7 Tips to Ease the Transition From Hospital to Home
Key takeaways:
Coming home from the hospital involves careful planning and preparation.
For a smooth transition home, talk with your medical team ahead of time about possible challenges.
Before you leave the hospital, make sure you understand the next steps for medication management, your medical records, and follow-up appointments. It’s also essential to know which “red flag symptoms” to watch out for once you’re home.
When you’re in the hospital, everything is taken care of for you: your therapy, medications, treatments, and even your meals and clothing. But what about when you go home? After all, being discharged doesn’t necessarily mean you’re ready to take full responsibility for caring for yourself. That’s why careful planning is essential for a smooth transition from hospital to home.
Here are seven steps to take when preparing to leave the hospital, so you can make the transition as safe and stress-free as possible.
7 tips for a successful transition from hospital to home
Whether you or a loved one needs help planning a hospital discharge, here are a few helpful strategies to make going home from the hospital as easy as possible.
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1. Plan ahead
Proper planning and support are essential for a smooth transition of care from hospital to home. Before you’re discharged, Dr. Neil Patel, MD, primary care physician and Chief Health Officer at Patina Health, says to ask your medical team, “What challenges should I expect when I return home?”
You’ll also need to consider how you’ll actually get home from the hospital. Will a family member or friend drive you, or do you need another option? Can you use a standard vehicle, or will you need specialized transport? Check to see if your insurance plan offers transportation benefits.
2. Decide who will help you after discharge
Consider having a family member or close friend stay with you briefly to help with non-medical tasks, like cooking and cleaning. Dr. Gerda Maissel, MD, a physician certified in physical medicine, rehabilitation, and patient advocacy, says you may still feel ill and have weeks of recovery ahead of you — even after discharge. Friends and family can help a lot with coordinating your transition from hospital to home, taking on tasks you may not feel well enough to perform.
3. Outsource tasks when possible
Most people underestimate the extent of basic support they’ll need with daily activities — and overestimate the bandwidth of kind family members, friends, or neighbors, Dr. Massiel noted. “Don’t rely on them for an unrealistically long time,” she said. If possible, think about which tasks and services you can outsource, like hiring a housekeeper or pet sitter, or using a meal kit delivery service.
4. Sort out your medications
Medication changes are one of the biggest pain points of being discharged from the hospital. Nearly 1 in 5 adults will have a medication issue that causes harm after a hospital discharge.
Make sure you clearly understand your medications before you go home. It’s also a good idea to have your healthcare professional explain your medications to you in front of a family member or caregiver, so you have another set of ears to rely on.
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5. Prepare your home
You might be going home with new mobility limitations after surgery, a new diagnosis, or starting a new medicine with side effects. Talk to your medical team while you’re still in the hospital so they can help you work through any specific obstacles. Dr. Patel said to ask questions like, “Will I need help getting downstairs to the kitchen, or should I plan to spend a few days in my bedroom? Is there any equipment I’ll need to be safe?”
6. Anticipate emotional challenges
Your recent hospital admission might have been an emotionally challenging time. Or maybe it created a lot of lifestyle changes. Set up an emotional support network of people who are willing to call, text, and listen when you need it. This is a perfect opportunity to enlist the help of loved ones who live far away but still want to support you.
7. Make sure you cover all four ‘pillars of care’ before going home
The care transition model, which was developed by Dr. Eric Coleman, a professor at the University of Colorado, relies on four pillars to aid the transition from hospital to home:
Medication management
Understanding your health record
Having follow-up appointments
Understanding “red flag symptoms” that signal you need medical attention
Before you leave the hospital, work with your care team to make sure each of these important pillars have been addressed.
Why is it important to make a smooth transition from hospital to home?
A well-managed transition of care from hospital to home can actually improve your recovery in two key ways: decreasing the chance you’ll get readmitted to the hospital and avoiding injuries.
Up to 40% of older adults fall within 6 months of discharge, and the average hospital readmission rate for older adults is almost 15%. By preparing your living space, you can avoid getting hurt. And, Dr. Patel noted, “With proper discharge planning, you can reduce your risk of being readmitted.”
What are common challenges people face after a hospital discharge?
Transitions from hospital to home can be difficult. Common challenges include:
A delay in the start of visiting nurse services
Insurance limits on in-home services (such as having fewer visits from a physical therapist than you’d expect)
Mishaps with medications (like pharmacy delays)
Accidents and falls
When should you consider working with a home healthcare aide?
A home healthcare aide can help you with your daily activities, like showering and getting dressed. This is different from a home health nurse, who performs skilled nursing tasks, like injections, wound care, or catheter care.
You may need a home healthcare aide if:
Your healthcare professional says a home health aide is medically necessary
You aren’t able to perform your daily activities independently
It’s not safe for you to take care of yourself
For more information on home health aides, talk to your medical provider. You may have insurance benefits or access to financial aid to help you cover the cost of home health care services.
The bottom line
A successful recovery is much more attainable with a proper transition of care from hospital to home. Plan ahead to arrange how you’ll care for yourself and your new medical needs at home. Talk to your care team about any concerns you have about going home, so you can address any questions before you’re discharged.
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References
Earl, T., et al. (2020). Care transitions. Making Healthcare Safer III: A Critical Analysis of Existing and Emerging Patient Safety Practices. Agency for Healthcare Research and Quality.
Flatman, J. (2021). How to improve medication safety at hospital discharge: Let's get practical. Future Healthcare Journal.
Hill, A., et al. (2019). Falls after hospital discharge: A randomized clinical trial of individualized multimodal falls prevention education. The Journals of Gerontology: Biological Sciences.
Medicare.gov. (n.d.). Home health services.
Weiss, A. J., et al. (2021). Overview of clinical conditions with frequent and costly hospital readmissions by payer, 2018. Agency for Healthcare Research and Quality.
