Sometimes it seems as though discharge from the hospital happens
all at once, and in a hurry. But discharge planning is a process,
not a single event. Medicare defines discharge planning as:
process used to decide what a patient needs
for a smooth move from one level of care to another."
a result of that process, the discharge plan may be to send you
to your own home or someone elses, a rehabilitation facility,
a nursing home, or some other place outside the hospital. A discharge
plan should be based on a careful review of all the options.
Discharge from a hospital does not mean that you are fully recovered.
It simply means that a physician has determined that your condition
is stable and that you do not need hospital-level care. Discharge
planning is a short-term plan to get you out of the hospital.
No one can predict future needs, as your condition may improve
or worsen over time. However, it is important for you to think
about the long term as much as possible.
Ideally the Discharge Planning process begins on admission to
the hospital. If the hospital stay was unplanned, as in the case
of an accident or sudden illness, you may not have a clear idea
of how long you will be hospitalized or what your condition will
be. Still, it is a good idea to start thinking about the options
as soon as possible.
Most of the time, an acceptable arrangement can be worked out
with you or your relative and the Discharge Planner. However,
there may be disagreements. For example, a patient may want to
go home as quickly as possible, or the hospital may need the bed.
In some cases, a family caregiver may have to balance a relatives
preferences and the hospitals needs against the hard realities
of the situation. Sometimes a patient may have unrealistic expectations
about what they can do for themselves.
A physician assessment will be done to determine how much care
will be needed immediately after discharge, and for the first
weeks of recovery. Your physician will keep you informed of the
change in your level of care status. Once your level of care changes
and you no longer need acute or skilled care, you should expect
to be discharged.
Handles the Discharge?
The Discharge Planner is your primary contact and may be a nurse,
social worker, or other medical professional. It is important
for you to know who this person is and to understand what she
or he can do as well as what is beyond their control. Your
Discharge Planner will do everything possible to assist with the
process. It may also be useful to talk to others who have been
in the same, or a similar, health situation.
Will Insurance Pay For?
Most people do not have a good idea of what medical insurance
will pay for until the need arises. It can be a shock to find
that insurance will not pay for many items and services needed
at home that are routinely paid for in the hospital.
Unless you or your relative has specific long-term care insurance,
many services, especially home care aides or attendants, will
not be covered at all or beyond an initial short-term period.
The Discharge Planner can assist with insurance, but may not be
able to provide all the necessary information regarding your specific
Basics of Discharge Planning:
A checklist to familiarize you with the process.
to Klickitat Valley Hospital
for information about Family Caregiving and Planning:
of Aging Parents
Alliance for Caregiving
Government MEDICARE website