Leaving the Hospital: What You Need to Know

Leaving the Hospital: What You Need to Know

• Length of Stay is the number of days that government-based and private insurance companies have determined you should remain in the hospital based on your diagnosis
• Hospital reimbursement is based on this predetermined length of stay.
• Planning for discharge and any required support (nursing, equipment, etc) should begin as soon as possible as hospitals will resist extending your stay as it costs them money
• Some patients require discharge to a short-term intermediate care facility (nursing home, rehab facility, etc.) prior to going home
• Social workers in the hospital will help organize your discharge planning with the aid of your doctors and nurses
• Depending on your insurance you might in your recovery at home be entitled to help by home health care aides or even nurses.
• If you need special equipment (beds, oxygen, etc) this should all be planned and delivered prior to your return home
• Changes in the normal family routine should be worked out with your family prior to your arrival at home
• Any change in your status (fever, chest pain, bleeding, etc) should trigger a call to your doctor (or 911 if life threatening)!

It used to be that if you had surgery and felt as though you were not ready to go home you would simply ask your doctor for an extra day or two. The same held true for childbirth. Say you had older children at home or if you had childcare issues you would just ask for an extra day. The doctors all knew that staying in the hospital was not pleasant so they figured if you asked for an extra day or two that you really needed it.

Those days are gone. Presently doctors are not afforded that same luxury. Insurance companies dictate how long you stay in the hospital after procedures. In fact, hospitals lose money and doctors can be penalized if you stay in the hospital too long.

Hospital-Home Transition Tips

Prior to leaving the hospital ask to meet with the hospital social worker. They will work with you to ensure that you are going home to a safe environment where you or your loved one are receiving the proper care. Some situations social workers can help with include:

• If you are to be discharged but require admission to a rehab or extended care facility, they can help with that transfer
• If you live alone, they can arrange visits by a nurse (VNS or The Visiting Nurse Service).
• If you are not ambulatory and live in an apartment or house that is not wheel chair friendly, they will help you find a solution.
• If you need a wheel chair, crutches, walker, hospital bed or other equipment needs at home.

Do not rush care or healing.

Do not do more than you can do. Report anything out of the ordinary such as fever, bleeding, falls, or confusion by calling your doctor’s office. If it is an emergency that cannot wait, go back to the hospital or call 9-1-1. Use your discretion. A good example of an emergency would be an elderly person who has fallen. You should call your doctor’s office the same day if you are experiencing a high fever or if an incision is red or inflamed.

Let family and friends help, whenever possible.

Do not take the “I’m okay attitude.” Take help where help will come: spouse, children, parents, extended family and friends. If you have the means and do not want to burden loved ones too much, food delivery services and cleaning services may be useful in the short run. If you find yourself in a bind and have nowhere else to turn, try your local church, synagogue or mosque. Often, they have the infrastructure in place to offer you some support.

Home Care Service

If you are eligible for home care service, use it. There are a variety of home care services depending upon your exact insurance coverage and your needs. For example:

• A Nurse may be able to come into your home to change your bandage, monitor your medication, and check your blood pressure.
• You find you do have home care needs but that they are not medical in nature. You may be able to get a home health aide to come into the home. This person should be able to change your bed linens, assist with bathing, dressing, cleaning, laundry, shopping, and preparing meals

It is important to make up a list of your requirements for the agency so that the person sent is a good fit. You don’t have to settle for the first person they send. No one will be perfect, but you definitely should try to get someone as close as possible to what you require. Invite family or friends over to help with the interview process, as you may not be in any condition to make a decision on your own.

If you are recovering from surgery or have had a stroke, you may need physical, occupational, or speech therapy. If you are not ambulatory or do not have a friend or family member to take you, your insurance may pay for ambulette services.

Home care agencies and surgical supply companies can provide home IV therapy and oxygen therapy.