This is a new addition to our quarterly Caregiver Connection, where we answer questions from family and friend caregivers.
My husband is being discharged next week and I’m worried about having him come home and not knowing what to do or what to plan for. How do I best plan for hospital discharge?
~ Worried Family Caregiver
Dear Worried Family Caregiver,
Hospital discharge can feel exciting and stressful for both the person being discharged and the family caregiver. One way to make the transition as smooth and safe as possible is to request you be included in a discharge planning meeting in the hospital.
At this meeting, the patient’s care team will meet to discuss the plan as well as answer questions you as a family caregiver may have. Professionals involved may include the attending or family physician, the Clinical RN in charge, a discharge planner, family caregivers and the patient. Other health professionals, e.g., a physiotherapist, social worker or occupational therapist may also be asked to participate. If no arrangements have been made for a discharge planning meeting, you can make such a request. This is especially helpful if you have questions or concerns about the discharge process. The best person to arrange a meeting is the Unit’s Patient Care Coordinator (PCC), Discharge Planning Nurse, Unit Manager, or Social Worker.
The discharge planning meeting provides essential information about the patient’s condition, care needs and supports needed at home. It also presents an opportunity to discuss any concerns and challenges. The meeting process and plan include:
- Providing patients and their family caregivers with information, support and resources to reduce the risk of complications and increase the opportunity to ensure continued recovery from a hospital stay;
- Discussing what phone calls to expect from community supports, i.e., a phone call from an occupational therapist to do a home safety check or a home care nurse for wound management, ;
- Reviewing medications, scheduled time for medications and any changes made;
- Reviewing what to expect for recovery and going over warning signs and problems to watch for, including what to do and who to call if there is a problem; and
- Discussing what follow-up appointments are needed and with
Logistics of discharge can also be included in this meeting, such as:
- Discussion of the arrangement of any required home care support services for the This can be organized through the Health Authority or through a private pay agency;
- Identification of mobility supports for the care recipient;
- Identification of environmental home limits that would impact safe care; and
Getting a written copy of the discharge summary is a must (where possible) as well as any recent test/procedure summaries when leaving the hospital. If referrals were made it is also advisable to ask for a list of these referrals and how the referral is being processed.
The following are reasons when it is especially important to request a discharge planning meeting:
- You do not feel your loved one should be discharged from the hospital.
- As a caregiver you see barriers to providing safe and adequate care when your care recipient returns home, for example, your living space is too small to allow for a hospital bed lift equipment. Or you may not be able to organize the necessary mobility equipment on short notice.
- You foresee the need for home care support services and are unclear as to what will be provided by community services or how they will be put into
- You think the transport home will be an issue.
- As a caregiver you feel emotionally and/ or physically unable to provide safe and adequate care under these new conditions.
If you feel that you are not being heard and are being pushed toward an unsafe discharge, you can further request to speak to the following individuals, in this order: Discharge Planning Nurse, Unit Manager, Patient Care Quality Office for the hospital (the contact information for this office is usually posted near most elevators), Director of Nursing, Director of Medicine.
Good communication between all essential partners in care prior to discharge can alleviate any anxiety you, the caregiver may feel about any new responsibilities in providing care in the home. A discharge planning meeting can be key in ensuring that the transition from hospital to home or a care residence is as seamless as possible for all involved.
The Caregiver Support Team