Most of us, at one time or another and whether we like it or not, end up in a hospital. Coincidentally, many of us don’t feel real good when we’re in the hospital. One of the many unintended side effects of not feeling real good in a hospital is that most of us aren’t as sharp as we might otherwise be — because we don’t feel real good and are in a hospital.
And, as many of us well know, one of the more dramatic (or traumatic) challenges associated with being in a hospital is getting out of the hospital — specifically, what do I do, where and when do I do it, and/or who’s going to do it to me — and where. This is what’s referred to as “discharge planning,” meaning “what the heck ought to happen when I get the heck out of here.”
The first rule of being in a hospital (or any health care setting, including just going to see your doctor/provider) is to make every reasonable attempt to avoid doing it alone — and not just because you need your hand held (although that’s not an altogether bad idea). It’s mostly because most of us need another person’s mind, ears and memory to help us understand and incorporate everything that comes at us.
Often (but not always), as getting out of a hospital looms large, you’ll be visited by a “discharge planner.” Their title may be something a little different, but if you ask him or her if she or he is the discharge planner, they’ll tell you yes or no. Their role is to help you understand what needs to happen in order for you to do as well as possible once you’re out of there, so here’s Rule No. 1 for speaking with the discharge planner:
Don’t fib.
Think I’m kidding? Many of us are forever lying to discharge planners because we’re scared of what they’ll do if they know the “truth,” which usually translates into “if they know how much help I really need, they’ll put me someplace I don’t want to be or make me do something I don’t want to do.”
Here’s what discharge planners can make you do:
Nothing.
They have no power over you whatsoever, so quit worrying about that and try to remember that they are trying to help you, so tell the truth and pay attention.
But even in the best possible circumstances, these conversations are often difficult because we get too much information and too much paper in too short a conversation, and we weren’t feeling all that sharp in the first place, remember? Besides, we often don’t even know what to ask until we’re someplace else and realize that there’s a problem like, “Oh, piffle! How do I get up off the toilet?”
And many of you know that, as usual, I’m not kidding.
Well, here’s something that might help some of us at least some of the time. Go to www.medicare.gov/pubs/pdf/11376-discharge-planning-checklist.pdf, and you’ll find a nifty little six-page document from Medicare called “Your Discharge Planning Checklist.” You don’t have to be on Medicare to use this, and you could use it if you’re leaving a hospital or a skilled nursing facility/rehab facility/nursing home or any other health care setting. It’s very straightforward, and we can all understand it.
It just reminds you to ask about (and write down) things like what to expect from your medical issue, what you can do to help yourself get better, what to do if there are “problems” (and how to know if you were even having a “problem”), what prescriptions you have and/or need and when and how to take them, what appointments you have in the next few weeks, what might you need help with and who’s going to help, what equipment you might need, what does your insurance cover (or not) and what you can do about that, etc.
It isn’t rocket science, it’s a “checklist,” and its reason for being is to help you remember what you might not remember because you weren’t feeling too sharp because you were in the hospital.
If you’re the “caregiver” (which just means the person who’s going to be providing most of whatever help to the “patient” until she/he can do “it” on their own), there are some questions that you might want to ask and write down the answers.
The last page is a list of national resources that might help you get onto the scent of finding local help if you need it and, of course, you can always call any of the numbers at the end of this column.
You will probably also get written discharge instructions from the hospital. That’s good, but only if you know what they mean; so if you aren’t sure, ask. Believe me, you won’t be the first, and this isn’t a test.
Is this absolutely guaranteed to cover the entire ballpark? Of course not — this is Earth. The biggest mistake most of us (including caregivers) make is that when we get home and find out that we should have asked this, or that, or don’t remember whatever (because we didn’t write it down), we don’t call and ask; we guess. Good luck with that, but don’t be surprised if you’re back in the hospital again later, talking to the discharge planner — again.
Remember, the object of the game isn’t to look “smart”; the object of the game is to go home, get better and stay home.
That’s smart.
Mark Harvey is the director of information and assistance for the Olympic Area Agency on Aging. He can be reached by email at harvemb@dshs.wa.gov; by phone at 360-532-0520 in Aberdeen, 360-942-2177 in Raymond, or 360-642-3634; or through Facebook at Olympic Area Agency on Aging-Information & Assistance.
