August 25, 2023
Reading Time 4 min.

Discharge Decisions: Exploring Your Options for Recovery and Care

While writing my book, and continuing clinical work, I have found that there is a large need for a resource for people whose loved one is in the hospital. Now they need to be discharged, but are unable to return back home at their prior level of function.

It seems to almost everyone that time to discharge from acute care comes rather quickly and abruptly. Also there is a lack of understanding on the caregivers part as to what comes next. This will be the first part in a short series looking at what you need to know when your loved one is being discharged from the hospital. I hope this is helpful!

Be Prepared for the Speed of Discharge

While the medical team tirelessly works behind the scenes, it often feels like a whirlwind of decisions once discharge is imminent. Today, we'll navigate through potential discharge destinations. Your role as a caregiver is crucial in helping guide the transition to the next level of care. This post aims to make that journey smoother for both you and your loved one.

Discharge planning starts on the first day in the hospital with the gathering of information. Diagnosis, prognosis, age, medical history, prior level of function will all play a role in expected discharge scenarios. You will likely not know that the planning is going on until the course of care is determined and discharge plans are actively being worked on. This will be based on your loved one’s medical condition and recovery and expected continued progress.

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Opt-In Magnet #1

Is Your Loved One Safe to go Home?

The topic may have been discussed frequently by social workers, the medical team, and the therapy team. However, since you likely had limited involvement in the day-to-day, when the time comes, it can feel like it happens with haste.

The process is geared towards getting people home as safely as possible with adequate support. If you have been at the hospital often throughout this process, it will likely be assumed that you are available and able to assist your loved one at home. With some nursing and therapy support of course. But even with the help it is likely more family or additional paid caregivers will be required for some amount of time to help mom return to managing on her own day to day.

And that is if she is doing well enough and has enough support to go home safely. 

What are Possible Destinations for discharge from Hospital?

Let’s take a look at possible destinations for discharge from the hospital. 

  • Back home: Ideal scenario where mom returns home safely and almost fully recovered. She will have some light nursing assistance and therapy services a few times a week for 30-45 minutes. Some help from rotating family members or additional paid caregivers can make this setting a good choice.
  • Family members home: Mom needs more support, but has adequate family and financial resources to provide round the clock care. Again some light nursing assistance and therapy services a few times a week for 30-45 minutes can be provided.
  • Inpatient rehab facility (IRF): Extensive assistance required. Daily supervision by multiple doctors of differing specialties. 3 hours or more of therapy per day split between physical, occupational and speech therapies. Very expensive daily rates with most stays lasting 1-2 weeks before transition home. High intensity rehab to maximize results in the least amount of time possible.
  • Skilled nursing facility/short term or sub acute rehab: Often used as a bridge between the hospital and home. For those patients who are not so medically complex that they need IRF. It is not as intense as inpatient rehab. Stays lasting from days to 3 months depending on the patient’s needs to return home or next level of care safely. Physical, Occupational and Speech therapy are provided based on need for 15 minutes to an hour, 5 days per week on average for each discipline. Most patients receiving 1-2 total hours of therapy per day.
  • Long term care: Usually not the first choice unless the patient came from long term care or has no support in the community and would be unsafe to return home. If this were the case, you would not be reading this book!
  • Hospice: This is only an option if the medical condition is quickly declining and it looks as though your loved one will not be with you for more than six months. This is end of life comfort care.
lady in wheelchair going home from the hospital

If you are unable to provide the assistance required for your loved one, there is no other family to help, or she needs more care than can be provided at home, discharge to a rehab facility is likely the best option.

It is best to be in touch with the case manager at regular intervals to stay up to date with how your loved one is progressing.

Next week, well take a look at who to ask, when to ask and what to ask for the critical time of discharge planning.

That's all for today.

Take care, keep mom safe at home and have a great day!


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