The nurse comes into your hospital room and says that you are ready to be discharged. You’re happy to be going home to the comfortable surroundings of your home and your own bed. The last thing you want is to be readmitted to the hospital because you run into problems taking care of yourself after you are discharged.
The hospital staff also wants your transition from hospital to home to go smoothly with no return visits. However, almost 20 percent of Medicare patients are readmitted to the hospital within 30 days after discharge, according to a New England Journal of Medicine article. This is a huge financial issue for Medicare which is searching for solutions to the “readmission” problem. Why do so many elderly patients need to be re-admitted to the hospital?
They may not understand or may be too weak to fully comprehend the discharge instructions provided by the doctors and nurses.
They may have difficulty understanding and managing changes to their medications.
They may find it difficult to get to follow-up medical appointments because of fatigue or lack of transportation.
They may be too tired or uncomfortable to prepare nutritious meals which can jeopardize their recovery.
They may not recognize warning signs that require medical assistance and may delay notifying their physicians until the situation becomes acute.
They value their independence and may be reluctant to ask for help at home. They may neglect their discharge plan when they return home because they are tired, confused or frustrated but still hesitant to ask questions or to seek help.
When elderly patients are ready to return home from the hospital, it is very important for everyone involved in their care – patients, families and medical caregivers – to be realistic about the challenges facing the elderly while they are recuperating from illness.
As a patient, what can you do to better ensure a successful recuperation after you are discharged from a hospital? When you receive a discharge plan, ask yourself the following questions:
Do you have the names and phone numbers of all medical personnel you may need to contact when you return home?
Do you have a schedule of all follow-up medical appointments? Do you feel strong enough to call to set up medical appointments when you return home? Can you get to these appointments on your own or do you need help with transportation?
Are you willing to ask another family member or professional caregiver to coordinate your discharge plan if you feel too weak to handle it yourself?
Do you need help with normal housekeeping duties, such as food shopping, cooking, household chores and personal care, during your recovery?
Do you have any new dietary restrictions? Do you feel strong enough to prepare nutritious meals and to shop for groceries? Do you understand that certain medications need to be taken with food at certain times of the day or that some medications cannot be taken with specific foods?
Do you have a list of all your medications, especially any new or unfamiliar medications? Do you understand the dosage and when to take your medications? Are you aware of any possible side effects, especially adverse reactions that require prompt medical attention?
Will you be able to pick up prescriptions from your pharmacy and do you know that you can ask for easy-open bottles with large print labels if needed?
Do you use a pill box to organize and manage your medications and are you able to refill it and use it properly while you are recuperating? Do you understand how to incorporate new medications into your pill box? If you have not used a pill box, is it time to start using one now? Are you willing to ask a family member, your pharmacy or even a professional caregiver to manage your pill box until you feel better?
Do you know the warning signs that your recuperation is in trouble and that your health may be declining – or are you willing to ask someone else to look out for these warning signs – so problems can be addressed before they turn into a medical crisis?
After you look over this checklist, you may decide that you can handle all the discharge instructions on your own — or may decide that extra help is needed while you are trying to get back on your feet. Are family members willing or able to help you or is a professional caregiver a better option during this transition period? It is normal to feel frail and confused — and even angry or anxious — when you return home. With the right support and kind encouragement, you will stay on the road to recovery without a readmission back to the hospital.
Jack Cross is President of Home Instead Senior Care-Lexington a provider of companionship and home care for the elderly. He can be reached at 781-402-0060 or firstname.lastname@example.org . See our website at www.homeinstead.com/404.