Seniors in Transition: Going Home From the Hospital

Hospital Discharge, the term that describes a patient's official release from an acute care hospital to another level of care or to home, might lead you to believe the work of getting well is over. Yet, in most cases, discharge from the hospital might be just the beginning of a new health care routine. An effective discharge can help you get a good start on wellness and may prevent you from having to return to the hospital. According to MedPAC, a Medicare research organization, 17.6 percent of hospital admissions are actually hospital re-admissions, and the majority of those readmissions were potentially preventable (1).

Be Prepared

Discharge from the hospital can be a very stressful time. Sometimes the discharge day is so jammed packed with visitors and activities, you might not remember what is said or what you are supposed to do. Instructions can be overwhelming, yet they may be critical to your recovery. Don't be shy, ask for help if you need it---most of us do when we have been ill, had interrupted sleep, and are experiencing the side effects of new medication, anesthesia and stress.
Anticipate your discharge day by getting to know a person in the hospital called a discharge planner (every hospital has one). This person is likely a nurse or a social worker who will coordinate your discharge and knows where to get information. Ask questions like:

* What services, if any, will you be eligible to receive after discharge? Can you line those up early?
* Will you need to add another physician to your list of providers? Can you meet this person ahead of time?
* When and how will you be expected to refill or obtain new medications or medical supplies after discharge?
* If all goes as planned, when can you expect to be discharged?

By knowing this information up front, you can begin the process of preparing and lessen the number of confusing details you must manage discharge day.

Questions to Ask on D-Day

Be very honest when you are asked if you understand your treatment plan. Ask your discharge planner to listen as you recall and restate instructions. Write down the answers to these questions, also known as "Ask Me Three:"

1. What is my main problem?
2. What do I need to do?
3. Why is it important for me to do this?

Tips

Thinking of discharging yourself from the hospital, earlier than the doctor advises? Proceed carefully. Here are some interesting facts about discharges against medical advice (AMA). The Department of Veterans Affairs studied patients who left the hospital AMA and found them almost seven times more likely to be readmitted within 15 days when compared to those who were discharged with medical consent (21 percent vs. 3 percent)(2) .

If you will be taking new medications, ask to meet with a pharmacist or make an appointment to meet with your own druggist after discharge. This way you can understand the little things that influence the medication's effects, such as the best time of day to take each medication.

If someone else is going to be very involved in your post hospitalization care, be sure he or she is also provided a chance to ask questions and hear instruction. Both you and your caregiver should be very aware of what symptoms would warrant a call to the doctor after you get home.