Caregiver showing client information

The transition from a hospital/rehab stay or an ER visit to home is vital to your recovery and avoiding re-hospitalizations. Discharge day can be chaotic and stressful for you and your loved ones with everything that must be done. Although you won’t be discharged until you are medically stable, that doesn’t mean you’re feeling up to staying on top of the many details that must be managed for a successful transition home. It can be overwhelming for you and those who are there to support you.

On the day you come home, your discharge planner will review what needs to be done. This can include medical treatment orders such as:

• Making sure all needed medications are ready to be picked up and reviewing the schedule for taking them with you and any caregivers,
• Ensuring you know about symptoms you must report to your doctor immediately or that might require emergency assistance,
• Ordering necessary support equipment and supplies, such as walkers or oxygen, and having them delivered in time for your arrival at home, and
• Discussing special diets or specific dietary restrictions that must be followed.

Many of our clients engage our registered nurse to help with all of this, including meeting with you and the discharge planner to go over everything before you go home, creating a list of symptoms you or your caregivers must report right away, and ensuring all medications, equipment and supplies are ready for pick up. The nurse also reviews instructions and schedules with you. Our nurse also can follow up with you as needed for medication management and to help ensure your recovery plan is on track.

Sometimes additional help is needed with transportation home and helping you get settled. You may want someone to go grocery shopping to restock the fridge and find anything needed to meet dietary restrictions. Some of our clients also want help with daily meal preparation, assistance with taking medications, and making sure important phone numbers are readily available. Over the short- or longer-term, our clients also ask us for assistance with personal care, light housekeeping, pet care and transportation to doctor appointments.

We also help make sure the environment supports your needs when you return home and evaluate potential issues with a total home safety assessment. Both the interior and exterior are assessed for any safety considerations or issues that could contribute to health concerns. Short-term fixes like eliminating trip hazards or installing safety bars are identified along with ongoing maintenance issues that should be addressed.

Our ultimate goal is to give you and your loved ones the peace of mind of knowing that you have the caring support you need to focus fully on your health and recovery.