A Family Guide To Hospital Discharge Planning

If your or your loved one is headed for a stay at the hospital, perhaps after a joint replacement or other major surgery, or your loved one has unfortunately suffered an accident or illness that has required a hospital stay, you may have heard of hospital discharge planning. If you’re unfamiliar, you may also ask yourself, “What is a discharge plan?”

After a stay in the hospital, returning home or to another level of care may not be as easy or straightforward as it seems. This is where a hospital discharge plan is invaluable. A discharge plan can help you and your loved ones ensure those leaving the hospital receive the care and attention they need to heal fully.

Especially for the elderly, many patients do not return home after a stay in the hospital. Rather, they will enter a skilled nursing facility, like those offered at Monument Health Group. A skilled nursing facility offers expert care after hospital stays and acts as the bridge between hospital and home.

What Is Hospital Discharge Planning? How Can You Make A Plan?

Hospital discharge planning refers to the way a patient is prepared to leave the hospital, usually to their home or a skilled nursing facility. It often involves a team of healthcare professionals that can make recommendations, family and other loved ones, and the patient themselves.

The goal of a hospital discharge plan is to create a strategy for personalized care that addresses all medical and personal needs post-hospital. Any plan should be made by first consulting medical staff and understanding the needs of the patient, and by consulting the patient to take their wishes into account, if appropriate.

Creating a medication schedule will be helpful, a list of medical equipment that may be needed, how the home should be prepared if returning home, and the assignment of caregiving responsibilities should be made. Dietary restrictions, comfort concerns, and follow-up appointments should also be considered.    

What Questions Should You Ask Before Discharge? 

Before leaving the hospital, you should ensure you have a good understanding of the needs of your loved ones and the care they will require.

Consider questions like:

• Is home the best place for my loved one, or is entering a skilled nursing or other facility best?
• Will professional home health care be required?
• What medications are my loved ones taking?
• Is there any special medical equipment my loved one may need? What are the best practices for maintenance?
• What is the expected recovery prognosis of my loved one? What does the recovery timeline look like?
• What regular follow-up appointments should be scheduled, and with whom?
• What symptoms should prompt a follow-up appointment or emergency care?
• Are there certain activities that are unsafe, and what physical limitations should be followed?
• Are there any dietary restrictions?
• Will additional therapy, such as speech, occupational, or physical, be needed?
• Should my home be modified in any way?
• Who should we contact with questions?

You may want to ask for written discharge instructions as well as keeping these recommendations and orders written down in the same, easily accessible place. 

What Are Some Signs That A Loved One May Need More Care Than What Can Be Provided At Home?

In many instances after hospital discharge, patients need more care than what can be provided at home. When patients need additional care, skilled nursing facilities provide the bridge between hospital and home by providing 24 hour-a-day nursing and physician supervision, as well as numerous therapies that can help your loved one get back to health sooner.

Signs that your loved one may need additional care include:

• Complex conditions that require consistent medical care.
• The need for intravenous or other complex medications.
• Post-surgery or post-illness frailty.
• Trouble walking or moving around or frequent falls.
• Need for therapies, such as speech, occupational, or physical therapy.
• Trouble completing the activities of daily living, such as cooking, bathing, and toileting.
• Forgetfulness or other memory problems.
• Family caregivers are unable to provide the level of care needed.

If your loved one is facing any of these issues or will be facing them in the future, skilled nursing care may be the right choice and is available across Utah in partnership with Monument Health.

How Can Skilled Nursing Facilities Support A Safe Transition?

Skilled nursing provides an important bridge between hospital and home. At Monument Health, we offer 24-hour nursing care, medication management and wound care, multiple therapeutic options, and individualized care plans to ensure all our patients receive the personalized care they deserve. We offer locations across Utah to serve you and your family close to home. Give us a call today.