Q: My husband just transferred from the hospital to a rehab facility following a fall. What do I need to know about how to manage his care while in the facility?
A: When your loved one is in a skilled nursing facility for rehabilitation, it is important to be a strong advocate and use the time to prepare for their return home.
Start by helping your husband feel comfortable and safe in the new facility. Bring him some comfortable clothing, non-slip footwear for when he does physical therapy, and a few items to help him feel at ease. I recently had a loved one in a rehab, and I brought them a colorful blanket to feel cozy and bring some cheer to their room. If they use a cell phone, make sure the charger is accessible and set up the side table with easy to reach items.
For qualifying stay in a skilled nursing facility, Medicare will cover the full costs for the first 20 days. Then you pay a portion of the costs from days 21 to 100. The benefit ends after 100 days. If you have supplemental insurance, check with your provider to determine whether additional coverage is available.
Within the first three days of admission, the care team will work to complete an assessment and develop a plan for his rehabilitation. They should schedule a meeting to review this plan with you. If they do not, you can request one. Bring a notebook with your questions and be sure to take notes during the meeting. If you feel uneasy about navigating the process, consider asking a trusted friend or family member to attend with you for support and an extra set of ears.
When talking to the care team, which usually includes the nurse, physical therapist and occupational therapist, ask questions to understand the goals for care. What are the benchmarks they are hoping to achieve in his therapy to allow him to return home safely?
Be sure to share your expectations and any home-related considerations with the team. For example, does he need to navigate stairs to enter the home or access his bedroom? Will he have support from family members or caregivers? What level of function are you hoping or expecting him to regain?
Get to know the schedule at the facility so you can plan your visits. Talk to your husband about what he needs from you and if he wants other visitors or not. Recovery in an unfamiliar environment can be stressful, and getting adequate rest can be difficult. Noise-canceling headphones, an eye mask, or earbuds with calming music may help promote rest and relaxation.
Discharge planning often begins sooner than families expect. Many people tell me they felt the discharge date arrived with little warning. Ask regularly about the anticipated discharge date, and begin preparing for the transition home as early as possible. Doing so can help you avoid feeling rushed or unprepared when it is time to bring him home.
Ask about any durable medical equipment he may need after discharge, such as a walker, shower chair, or raised toilet seat. Also, find out whether the facility plans to arrange home health services after he returns home. Home health providers may be able to continue physical therapy or other medical services for a period of time following discharge.
Having a loved one in a skilled nursing facility can be overwhelming. Remember to care for yourself as well. Prioritize rest, extend yourself grace and kindness, and ask for help from family and friends when needed.
Martha Shapiro can be reached at Senior Concerns at 805-497-0189 or by email at mshapiro@seniorconcerns.org.
