Our Safe Transition Home Program provides help and assistance to most vulnerable patients who are at High Risk for Readmissions.
The time after a loved one returns from the hospital is a critical period. Both patients and families alike look forward to the day when a loved one can return to the comfort at home, however often times the road to recovery is only beginning.
While 75% of seniors are discharged to home following a hospital stay, nearly one in five returns to the hospital again.
Is your aging parent at risk for a re-hospitalization? What risk factors dispose one senior to a readmission after returning home versus another?
What other factors may place an elderly person at risk for re-hospitalization? What can caregivers do to help readmissions while the person recovers at home?
A re-hospitalization could be next if:
There has been an unplanned hospitalization in the 6 to 12 months
Your parent is on a “high risk” medication (narcotics, antiepileptic medication, antidepressants)
Polypharmacy, or your parent is on five or more medications. Note: The average elderly person takes three times the amount of medication as other adults do and refills nearly 29 prescriptions per year.
Your parent has more than six chronic conditions, or specific clinical conditions including advanced COPD, diabetes, heart failure, stroke, cancer, weight loss, depression, and palliative care.
Your parent lives alone or has limited social contact.
Your parent has not received a follow up call from a member of the health care team following discharge. Such calls have been shown to be effective at lowering emergency room visits.
You do not have an in-home health monitoring system. As an example, one study showed real-time home health care monitoring system decreased physician and nursing visits for frail elderly patients. No patients on the system had an unplanned visit to the hospital during the trial period and for several months after.
Readmissions of elderly Medicare patients pose a huge financial burden on the American healthcare system and can drastically impact the health and wellbeing of patients and family. While knowing the factors that place your aging parent at higher risk can help you be more vigilant about post-discharge home care, sometimes a hospitalization is unavoidable.