Being in the hospital stinks.  There’s just no other way to describe it.  Whether it is a knee replacement planned months in advance, or an emergency appendectomy that brings your senior family member to the hospital, the experience can be stressful and somewhat unpredictable.

In this 4-part series, we will explore the before, during, and after of a typical hospital stay.   Click the links below for the prior posts:

Mom’s in the hospital! What do I do? Part One: How to Prepare
Mom’s in the hospital! What do I do? Part Two: What to Expect
Mom’s in the hospital! What do I do? Part Three:  What You Can DO

Discharge can be a chaotic and confusing time for families as they try to navigate through insurance issues, follow up appointments, and make decisions about how much help their family member will need, who will provide the help, etc.  This article will explain how to prepare for the next steps you will be taking together upon their discharge.

The Discharge Process

EF3A7129Often when a senior goes into the hospital for any reason, they come out weaker, sometimes needing a variety of therapies.

This means that their ability to live independently may be compromised either short term or long term.  The doctor will usually recommend discharging to rehab if it is necessary.  

However, even if the doctor releases your loved one to go home, you may feel that additional support is needed, and you may not feel comfortable leaving them alone.  There are many options for assistance, and this is where the social work department comes into play.  

At some point during the hospital stay, usually near the end, a hospital social worker or discharge planner will come to see you.  It is their job to provide you with options for post-discharge care and assistance and help you come up with a plan.

Be prepared to ask the social worker for resources and have them help you think through all aspects of your loved one returning home (transportation, meals, ability to shower, etc.)  They won’t know how much help you need unless you tell them, so don’t be afraid to ask questions.  They are there to work for you.  

They can provide you with a list of assisted living facilities, rehab facilities, long term care options, etc.  They can often call insurance companies for you to help you figure out your loved one’s benefits.

Keep in mind that you may not know how much assistance your loved one really needs until they return home and you can evaluate their ability to perform various tasks.  It will be an ever-changing process that you will walk through together.  

Some seniors bounce right back after a hospital stay or surgery, and others do not.  Everyone is different, and time will tell how much assistance they may need moving forward.  

Below are some resources and topics to consider upon discharge:

In-Home Help

Your local Area Agency on Aging (Dg County: 785-235-1367, Fr County: 785-242-7200) can help you figure out some next steps as your loved one returns home.  

They can help determine whether your family member may qualify for state or federal subsidized in-home assistance, or can provide you with a list of local companies where you could privately hire an in-home aide.  

Level of Care

EF3A7053Begin to think about exactly what type of assistance is needed.

Does your loved one just need someone to come in for two hours a week to do some housekeeping?  Do they need help dressing?  Using the restroom?  Setting up medications?  Constant supervision due to their fall risk or level of confusion?

These questions will help you make decisions about what level of care they need.  Everyone’s situation looks a little bit different.  

Some seniors stay at rehab for a few months, then return home fully independent, some return home and go to out-patient therapies, some just need meals brought to them, and help setting up their meds once a week.

Others return home and family members take shifts caring for them around the clock, using respite services/adult day care at local long term care facilities as needed to give the family a chance to rest.

Unfortunately, no single social worker or doctor will be able to give you an exact answer as to what level of care your family member needs when they leave the hospital.  There is no one-size-fits-all answer for temporary assistance or long term care.

You, as the family, in conjunction with your loved one (as they are able) will be the ones making the decisions regarding their post-hospital care.  We here at ComfortCare are happy to discuss these issues with you and help you think through different options as you make these difficult decisions.

We are here for you.

Walkers, Wheelchairs, Commodes, Oh my!

You will want to think through what assistive equipment you loved one may need upon returning home.

Do they need a bedside commode?  A wheelchair?  Walker?  Raised toilet seat?  Grab bars in the bathroom?  A Shower chair?

Sometimes if a doctor writes a prescription for one of these items, Medicare will cover the cost.  You will need to call Medicare to find out.

Also, local agencies sometimes have equipment loan programs.  Try the Area Agency on Aging, Independent Living Centers, or the VFW.

Share the Burden

Think through the various responsibilities of caring for your loved one as they recover, and divide them between different family members.  There is no reason you should have to shoulder the burden alone.

For example, maybe one person can take them to doctors’ appointments, one person can handle their finances, one person can clean the house, another can mow the lawn, etc.

Have a family meeting to divide responsibilities and get a schedule in writing.  Decide how to keep everyone informed of important information from doctors, etc.  Phone calls? Emails?

“Will insurance cover that?”

If you have any questions about what types of assistance, care, or equipment might be covered by insurance, the hospital staff will not likely know the answer.  It depends on your loved one’s insurance.

You will need to call their insurance company/companies to see what may be covered and find out about any copays or coinsurance.  

Let’s eat!

EF3A6905If your loved one finds it difficult to cook for themselves after returning home, there are several options to consider.

First of all, you may consider making meals for them and freezing small portion sizes that can be easily microwaved.  If this is not an option, and if they are able to safely drive, they can go to their local senior meal site M-F to get a hot meal at lunch time.

They can even arrange to pick it up to go if they would prefer.  Call to get details on suggested donation, times, addresses, etc.  In Dg County, Call Douglas County Senior Services at 785-842-0543.  In Fr County, call Mid America Nutrition Program at 785-242-8341.

If the senior is not able to drive safely, home-delivered meals may be an option.  Call the same numbers above to see about having an in-home assessment done.  If they qualify, it may be an option to get one hot and one frozen meal delivered M-F, and two frozen meals a day dropped off for the weekend.

Goin’ Home

Have one family member be in charge of keeping track of any paperwork received from the hospital.  After all doctors involved in your family member’s care have signed off on their discharge, you will be given a discharge date.  You will be given discharge paperwork (instructions) the day your loved one leaves the hospital.

Read over the paperwork and make sure you understand the steps you need to take before leaving the hospital.  Make sure you understand what follow up appointments are necessary.  Ask whether those doctors’ offices will call you, or if you need to call them to schedule any necessary appointments.

The same goes for any prescribed out-patient therapies.  Also ask whether or not you should set a follow up appointment with your loved one’s primary care doctor, regardless of whether that doctor has visited them in the hospital.

Even if no follow up appointment is recommended, it is a good idea to call them anyway and inform them about what happened so they can add that information to the patient’s file.

Ask hospital staff if they should continue on the same medication regimen they came in on, or if changes are recommended.  Ask if they are adding any new prescriptions that you need to get filled.


I hope that you have found this series to be helpful in planning for your senior loved one’s possible hospital stay.  I hope that you have picked up some tips that will lessen your anxiety about a hospital stay, should it ever happen.

If you have any questions or need additional support, feel free to contact Scott Schultz, president of ComfortCare Homes in Baldwin and Ottawa at 785-594-2603.

DSC_0720-3 -

- -