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Health & Fitness

From Hospital to Home: A Smooth Transition

Margalit Tocher of Kenilworth-based Home Care Assistance of Chicago provides tips on how to ensure a smooth transition back home after a stay in the hospital.

No one likes to go to the hospital and once in the hospital, no one wants to stay in the hospital. The absolute worst is when you have to go back to the hospital.  Unfortunately, re-hospitalization rates in the United States are alarmingly high, often around 10 percent. For example, U.S. statistics show that 1 in 10 Medicaid patients between the ages of 21 to 64 were readmitted to the hospital within 30 days of discharge in 2007. Patients often believe that the story ends once they go home, but for every day spent in a hospital, a week of recovery is typically needed until they can safely and comfortably return to their normal routine.

Fortunately, with planning and the right care, re-hospitalization rates can be significantly reduced. Before you return home, be sure to understand your options. Perhaps the most important trait for success once you arrive home is patience. Be patient with yourself. If you push yourself, you will be pushed right back to a facility. Relax. Accept help. Expect your recovery to take time. Listen to your doctors and therapists. Exercise, take your medications correctly and allow others to help you.

If possible, consider having a family member or trusted friend sit in on the meetings and take notes for you. A second pair of eyes and ears can be helpful when trying to remember instructions, particularly if you are recovering from an illness or event. Do the following before you or your loved one is discharged from the hospital. 

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  1. Understand your care options. Be sure to let your family and discharge team know your preferences.
  2. Make sure you understand the medications that you will be taking upon discharge and how to take them.
  3. Ensure any equipment you may need for continued recovery at home (e.g. a hospital bed or walker) is in place before you get home.
  4. Understand all the therapies that are assigned. Have a schedule in place, as well as contact numbers.
  5. Ask the staff to demonstrate any tasks that require special skills, such as changing a bandage. Ask anyone who might be helping at home to watch the demonstration too. 
  6. Ask your discharge team about common problems for patients with your health condition, what you can do to reduce your risk and what you should do in the event of emergency – take notes! You may not remember all the details once you’re home.
  7. Understand your physical limitations – plan for them and don’t push yourself.
  8. Know that you have access to a social worker if you have concerns about coping with the situation.
  9. Request written discharge instructions and a summary of your current health status. Bring this information and your medication list with you to all follow-up appointments. Don’t assume the doctors have all of the information or that they have read it. Remember, you must advocate for yourself (or have a family member or friend advocate for you), so it is important that you are familiar with your conditions, medications and instructions.

Once you or your loved one is discharged, there will be a number of steps before full independence can be reached. The length of each step is determined by a number of factors, including the condition that caused the hospitalization, your age, your general health and how well you treat your transition home. You have control over your transition if you remember that this is a gradual process – be patient! 

Here are the steps to independence:

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  1. Dependence: When you first return home, your primary goals are rest and recovery. Hire an experienced caregiver from a stellar agency who will support you. Your caregiver should take care of laundry, meal prep, errands and any other household tasks. Let them do their job! You can return to your household routine in the near future. In the meantime, focus your energy on resting, recommended therapy exercises and proper caloric intake. 
  2. Mild Independence: When you feel stronger, ask your caregiver to cut back on hands-on care wherever possible. Identify tasks that you can now manage independently and slowly wean yourself off care in these few areas. Never compromise your safety though; ask your caregiver to step in if you feel uncomfortable.
  3. Supervised Independence: Over time, you should gradually increase your independence. Your caregiver should be there to assist if needed, but her primary role should be supervision and safety monitoring, rather than direct physical assistance for your immediate care. She should still take the lead on household chores. 
  4. Supported Independence: Once you are comfortable with activities of daily living, you can incorporate chores and other housework into your routine. Try a trip to the grocery store or prepare a meal with your caregiver. These seemingly minor steps are important milestones in your path towards a full recovery.
  5. Semi-supported Independence: Slowly start to return to your pre-hospitalization routine.
  6. Full Independence: If you feel you can safely return to all of your regular activities independently, evaluate your comfort level and assess if you’re truly ready. Remember, full independence is a long-term goal and should not be prioritized ahead of your safety.

While you safely and methodically work towards full independence, remember to be alert – keep an eye out for anything that seems out of the ordinary or is of concern by listening to your body. Never hesitate to call your doctor with questions. Review the list of risks that you received while in the hospital. Listen to your doctors’ instructions and follow the exercises prescribed by your therapists. For now, it’s all about you. Once you have successfully reached full independence, throw yourself a party, take a deep breath and start to look around again – it’s a big beautiful world, and through planning and care, you will soon be ready to fully join it again!

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