Before a Hospital Stay:
What You Need to Know About Discharge Planning
The day your loved one is admitted is the same day the hospital has already begun planning for their discharge. You should take the same approach.
Hospitalization after an illness or injury is traumatic enough. For many people—patients, family members as well as caregivers—what comes next can be trying, too.
Hospitals are under tremendous pressure to reduce patient length of stay, and while it’s comforting to believe that the hospital’s discharge planning team is putting your loved ones’ needs front and center, it’s often not the case. Even with stiff penalties for too-early releases, patients may be sent home “quicker and sicker” than in years past.
This practice has alarming consequences. Nearly 1 in 5 (18%) of Medicare patients are readmitted within 30 days, and some studies have shown that 40% of patients over 65 had medication errors after leaving the hospital. (That’s not surprising since nearly 40% of patients are discharged with tests pending—and no plan to complete a diagnostic workup as an outpatient.)
Continuity of care is key to recovery, so what you need to do is actually the same thing as hospitals:
Start thinking and planning for care after discharge as soon as your loved one is admitted!
Here’s what you should be doing:
- Make connections: Find out the name and contact information for the hospital’s discharge planner (usually a nurse).
- Get involved: Let your discharge planner know that you want to be closely involved in the transition plan.
- Do your research: If your loved one will be returning home, anticipate what services may be needed. Unless your loved one is part of a Medicare Advantage plan, you can choose which Medicare-certified home care agency you want to provide follow-up care.
- Plan ahead: If your loved one doesn’t need skilled nursing at home, you will have to arrange for extra help on your own. This might include shopping, cooking, light housekeeping or bathing.
- Investigate your options: If the hospital determines your loved one ongoing patient care, you’ll have little time to determine which facility you prefer. You may be handed a list of options and asked to indicate your top three choices. Make sure you understand what your loved one needs and if these places can meet their needs. Know who is paying and for how long. Easy access, good fit, and quality of care are things you should consider but hard to really discern from online ratings or reviews.
- Enlist an advocate: You have a right to have an advocate (a trusted friend or relative or someone you hire privately) present at the discharge planning meeting.
- Know your rights: You can appeal the discharge if you feel your loved one is being released from the hospital too soon.
All of this is a lot to research and evaluate, especially if this is the first time you’ve had to face these kinds of decisions. If you need information, guidance, and support at any step of the process, the professionals at Allies in Aging JFS Elder Care Solutions can help.
Our professional care managers can design a custom plan to make sure your loved one has the easiest, most appropriate transition from the hospital. We know what your options are, know the best local care facilities and can connect you to high-quality in-home care. If you run into problems, our care managers have the experience to successfully advocate for the quality care your loved one needs.
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About the Author:
Malka Young, LICSW, CCM
Director, Allies in Aging JFS Elder Care Solutions