Transitioning to Home Care

Transitioning from the Hospital or Rehab to Home

What should I ask before I (or my loved one) leave a hospital or rehabilitation facility to home?

An appropriate, well-planned discharge from hospital or rehab to home greatly reduces the chance that you/they will return to the hospital. Ask these questions and seek out resources to support the transition.

  • How were you (or your loved one) coping at home prior to entering the hospital or rehabilitation facility? Were you or they receiving care from the family before being admitted to the hospital or rehab?
  • Assess if you/a loved one will need more assistance after your/their discharge.
  • Review your (or a loved one’s) situation with a discharge planner:
    • How well do you/they now perform activities of daily living after hospitalization or rehab?
    • What changes must be made in your/their care at home?
    • Ask for names of home care agencies that can support you or your loved one at home.
    • If you have a long-term care insurance policy, call the insurance company and find out if you are eligible to activate it.
  • Find out if you are eligible for federal or state assistance programs that may help pay for home care.
  • Ask family and friends to suggest options that may help you receive or provide care at home.

Additional Tips

  • Have a nursing professional assess your situation.
  • Select a home care agency with nurse supervision for the best outcome of recovery at home.
  • Select an agency that offers flexibility in scheduling. Sometimes grocery shopping, transportation or meal prep and laundry is all that is needed to help.
  • For younger people who are sick, a few hours’ support by a home care aide with meal prep and laundry keeps the house running smoothly and speeds their recovery time.

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