Caregivers can make a critical difference in the quality of health care a loved receives when they leave the hospital to go home. Knowing what to expect, staying informed, and making key preparations will be vital in ensuring that few or no adverse events take place and that there is no need for readmittance to the hospital.
Consequences of Poor Hospital-to-Home Transition Planning
- Care during a critical recovery period can be compromised, resulting in mistakes and delays that could have serious consequences.
- Infections, emergency room visits, readmission to hospital, and greater medical expenses.
- An increase in patient distress, which can exacerbate symptoms and prolong recovery.
- Greater physical pain, which could be avoided, as well as depression.
- Greater distress and anxiety for caregivers and their families, as well as more disruption in family life.
What Is Lacking During the Hospital-to-Home Transition
Just how challenging this transition can be is clearly revealed in a quality standard report from Health Quality Ontario.
For the report, the authors compiled information from two studies of patients giving feedback on their transition from hospital to home.
- 25 percent of respondents said their primary care providers were unaware of the treatment they received while they were in hospital.
- Just 59 percent knew which danger signs to watch for when they got home.
- 48 percent did not know when it would be safe for them to return to their usual activities.
- 80 percent reported that they knew how to take their medications, but 36 percent were not aware of side effects.
- One-third of the respondents who were hospitalized for a mental health or addiction condition did not have a follow-up visit with a physician within one week after their discharge.
- Less than half of those hospitalized with a serious chronic condition were seen by a physician within one week of being discharged. The report points out that this is particularly concerning because 20 percent of people with serious chronic conditions return to hospital within 30 days of being discharged.
- 44 percent of patients do not go to recommended post-discharge appointments for follow-up care. Prohibiting factors include money, mobility challenges, lack of social support, and low health literacy.
Paying attention to reports from patients on what was lacking when they were discharged can play a significant role in helping to inform and structure a better hospital-to-home transition.
What Can Caregivers Do
The periods before your loved one is admitted to hospital and after they are released can be very stressful — for them and for you. Fear, anxiety, and a lack of knowledge can lead to poor decision-making, confusion, and forgetfulness.
On the other hand, knowing what to expect, knowledge-seeking and planning can help you as a caregiver to make the transition to home simpler and safer. For the following tips, be sure to write down information you are told so you do not forget.
Here are 15 things caregivers can do to:
- Keep learning as much as you can about your loved one’s condition.
- In advance, ask what your loved one’s health status is likely to be when they are discharged.
- Closer to discharge, confirm your loved one’s health status from the medical staff. Also, consider what your loved one is telling you about how they are feeling.
If your loved one still feels too poorly to leave the hospital, or you believe they should stay a bit longer, ask for a discharge planning meeting and voice your concerns.
- Get a picture of what life at home is likely to be when your loved one gets home. For instance, find out what type of support they will need, including any assistive devices or other equipment, such as an oxygen tank.
- Find out about dietary needs. It is a good idea to have several meals prepared and frozen in advance.
- Get a discharge summary and any recent test or procedure summaries.
- Ask about possible warning signs or complications to watch for and get specific information on how they should be handled.
- Review medications with the medical staff. Ask for generic options if those are not provided. This will help to reduce financial costs as a hurdle to a good recovery. Also, get a full list of possible side effects and recommendations on what to do if they occur.
- Ask about follow-up appointments and arrange to accompany your loved one to them so they do not skip them.
- Find out about any follow-up tests your loved one might need and why. Get a clear explanation of what any results mean.
- Arrange for in-home, professional caregiver visits if you need extra help. Do this well in advance of your loved one leaving hospital so you have time to vet candidates or make arrangements with an agency.
- Be sure to let the agency or caregiver know what type of assistance will be needed so that the person you hire has the right skills to give the care that is needed.
- Plan to be there when your loved one is discharged and to stay with them until they are in stable condition. If you cannot be there, ask another trusted relative or friend, or professional caregiver to be there.
- Keep your loved one’s primary healthcare professional informed and ask for any recommendations they have for your loved one’s care or next appointment.
- If you are providing most of the care yourself, arrange with someone — a sibling or other family member — to help out so you can have a break and be at your best for your loved one during this difficult period.
When you are tired, stressed, or reaching the point of burnout, you are a less effective caregiver, which compromises your loved one’s care. Do not feel that you have to do everything by yourself.
