Home or Inpatient Rehab? Four Questions Every Caregiver Should Ask Before Hospital Discharge.
Your loved one has been in the hospital for several days, has not gotten out of bed since arriving at the hospital. They are finally feeling better but the doctor states they are very weak and needs to have some intense therapy — occupational and physical therapy on the inpatient rehab unit.
The tears start
to flow because
your loved one just wants
to go home…
I, too, have been faced with this dilemma. After my mom had been hospitalized for almost two weeks after a septic urinary tract infection, she was severely weak but wanted to come home. Her only thoughts were her bed and eating home cooked food.
But there are other factors that must be considered. As a family caregiver, you must be able to weigh the options and determine what is the best and safest option available.
It’s hard — you can even feel like the villain, when the tears are rolling and you want to please them, because of course, they have already been through so much.
4 Questions to Ask Before Bringing Someone Home
Do you know the level of weakness your loved one has?
Determining the level of weakness is essential. Can they sit up on the side of the bed by themself? How much help will they need to get out of bed? Will they need help to walk? Talk with the therapist that comes to their hospital bedside, learn what their weaknesses are.
How strong are you? Do you have the strength to endure the physical challenge of having to lift, pull and carry their weight to assist with moving them several times a day? Do you have any health issues or physical limitations yourself?
If you are physically not able to handle the daily tasks of caring for their needs, you place yourself and them at risk for injury. You can injure yourself and then be unable to care for them or an injury can happen to them due to your inability to safely provide the support for balance and movement that they will need.
If the result is that they remains in bed all day because it is not safe for you to get them out, it can lead to a long list of health problems —which can include pressure sores in the bed and a worsening of their weakened state.
Who is going to help you?
If they are too weak to handle on your own, who is available to help you care for their needs? Not just someone who is going to show up on the first day they home to check in on them, then disappears. Are you able to gather a team of support and line up a schedule of people who will be available to assist with what may initially be around-the-clock care? Are there funds to hire a paid caregiver to assist with the care?
Yes, home health services are available. They can receive home health OT and PT and it can help her to gradually recover, but who will help you with the day to day care until they are back on their feet. Please note that the home health aide service that is available is often limited to one to two visits a week and the length of stay in the home is usually 45 minutes only.
Remember, caring for your loved one includes managing the household chores, medication and doctor appointments. Also, who is available to be with them while you run errands and take care of other needs in your life.
Can you quickly setup the home to accommodate for her needs?
Oftentimes discharge from the hospital happens quickly. The nurse can walk in and sudden spring the news of the upcoming discharge that day or the next — and you are forced to make quick decisions. This makes things stressful. Do you have adequate time to make certain that access into the home will be easy and that it is setup to accommodate new equipment to make it a safe transition home? Do you truly understand all the medical issues and the duties that will allow you to safely provide the care?
Do you need to go back to work soon?
How long you can be off to oversee the care is a big consideration, especially if no one else is available to help with the care. If bringing them home right away will mean that you will unable to return to work, you must make the plans and complete the paperwork with your employer to take a leave of absence to care for your loved one. Returning to work when they are not safe to be home alone is not an option that you have. The financial hardship due to you not working is a definite factor to consider.
Bottom line:
I know it will feel good to them to be back home. But there is also a great benefit to receiving inpatient rehab services to regain strength and independence first. Often the added temporary inconvenience to your loved one of going to inpatient rehab will reap a lasting benefit of them being able to return home stronger, more independent and requiring less help from you. Returning home stronger and more independent can result in you having to stay home with them for a shorter period of time while they get acclimation back into their home setting and it can also result in a decrease in the physical load you will have in assisting with their care.
It’s a tough decision, I know. You don’t want to disappoint them, but you have to make a decision that is best for them and you.
Thank you for caring for your loved one!
Consuela
Disclaimer: The podcast and blog are intended to provide basic information so that you can become a more informed caregiver. The information presented is intended for educational and informational purposes only and is not meant to serve as medical advice or replace consultation with any health care providers you regularly engage with. Transmission or receipt of any of this information is not intended to, and does not, create a therapist-patient relationship. This information is not provided in the course of a therapist-patient relationship and is not intended to constitute medical advice or to substitute for obtaining medical advice from a physician or therapist licensed in the state where your family may reside. We encourage everyone to consult with your physician or therapist to see if they are appropriate and safe for you.