From your first day of admission, our nursing and rehabilitation team begins to customize a plan, unique to your needs, so that you are ready for the challenges involved with returning home or to an alternate level of care. Working with our case manager/social worker, we will arrange for wheelchair, walkers, dietary needs, wound care, and/or medication management; in addition to patient education needed to ensure a safe transition home. In addition, we offer a continuity of care with our Home Health Agency Stay Well Home Health.
Helpful tips for a successful transition home:
- Be an active presence in the discharge planning process.
- Make sure you understand why your loved one was in the hospital.
- Plan to provide extra help and support to your loved one during the recovery period.
- Understand what symptoms and signs your loved one should be monitored for, and who to call if you have concerns.
- Make sure the discharge instructions are clear regarding medications - make sure you take the medications as they're prescribed on discharge from the skilled nursing facility.
- Prepare the home for your loved one's recovery.
- Understand what home health services will be provided.
- Make sure follow-up has been arranged with a primary care doctor or other outpatient health provider.
- Understand your symptoms so you know when to call the doctor or go to the hospital.
- Do you have increased shortness of breath?
- Swelling in your feet, ankles, legs, arms or stomach?
- Are you experiencing any chest pain?
- Consider calling your doctor if you feel or notice the following:
- New, more, or worse dry coughing
- More shortness of breath
- New dizziness
- No energy; more tired than usual
- Increased pain/discomfort
- Any unusual feeling