Changes in healthcare and advances in medicine have created a situation where patients are discharged from the hospital much sooner than previously. While the patients may be medically fit to return home, they are often not mentally and emotionally prepared for the in-home recovery process. Unfortunately, this can lead to patients returning to the hospital rather than recovering and thriving in the community. Offering the appropriate support at home, however, can give patients a feeling of security and increase their chances of a successful recovery.
One in five seniors are readmitted to the hospital within 30 days of discharge. Many factors contribute to this figure, including stressors the senior encounters when returning home. Often admission to the hospital happens unexpectedly through an emergency situation. As a result, the senior may return home after an extended hospital stay to discover there is no food in the home, the home may be in disarray, bills may have collected in the mail, utilities may have been cut off due to lack of payment, and so forth. These immediate problems may prompt the senior to attempt to do more than (s)he is physically able.
Many seniors live alone as well and must deal with the problem of taking care of themselves while they recover. Even if there is a family member or friend to assist, it may only be for limited times during the day such as before or after work. Data show that individuals who felt safe were more prepared for recovering at home. Feeling safe extends beyond the physical aspects; those who felt they had support after discharge felt more prepared to face the recovery process. That support includes not being alone for extended periods of time. Studies indicate that a main concern of patients being discharged from a hospital was being left alone to manage for themselves.
Additionally, the senior may be unprepared for what recovery “looks” like and may not be able to differentiate between normal physical changes during recovery and changes that indicate a problem and should be immediately reviewed by a physician for intervention. This could result in either a panic that sends the senior to the hospital unnecessarily or, worse, in the senior ignoring symptoms of a serious problem believing they are normal for the recovery process.
While there are numerous formal community services for seniors leaving the hospital, often these services do not address the basic everyday needs. Further, the senior may have to apply for these services, causing a delay in services, and may have to meet eligibility requirements.
Easing the Transition Home
Ideally readying the senior for the return home should be done before the senior is discharged. Preparing the senior for the physical aspects of recovery by explaining what physical changes are to be expected and how (s)he can best manage his or her condition is important. There is also interesting data that support educating spouses and partners on the illness and recovery process. Studies show that when the spouse’s or partner’s anxieties regarding the illness are relieved, the patient has a better chance of recovery. In one study, when the spouse was given appropriate timelines for the loved one to return to normal functioning, and when the condition and its causes were explained clearly to the spouse, the stress of not knowing why the illness happened was relieved. Additionally, if the cause of the illness was attributable to a high genetic risk, the spouse and patient were more motivated to make changes to factors they could control, such as improving diet and increasing exercise, thereby increasing the chance of recovery at home.
Before the senior leaves the hospital, it is important to speak with family members about ensuring the seniors’ bills are paid and the home is ready to help alleviate the burden of immediate daily responsibilities. Hospital personnel or family can arrange for an in-home service to prepare the home if the family or friends are not readily available. In-home care by Comfort Keepers® ensures the home is clean, meals are ready, and assistance is available when the senior returns home so (s)he can focus on recovery rather than attempt to undertake tasks that are not recommended by his or her physician.
Supporting the senior during the recovery period is also critical for successful healing. However, often the family is unable to be with the senior due to work and home obligations or because they live out of the area. While friends and community can help for some of these individuals, others may not have a network to aid them. Often, this prompts the family or hospital to place the senior in a care facility for the duration of recovery, which can be costly. In-home care by Comfort Keepers® can be a better option. Unlike care facilities, our caregivers work one-on-one with the senior and provide companionship and transportation to appointments, remind the senior when medications are due, help with light housekeeping and meal preparation, and do other tasks that can provide the support the senior needs for recovery at home.
- Boughton, M. & Halliday, L. (2009). Home alone: Patient and carer uncertainty surrounding discharge with continuing clinical care needs. Contemporary Nurse, 33(1), 30–40.
- Broadbent, E., Ellis, C.J., Janine, T., Gamble, G., & Petrie, K.J. (Can an illness perception intervention reduce illness anxiety in spouses of myocardial infarction patients? A randomized controlled trial. Journal of Psychosomatic Research, 67, 11–15.
- Grimmer, K., Moss, J., & Falco, J. (2004). Experiences of elderly patients regarding independent community living after discharge from hospital: A longitudinal study. International Journal for Quality in Health Care, 16(6), 465-472.
- Heine J., Koch, S., & Goldie, P. (2004). Patients’ experiences of readiness for discharge following a total hip replacement. Australian Journal of Physiotherapy, 50, 227-233.
- Landro, L. (2013, March 17). The hazards of leaving the hospital. The Wall Street Journal, Retrieved from http://online.wsj.com/news/articles/SB10001424127887323826704578353131038599350.