Seniors are being discharged from hospitals quicker than ever. In 1970 the average admission for a person over 65 lasted 12.6 days. By 2001 it had dropped to 5.8 days. This has put more pressure on families who want to be sure that safe arrangements are made for their loved one at discharge. Here are four tips to avoid being caught unprepared on discharge day:

Start Planning for Discharge from Day One
Be thinking from the start about where your loved one will need to go for safe care post-discharge, and what services will be needed. Will he or she be able to return home? Would it be safer to stay with a family member for a while? Will home care or medical equipment be needed?

Each hospital patient is assigned a social worker or case manager who coordinates discharge planning under a physician's direction. Find out who this person is and contact her. Don't wait until the last minute.

Talk Regularly with the Doctor(s)
Talk to your loved one's physician(s) daily about his or her progress. A good doctor, even if busy, should want to keep family members informed.

Find out what works best with each doctor. Often a phone call to you after morning rounds is an efficient way to stay in touch. Or, you might arrange to meet him or her at the bedside during rounds. Some doctors' schedules make a late afternoon or evening telephone conversation most workable. The important thing is to establish lines of communication early on.

Observe Things First Hand
Nothing beats frequent visits to the bedside and seeing for yourself how your loved one is doing. How is he or she feeling day to day? Walking? Eating? Responding to treatments and therapies?

Ask staff members like nurses, physical, occupational and speech therapists what they're seeing as they work with your loved one. Get on a friendly basis with these people, because they can be invaluable sources of information and support.

Get the Medicare-Covered Services You'll Need
Medicare will pay for home care and medical supplies up to certain limits, but only if:
1) the services are physician-prescribed;
2) the patient requires intermittent skilled nursing care, physical, speech or occupational therapy;
3) the patient is "homebound" (this is loosely interpreted in practice); and,
4) a Medicare-certified agency provides the care.

Medicare will pay for limited home health aide services if skilled care is also needed, but not aide services alone. Medicare will not pay for 24-hour care, meal delivery or homemaker services. If needed, these services must be obtained privately.

April 2004