“I think the most important thing is are they clear on what medicines you’re supposed to take? Do they have all of the pieces in place for whatever the followup care is going to be? If they need therapy once they get home, is that in place? If they need any kind of equipment, walkers, wheelchairs, has that been arranged? If the person needs a walker, they need it the second they’re getting out of their vehicle, not the next day. And are they physically able to do all the things, we call them activities of daily living. That’s things like can they do their own bath, can they move from the chair to the bed, to the toilet, to the kitchen? Those kinds of things. Can they prepare their own meals? If they’ve been in the hospital any length of time, do they need food? Because whatever food they had in their refrigerator may have spoiled.
I think that hospitals do a pretty good job of phoning in the prescriptions or giving the person prescriptions, of arranging for therapy or whatever. I think that they don’t generally look at can the person really be at home by themselves? Who’s going to do the meals? Do they have the groceries? And what was going on right before they went in the hospital? If the person fell and went to the hospital by ambulance, their house is pretty much exactly the way it was when they left, things knocked around and spilled because of the fall. If the person’s been falling a lot, there may be some other things that need to be addressed, the place may need to be straightened up, new sheets on the bed, maybe they need a hospital bed now that they didn’t have before. There may be a mountain of mail that needs somebody to sort through it and decide what’s going to happen with that. If they’ve been in hospital any length of time, they may have shut off notices and may have had their utilities shut off because there was no one there to take care of paying those bills.
So there’s a lot that goes on in the background. Years ago I had a doctor call me and ask me if I would help this patient learn how to do a feeding tube at home, and I said, “Sure, no problem.” And the hospital called me about an hour and said, “By the way she doesn’t have transportation.” So I was young and foolish then, I said, “I’ll go get her and take her home.” And when we got there she didn’t have any electricity, because she’d been in the hospital, she’d had a couple of surgical procedures, she’d been to rehab. Now she was coming home but her electricity had been shut off. So we had to run it, we borrowed a heavyweight extension cord from the next door neighbor to run her feeding tube pump until we could get somebody to go pay her electric bill, and when we did that we found out that not only did she not have electricity, but that the wiring in her house would not run the pump that she had.
So it made me a believer in you don’t just assume that you can just come in and everything will be adequate for what they need. You start looking at the little things. If there’s no electricity in the summertime, maybe better not to bring a really fragile patient that just came out of hospital with dehydration back home in an environment where there’s not going to be any AC. Or if their refrigerator stopped working but they just were not in good enough shape to call a repair man or go buy a new one, you might have to be a little resourceful in what you’re going to do to keep their food refrigerated and have adequate food for them. Now, those are not common situations that happen, but it doesn’t matter how common it is, if it’s your mom or your dad.”
Anita Roberrson RN
Director of Nursing | Aging Life Care Manager