Preparing for your loved one to come home from either the hospital or a rehab facility can be overwhelming. When do you start planning? What can you do to prepare? What can you expect to happen? No single case is the same, but there are similar steps and elements when it comes to preparation. Read on to learn more about preparing for your loved one to return home.
When is the best time to start planning?
Right away. If you have any concerns about having the house “ready,” speak with the hospital or rehab case manager and express those concerns right away.
It’s also recommended to figure out how much time you have by requesting a potential discharge date.
How can I find out how they will be functioning before they discharge home?
Speak to the Physical Therapist and Occupational Therapist about how much they think your loved one can do now and what they think is the potential for improvement in the short- and long-term run. This gives you an idea of how to prepare as well as figure out if the need initially is temporary or that you need to think long term. For example: someone is in a wheelchair now – do they have the potential to walk again, or will they need to use a wheelchair for the foreseeable future?
Think about your own responsibilities to other family members, work and children. Do you have the capacity to care for your loved one – or are you going to have to recruit other family members or a professional caregiving agency to help you?
Can your loved one currently safely access the home?
In general, you will need to consider two exits from your home for safety in the event of an emergency. One exit can be for regular use – and then one for emergencies. Do you need a ramp or a stair lift? If you have many steps and you have someone in a wheelchair you may need to think about a vertical platform lift.
Can your loved one safely access and utilize the bathroom?
This depends on the configuration of your bathroom and how your loved one is doing. Take pictures and show the physical therapist or occupational therapist. They can help guide you to where to start. Medicare pays for some equipment – but not bathroom equipment.
If your loved one is very tall or having difficulty standing up from a toilet, a bedside commode may be helpful. There are many price points and models to choose from and Amazon has a great selection. Look for one with a comfortable seat and easy to clean (again the physical therapist and occupational therapist can recommend one specifically for your loved one).
Showers can be tricky. Just know that you can bathe someone without a shower in the short term – most showers over a tub are hard to negotiate. There is a specific piece of equipment called a “tub shower bench” which sits over the tub and sticks out over the side. This equipment allows you to sit on the outside of the tub and scoot over into the tub so you can use the shower. This is also available from Amazon and most durable medical equipment stores. Look for one that is comfortable, easy to clean and has a back on it.
Where can you find help setting all this up and finding the appropriate equipment?
Often, your loved one’s treating Physical or Occupational Therapist can advise you if you can provide them with good photos of your home and set-up. Because they’ve been treating your loved one, they also know what they can handle, meaning they can make the most appropriate recommendations.
Or, you can hire a Physical Therapist to come to the home. Please note that this service is not generally covered by insurance, but many local private pay therapists can do this for you. They will meet with you before your loved one comes home and can make specific recommendations for equipment that fits your home and your situation. It’s always helpful to have that therapist speak to the therapist caring for your loved one.
The third option is hiring a private care manager. They perform a number of functions. One of which is to facilitate a smooth discharge from a facility to the home. Not only will they liaise with the hospital staff on making sure that all appointments are made, and medications reconciled, but they will help you set up the house to ensure it’s ready for your loved one to come home. If you don’t know a private physical therapist – most care managers will have contacts you can use. Keep in mind that hiring a care manager is best done by a personal recommendation. You can find one in your area on the following directories: Patient Advocate Certification Board and The Advocate Connection.
For long-term solutions:
Once you have an idea on how your loved one is doing at home – it might be time to consider making some bigger renovations. The choices are wide and mostly dependent on a combination of your loved one’s abilities, your home’s accessibility, need to navigate steps, as well as budget.
If you are looking at more permanent renovations and are committed to remaining in the home, or providing long term care for your loved one, consider planning for a wheelchair user. Very often renovations are made to make life easier for an able-bodied person and then are rendered useless if a mobility device such as a wheelchair or scooter is needed. Being proactive can save you money in the long run.
Some things to consider for either your future or your loved one’s:
- Do you want to live in your current residence forever?
- Can you make renovations so you can live safely in the home?
- Do you need stair access, or can you make one floor your base by creating a bedroom out of another room?
- Can you get in and out of the house safely?
- Do you need a stair lift, ramp, or vertical lift to help get in or out of the house?
- Is your bathroom accessible – do you need a zero-entry shower (to avoid stepping) or can you step up into the shower you already have?
- Is your home wheelchair accessible?
- What if you need a wheelchair one day?
What about making sure everything fits?
There are many Certified Aging in Place (CAPS) professionals who can help you with placement of these new tools. A list can be found in the directory at NAHB. You can also find who is CAPS-certified and current with their certification by emailing the NAHB at the Professional Designations Helpline at [email protected] or calling (800) 368-5242 ext. 8154.
Or, you can look for a licensed contractor, accessibility or mobility lift dealer, or architect to help you in finalizing the designs.
What about financial aid for these products and tools?
For those without funding, financing a large renovation can be overwhelming. It is important to consider the cost of the alternatives. Moving into an assisted living facility can run upwards of $10,000 a month, and nursing home care can double that number.
Being open to other types of financing can really help you save money in the long term. If you obtain a prescription for your renovations, you may be able to deduct the cost of renovations as non-covered medical expenses. Consult your accountant to see if you are eligible. Prescriptions for medical devises/ equipment may also help you avoid state sales tax. Other avenues to consider include:
- Funding through the Veteran’s Administration for eligible beneficiaries.
- Consulting your long-term insurance policy.
- Considering a second mortgage or home equity line.
- Consulting the CAPS program for Medicaid recipients.
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