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Hospitalizations and Planning for Discharge
Hospital stays are stressful for families and caregivers – especially when the patient is a spouse or parent. As a family member, you are concerned about your loved one’s condition, often anxious about the treatment and unsure about what the future might hold. Planning for discharge is likely the last thing on your mind.
In 2014, Oklahoma’s CARE Act (Caregiver Advise, Record, Enable Act) was passed. The CARE Act recognizes that families are a vital part of discharge planning and help ensure that the patient follows through with all physician orders. As a result of the CARE Act:
• The family caregiver should be named and recognized by the hospital when a loved one is admitted.
• The hospital is required to notify the caregiver regarding when their loved one is to be discharged and whether they will be discharged to return home or to another care facility. • The hospital is responsible for consulting with and training the caregiver for any medical tasks they may need to continue at home, such as medication management, injections, wound care, and transfers.
At the Time of Admission:
• Be sure that you or another designated person is listed as your loved one’s caregiver and that the hospital has the caregiver’s phone number. • Present a current, signed HIPAA release to the hospital if one is not already on file. This will allow you to communicate with doctors and be in the loop regarding your loved one’s condition and treatment decisions.
• If there is a durable power of attorney for healthcare or an advance directive in place, bring those documents and make sure they are noted in hospital records.
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• Be sure the hospital has your loved one’s complete list of medications and supplements, as well as the name of the primary care physician and preferred pharmacy.
During the Hospitalization
• Introduce yourself to doctors and nurses. Keep a list of all who are involved in the care of your loved one and what role they play in caring. • Keep a notebook of all interactions and instructions given, as well as who gave them. • Ask to meet your loved one’s discharge planner. Make sure that you are kept in the circle of communication regarding health decisions and post-hospitalization plans. • Ask when your loved one will be discharged and where they will go. If they aren’t able to return home, make necessary decisions regarding which care facility to use. Prior to Discharge
• Ask for written discharge instructions (that you can read and understand) and a summary of current health status. Bring this information and complete drug list to any follow-up appointments. Ask about potential problems and symptoms to watch for after discharge.
Write down the name and phone number of who to call if problems arise or you have questions.
• Know about any new medications prescribed. Make sure you understand what they are for, how they should be taken, if there are any side effects and whether medications taken before the hospitalization should be
taken or discontinued. Get the name and phone number of who to call if you have questions later. • Ask if your loved one will need any durable medical equipment or supplies after discharge. This could include walkers, elevated toilet seats, shower chairs, etc.
Find out who arranges this. • Ask if your loved one is released to do the activities below. Circle the ones you think your loved one will need help with and tell the staff. If there are things you will not be able to help with, who should you call for assistance? • Bathing, dressing, using the bathroom, climbing stairs • Cooking, grocery shopping, house cleaning, paying bills • Getting to doctor appointments, picking up prescription drugs
• Ask the staff to show you and your loved one any tasks that require special skills (changing bandages, proper use of a walker or cane, medication management, etc.)
Make sure you are comfortable with what you need to do to help your loved one. Write down the name and number of who to call if you need help. • Ask about support groups and resources that may be helpful to both you and your loved one. • Talk to the social worker if you have questions about what insurance will cover and what may be out-of-pocket expenses. Post-Hospitalization
• Pick up prescriptions as soon as possible. • Make follow-up appointments promptly. • Follow-up with the primary care physician and any other specialists included in the discharge plan. • Bring the hospital discharge papers and the notebook you had in the hospital with you to all follow-up appointments.
