals and physicians attempt to share this information, it frequently does not happen. Scheduling this follow-up appointment will help to ensure that the physician stays attune to what’s going on with your caree.
- Review medications before transitioning Your discharge instructions will include a list of medications containing everything you should be taking. Review any medications that are new or unfamiliar to you. Question any previously taken medications that are no longer included on the list. Upon admission and again on discharge, all care facilities (hospitals, nursing homes, rehabilitation centers, etc.) should do a medication reconciliation. This list reviews the medications that a patient is on prior to coming into the hospital and reviews them again upon discharge. Frequently this list is woefully inaccurate. New and over-the-counter medications are frequently overlooked and facilities fail to correctly update them. As the caregiver, be diligent when comparing the medications on the discharge list against every medication that your caree has at home. Be sure to compare the dosage amounts as well.
- Ask lots of questions There will be lots of things you don’t know when transitioning family members home, and the biggest thing to do is to ask questions. What kind of problems can I expect to encounter in the next day or so? What if I need help? What resources would be useful to us right now? Is home health care necessary or appropriate now? Formal discharge planning should have included any additional services, referrals or equipment that you may need for your caree after discharge. However sometimes you don’t know what you need until you get home. Ask about who you would call then.
Every transition brings new challenges, new questions and new concerns. If you as the family caregiver are proactive during the hospitalization and are included in discharge planning, then the transition home is much smoother for you and safer for your caree.
About the Author
Elaine Tunnell is a Registered Nurse and a Transitioning Life Certified Caregiving Consultant. She has over 25 years of nursing experience. As a home health and hospice professional, Elaine has been working directly in the home with family caregivers since 2010. Hospice nursing is her passion. It is Elaine’s goal to educate and support the family caregiver along every part of the journey so they can make the best choices for their caree. Elaine is currently working on two books entitled “The Hospice Journey” and “The Caregivers Journey”.