by Jennifer Kazmaier
The hospital offers essential healthcare services to diagnose and treat serious illness and injury, however once the presenting problem is dealt with, rehabilitation and recovery happens outside of the hospital, often in your own home.
Since people are discharged home from the hospital before they are completely recovered, family caregivers carry the bulk of the responsibility when providing care at home. Home health care and home support services can provide assistance and respite for family caregivers.
An elderly person, especially someone who is frail, is vulnerable in the hospital to infections, de-conditioning, and at worst, pressure ulcers (bed sores). Recovering at home is ideal with the proper coordination of care, communication between health care providers, and adequate support to ensure safety.
If you are caring for an aging parent, make a note of these 5 tips to help make the transition home from the hospital as smooth and safe as possible.
1.Have a medication reconciliation completed before leaving the hospital.
Medications can be very confusing, especially when the number of pills your parent takes is in the double digits. Even if there are only two medications, make sure you are crystal clear on what they need to take, when, and why.
A few important questions:
Should my parent continue on the medications they were taking before coming to the hospital? (Ensure you have a list of those medications with you that is accurate and up to date)
Can you provide the reason for taking each of the medications? (i.e. heart, stomach, sleeping)
Can I have a written medication schedule to help me?
This schedule should include the name of the medication, the dose, and how often it is taken.
If there are new prescriptions, make sure you have those. Take the medication list provided on discharge with the new prescriptions, and your pre-hospital medication list with you to your regular pharmacist. If there are multiple medications, request to have the pharmacist dispense them in a blister pack for easy medication management.
2. Ask for written discharge instructions.
I often see people come home with a one page sheet that is missing a lot of important information. Make sure your instructions at least include information on the following:
-Diet & Fluids
Are there any restrictions?
When can your parent resume normal activities? Are there limitations on what they can do?
- Expected care at home
Will you need a nurse to change a wound dressing or administer medications? Will you be expected to change a catheter bag or administer a blood thinner by injection? If so, make sure you have ample time to practice under supervision so you are completely comfortable with the task. Watching someone give an injection is not the same as doing it yourself!
- Follow up plan
When is your follow up appointment? Which doctor will you see if you have had multiple specialists involved?
What medications still need to be taken today? Ask the nurse to photocopy the daily medication administration record for the day so you know what has already been taken and what still needs to be taken. If there are new prescriptions, should they be started today?
3. Know what equipment will be needed at home.
Make sure that this equipment has been arranged to be picked up by a family member or delivered before (or on) the discharge date.
Will an occupational therapist be coming to the home to do a safety assessment?
If your loved one had a fall and broke their hip, for example, you may need a mobility aid (i.e. a walker) and bathroom safety equipment.
4. Know who to call in case of questions.
If there is a case manger involved, make sure you have their contact information, and understand their role. What services will they be coordinating for your parent? What do you need to do?
Understanding what the health care system expects you to do is half the battle. You are probably more than willing to help, but there is a lot to navigate. Find your go-to person and ask them questions until you feel comfortable in your role as caregiver.
5. Get a copy of the discharge summary from the hospital.
This is a summary of your hospital stay and the care provided. It is not an instruction sheet for you, but is very important information that you can share with other health care providers. Don’t assume that the home health care agency has all the information from the hospital. You are your own best advocate!
The discharge summary should include:
- Any procedures or surgery
-The reason for admission to hospital.
-Admission and discharge date
-A brief description of the course of the hospital stay
-The follow up plan
Often the discharge summary is not available on the day of the discharge. Ask for it ahead of time; sign a consent form for the hospital medical records department if necessary. It is your information and you can access it. Just ask!
If you need more help or have specific questions, contact me and I would be happy to help!
Jennifer Kazmaier is a Registered Nurse, and the Owner & Director of Care of CalaCare Ltd.
Jennifer obtained her Bachelors of Science in Nursing from the University of Toronto and also holds a Bachelor of Science in Biology from Queen’s University. She began her career in the Emergency Department at Joseph Brant Memorial Hospital in Burlington, where she also worked as a Sexual Assault Nurse Examiner for the regional sexual assault and domestic violence center for Halton. With this valuable experience, Jennifer moved on to the private sector and worked for Best Doctors Canada where she became a skilled coach for patients and their families who are coping with critical illness and navigating Canada’s complicated health care system.