12 Aug 2007
Dear Mary,
I am an overworked hospital discharge planner who tries hard to get patients out of the facility once doctors write the orders. The thing that really bothers me is when caregivers ask me what I expect them to do with their elderly loved ones. More than once I have seen family members who are angry and resentful because they have to take their mother or father home. It seems they expect discharge planners to be concierges and make all the arrangements for them.
I know through personal experience that a caregiver’s job is not easy, but please tell them they have to take some responsibility for finding services and putting them in place.
Dear Reader,
I have a lot of respect for discharge planners - the job is not easy and a “thank-you” is far and in between. Insurance companies dictate how long patients can remain in the hospital and you are under pressure to get them out which, unfortunately, makes you look like the bad guys.
On the other hand, caregivers are shocked by this state of affairs. Their newly discharged loved ones typically require high levels of care which they are ill-equipped to handle. But be that as it may, quick discharges are a fact and they can go much smoother if both sides are prepared.
Ideally, plans for discharge should be initiated the moment a patient is admitted. The discharge planner should make contact with the designated family member and remain in contact throughout the course of the hospital stay. Once the date of discharge is known, a meeting should be scheduled to inform and empower the caregiver. This meeting should take place in a quiet room with no disturbances and the planner should make eye contact with the caregiver, provide clear concise written information, and ask for feedback to be sure it is understood. The planner should have a list of resources available that are appropriate to the patient’s condition as well as a list of care managers to help put them in place if necessary. One of the most important resources caregivers of older adults (or any adult age 18 and over) must have is the number for the local Area Agency on Aging. Caregivers should come to the meeting with a list of questions and concerns, listen attentively and ask for clarification, and bring someone along to take notes and ask questions they may not think to ask.
I suspect this will not be the end of the discussion. I am sure I will hear more from both sides.
Dear Mary,
I want to thank you for writing your column, please don’t ever stop. I read it faithfully and clip it out to give to friends and family.
Your advice to the woman whose husband gave her an ultimatum, her mother or him, was right on. I, too, brought my elderly mother to live with me thinking she would see how much I loved her and be grateful. It took several visits with my husband to a marriage counselor to set my priorities straight and realize I had to make other living arrangements for her.
Moving my mother to an assisted living home was the best thing I have ever done and we now visit without hurting each other’s feelings. She was angry and resentful at first, but has settled in and enjoys the company and attention. The staff loves her and she smiles and laughs more than she ever did with me. This, of course, make me feel even guiltier but I am delighted to say that with continued counseling I am getting better. If I had known in the beginning what I know now, I would never have made the mistake of moving her into my home.
Dear Reader,
Thank you for your kind words. I am pleased that you and your mother can now peacefully enjoy each other’s company.
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