Dr. Melissa O’Connor examines discharge considerations in home care


Safety is of the highest priority when deciding whether to discharge a patient from home healthcare, particularly if they can adequately care for themselves or if their respective carer has enough support to do so too, said Melissa O’Connor, PhD, MBA, RN, FGSA, FAAN, Endowed Professor of Community and Home Nursing, M. Louise Fitzpatrick School of Nursing, Villanova University, and Director, Gerontology Interest Group.

Transcription

What are some of the factors that are considered when creating qualified home health care adult discharge plans?

That’s a very good question. We interviewed patients and their caregivers, as well as home health clinicians, including therapists, nurses, doctors and social workers. So it wasn’t just the nurses. And here’s what we learned: one of the most important things clinicians consider is safety, and what was most important to patients was being able to take care of themselves, which is logical. So, does the patient and/or caregiver have an understanding of what is often a chronic disease? When should they contact their primary care provider and when do they need emergency care?

So all of these things are really important for clinicians to consider before going out. Some other things they consider are their functional status, their ability to prepare and take their medications correctly. We know that medication errors are a very common problem among seniors that brings them back to the hospital or emergency room.

Do they have access to community resources according to their needs? Such as Meals on Wheels, lab work, transportation. Another consideration for clinicians is whether the patient has reached their maximum potential – if a patient stops progressing, home health must come out. Another consideration is having a caregiver and whether the caregiver has support; it was really important to the patients and caregivers we interviewed. And it’s not just the state of their chronic illnesses, of course, that many people might think of when it comes to home health.

Clinicians take very seriously how the patient will be able to cope at home after discharge from home health care. So, they also pay special attention to when patients are living alone, as sometimes they have unique needs or unique circumstances that make them unable to cope as well as someone who may not be living alone. . So all of those things are what we consider before we discharge someone from home health.

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