Welcome to the Light Keepers podcast. I'm Clayton
Vandiver, your Light Keeper, with the show dedicated
to everyone who wants to get the very most quality
out of life that they can. My co -host, as always,
Charlene, our very own licensed clinical social
worker in the state of Florida, who is joining
the conversation this week about what happens
when you get discharged from the hospital. We
talked last week about what happens in the hospital.
And now we're going to talk about what happens
next, right here on this episode of the Light
Keepers Podcast. Before we start, please leave
your questions or comments below. We love to
hear from you. Questions this week will be answered
on the show next week on the next episode of
the Light Keepers podcast. Every Wednesday evening,
7 p .m. Eastern. Charlene, good to have you again
with us here. What happens when you get discharged
from a hospital? Well, and a lot of people don't
know what to expect with that because it can
vary depending on why you were in the hospital.
Most of the time when someone is discharged from
the hospital, one of two things is going to happen.
They're either going to go home with instructions
to follow up with their primary care physician
or their specialist, whatever is required. On
the other hand, sometimes when someone is discharged
from the hospital, they may not be ready to go
home yet, and they may need a little more help
to get themselves ready to go home, at which
point they would be discharged to a rehab facility,
which is pretty much kind of like a nursing home,
except they do physical therapy there, and you're
not there permanently. Okay. When you are in
these sorts of facilities, is your family a part
of that visit? Are they able to be with you as
they would be in a hospital? So every facility
has its own visiting hours. So I would encourage
everyone to check in with that facility and find
out what the visiting hours are before setting
up any preconceived ideas about when they can
visit and how much time they can spend with their
loved one. Now, something that a lot of people
don't realize, And this is very important to
know, especially during the COVID pandemic, when
people were being discharged to facilities, sometimes
the facilities were not nearby. And that's something
that the patient and the family has no control
over. The hospital will try to work with the
family to discharge their loved one to a facility
that's of their choosing or is nearby. But if
there is no availability, the hospital is not
going to let that person sit there. They're not
going to hold someone past the point that they're
ready to discharge because they're not getting
paid. Medicare, the insurance company, will not
pay. once that person is no longer meeting set
criteria to be hospitalized. And so what happens
then is if a bed is not available at the facility
that the family wants, the hospital caseworker
will set up a discharge to the first facility
that they can find to accept that patient. That's
not always in the same town. It's not always
in the same state. So who sets up all of those
travel arrangements and getting there? The case
worker at the hospital would be the one responsible
for setting that up. Now the trick there is they
don't always set up getting them home. That's
usually left up to the family. I see. And during
the COVID pandemic, I was working in the hospital
at the time, and it was not uncommon for us to
discharge patients because the facilities were
taking fewer people. There were more people being
discharged from the hospital, and we were discharging
people as far out as three and four states over.
Wow. Well, let me ask you, what other options
are there when you're leaving the hospital? What
other potential? scenarios might we have? So
the other possibility is returning home with
physical therapy being set up at home because
some people may have a better support network.
They may be able to do that at home. Some people
just have really strong aversions to going into
a facility. Maybe they've had a bad experience.
Maybe they've had a bad experience with a family
member. The option there is that they can go
home. and physical therapy can come to them and
they can finish recovering at home. Okay, so
physical therapy can follow you in a way. You
don't have to go into like a rehabilitation center.
Physical therapy, occupational therapy, most
rehabilitative therapies can follow you home.
Now it can become complicated if you are needing
very detailed equipment, like if you need a specific
piece of equipment to be able to do that physical
therapy, that may not be practical. But there
again, if you can be transported, if you can
move, if you're mobile, then you may be able
to go to an outpatient rehab to do that physical
therapy. Like for example, if you've got a broken
leg or you've had a hip replacement. you're going
to need to be doing exercises that you may not
have the equipment at home to be able to do.
And during those situations, if you can be transported
to an outpatient rehab facility, then you can
do that rehab there and go home afterwards. Well,
you also have the benefit in those facilities
of having a coach, if you will, someone to lead
you through those to make sure you're doing them
right and getting the most benefit out of doing
them. Correct. They're very well -trained, well
-skilled. We've got some great rehabilitation
centers. uh here in uh in our town and it's just
amazing to see them working with their patients
absolutely yeah they're very very are there any
other scenarios and i know you were talking about
a fellow i forgot his name now but you were talking
about a fellow that um that had an interesting
experience through the hospital stay and and
in leaving and i think the name that we came
up with was a very generic uh you know bob bob
yes everybody Identities have been changed to
protect the HIPAA privacy, of course. Actually,
we were talking about creating a bob to go into
the hospital and kind of a test patient to just
provide a possible experience of what someone
would encounter going through the hospital system,
including going through discharge and rehabilitation.
Again, it really does depend on why the person
was in the hospital. And I'm going to give you
a good example, like I was mentioning with the
broken leg or the hip replacement. That's going
to be a very different type of rehab than someone
who is in the hospital for a heart attack. There
are different types of rehab. There's cardiac
rehab. There is even concussive rehab if you
have a brain injury. Okay, like a traumatic brain
injury, a TBI. And it seems like if you had movement,
the inability with a broken leg, broken hip,
knee replacement, if you're having mobility problems,
the rehab is going to be very different than
if you, after you've had heart issues, I suppose
you don't want to get terribly excited, but you
can still move around. Correct. In fact, they
encourage movement, I think, to get you back
on your feet as soon as possible, it seems. When
you're coming out of a hospital these days, it
seems like they want you back on your feet. If
they could, I think they'd walk you from the
operating room back to your room. No, I'm kidding.
It's not that bad. Actually, no. Actually, they
do want you up and walking as soon as possible,
though, because that minimizes the risk for blood
clots. Oh, that's right. So that is important.
That is important. But the discharge process
can be different for everyone, like I said, depending
on why they're in the hospital. But the bottom
line, what it is most likely going to include
is a caseworker at the hospital who is going
to work with you to set up your discharge plan.
Now that in and of itself can be complicated
because depending on the quality of the hospital,
there have been situations where discharge plans
have been created without the patient's participation.
And that can happen. Visit the website at aguidinglight
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