6-Step Guide: Caregiving After a Hospital Discharge

When a parent or family member is hospitalized, it’s only natural to remain focused on their hospital stay. You may feel overwhelmed with questions about what comes next. How long will they be in the hospital? Are they able to come directly home? Will they need to recover in a rehab center or skilled nursing facility first?

The Agency for Healthcare Research and Quality (AHRQ) reports that almost one out of every five patients goes through “an adverse event” within a month of being discharged. The AHRQ strongly encourages medical professionals to include families in discharge planning, stating that it can “improve patient outcomes, reduce unplanned admissions and increase patient satisfaction.”

The best thing you can do to ensure a healthy transition and strong outcome for your parent is to educate yourself about the discharge planning process and get help from the discharge planners, along with other key members of your parent’s medical team.

Here are some topics to consider, which we’ll go over in this article:

• What to ask a discharge planner and attending physician
• Rehab tips that will help you take care of your parent
• Sensible medication management
• Guidelines for heading home or transitioning to another facility
• How a short-term respite care stay can be a great “soft landing” after a hospitalization
• Why moving to a senior living community might be the best solution for your parent

Step one: Take an active role in discharge planning

Discharge planning is the method used to find out what kind of care a person requires after they are cleared to leave the hospital. Sometimes, that means they will go to a rehab facility or nursing home next. Other times, they will head straight home. Whatever your parent’s destination following a hospital stay, discharge planning is meant to make the transition as easy as possible while keeping your parent safe.

Discharge Checklist: What to Ask Before Your Parent Leaves the Hospital

Here are the key features of a complete discharge plan:

• Evaluation
• Post-hospital care instructions
• Will the patient go straight home or transfer to a different care facility?
• Follow-up appointments, lab tests, and physical or occupational therapy
• Contact list with important names and numbers
• Nutritional information
• A medication plan
• Transportation arrangements
• Special equipment needs, if required
• Additional resources such as a home care agency, as needed

The bottom line for the caregiver? Detailed, professional discharge planning matters, because when it’s done properly, the person being cared for will be less likely to be readmitted.

Step two: Prepare for a new routine

Even if you are already the primary caregiver, you might need to relearn how to care for an elderly parent in your home following hospitalization.

Changes may include:

• Personal care: The discharge plan might require your help with personal hygiene, dietary matters, helping your parent get dressed and assistance using the restroom
• Household tasks: You might need to do things you haven’t done previously such as meal preparation, cleaning the house, doing the laundry and grocery shopping
• Health matters: There could be new prescriptions to manage, doctors’ appointments to schedule and accompany your parent to, and visits for physical therapy, infusion treatments and more
• Emotional support: You might need to spend more time with Mom or Dad, engaging them in conversation
• Lining up the help you need: If a hospital or rehab stay has changed your parent’s needs, you might need to reach out to other resources, such as:
• Friends, family and neighbors: Perhaps, until now, you’ve been able to care for your aging parent alone. It might be time to expand your network of helpers, many of whom you already know.
• Community organizations: A detailed discharge plan usually lists some community resources, such as a senior center or adult daycare. If not, ask the discharge planner for local options. Your neighborhood senior center can probably point you in the right direction, too.
• Home health care: The discharge instructions might recommend in-home care and include a list of local home health agencies. Just know that researching, interviewing and hiring the right help can be a time-intensive process. Ideally, you can talk this through with your parent’s healthcare team while they are still in the hospital.

Step three: Research rehab options if needed

Is your parent’s immediate destination a rehab or skilled nursing facility? If so, the key to success is continuity of care. If the care regimen isn’t laid out clearly, and if a facility is chosen hastily, it might result in your parent having to return to the hospital.

Get real with yourself and anyone else involved in this decision. Do you have time to carefully consider the care options and make the right choice? If not, ask for help.

One idea is to contract with a private geriatric case manager. You will pay for this service, but it might be money well spent. Geriatric case managers, as well as social workers, can speak to their experience with the various care options. Make sure you know the ratings of each facility and read online reviews. The most important thing to think about is quality of care. This is more critical than how close you live to the facility.

Step four: Understand the medication protocol

When it comes to prescription drugs, here are some questions you’ll want answered:

• What is the reason this medication is being prescribed?
• What is the length of the course of treatment?
• What are the possible side effects?
• Are there other medications, supplements or foods that might interact with the prescription?
• Is the medication covered by insurance?
• Is there a generic version of the drug that costs less?
• How and when will we know if the medication is working?

Step five: What is respite care – and is it right for your parent?

Respite care is a proven method to help aging parents following hospitalization. This short-term assisted living option lets your parent temporarily move to a senior living community to recover from an illness or surgery. It’s also an opportunity for your parent to discover if assisted living is a good fit for them while receiving the help they need to get better.

Every community is different, so the best way to know if it’s the right choice is to visit and ask plenty of questions, such as:

• What kind of short-term stays are offered?
• What is the cost of assisted living respite care?
• What is included in the cost?
• What kinds of meals and programs are offered?
• What are the living arrangements like?
• What amenities are available?
• What happens if my parent experiences a medical issue?
• What are your policies regarding visits by family and friends?

Learn more about short-term stays here.

Step six: Consider living full time in a senior living community

Everyone enjoys living independently with as little help as possible, and your aging parent is no different. Hopefully, Mom or Dad can move home and resume life as it was before their hospital visit. Unfortunately, that is not always the case. If your parent’s hospitalization results in them needing more help than before, ask yourself if living at home is the best choice for their well-being.

Sometimes, caring for your parent might mean looking for a permanent care solution. An assisted living community may offer the right combination of professional care, social engagement, proper nutrition and ample opportunities to enjoy activities – and relax.

Here are some things to look for:

• Does my parent have a degenerative disease or serious medical condition? Assisted living might help them maintain and even improve their quality of life.
• Will they need daily or even 24/7 in-home care? If so, you will likely find the cost of assisted living to be competitive – and possibly even less.
• Is your parent relatively healthy but tired of the upkeep, maintenance and daily tasks of homeownership? Assisted living can relieve them of these burdens while affording them more freedom to enjoy life.

If you answered yes to one or more of these questions, you’ll want to learn more about assisted living.

Doing your part to encourage a healthy outcome

While an unexpected health event can be a lot to take in, approach the discharge planning process in a serious, buttoned-up fashion. Don’t be afraid to ask questions about your elderly parent’s care. If the answer provided isn’t clear, ask for clarification. Do your homework and give your parent the best possible opportunity for a complete and healthy recovery after they’ve been discharged.