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I want to pass on some wisdom, learned here and applied during my husband's recent stay in the hospital. Add what you'd like!


1. Start advocating for rehab the minute the patient is admitted. My DH was still in the ER and I was already telling anyone who would listen that he needed to go to rehab.


2. Even if it turns out your patient doesn't qualify for inpatient rehab (after 6 nights bed bound in ICU, he got up and walked 1/10th of a mile, unassisted), make it clear that in-home services are needed.


3. Set up a post discharge appointment with patient's PCP while you're still in the hospital. Make it clear to the scheduler that this needs to be within a week of discharge.


4. Ask for an Occupational Therapist to pay your patient a visit. Although my DH didn't need formal OT, he greatly benefitted from the gadgets that OTs have (shoe horns, sock assist devices, tush wipers, bath wipes and grabbers). Also, they have good advice on shower benches and other adaptive equipment.


5. Make sure your patient gets a shower WHILE IN THE HOSPITAL.


I told everyone who would listen that I was not supervising DH's shower on his first day home. He needed to come home clean and I needed to see just how much supervision/assistance he needed. He was much more confident at home because he'd already done one post surgical shower with professionals.


6. Go over the discharge medication list while you are still in the hospital. Note any changes from before admission; if necessary, get PCP/cardiologist/neurologist on the phone then and there and confirm changes. Have any new meds delivered in house from the hospital pharmacy--avoid having to leave the patient at home while you run to the local pharmacy.


7. Make sure you get specific referrals for followup appointments with new providers.

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This is great, Barb. THANKS.
I so often say to the family that they need to call them all in on day one. The social workers, the discharge planners and the nurse managers. Find out who is in charge. And begin advocating right away, introducing yourself.
You did such a good job for your hubby.
This is appreciated.
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I agree this is great!
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Great info, Barb! Very helpful.

Thanks for posting.
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A scheduler has never set up a PCP appt for my LOs.

I did note changes, I questioned H/P meds for a man who has never taken them. "He was in AFIB " me "but he isn't now" then got that look I had no idea what I was talking about. Discharge paper said "see ur Primary in 2 weeks. After DHs problems with High blood pressure meds given, I will never wait one week or two weeks to see PCP again. I will make an appt as soon as I get home. My DH did not need H/P meds. The PCP was surprised he could walk his pressure was so low.

Rehab cannot be determined until a 3 or 4 day stay. Medicare determines that.

I find it does not matter what your primaries have ordered previously in your care. If they have no privileges in that hospital, their own doctors will do what they want and I was told that when I asked the doctor to call my Moms specialist. "She is my patient now". IMO this is why mistakes are made. Doctors not consulting with patients primaries.

Never heard of a hospital pharmacy delivering meds. Will have to remember that.

The making sure you get referrals is a good one. For me, though, the doctor has to be where I will drive. At 74 I will not drive into cities highly congested areas. So, especially with my nephew, I ask where the doctor is located. If not where I am willing to drive, they always find a doctor closer.
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I was watching an old Dr Phil showvthe other day about a couple who lost a child before birth. The mother had complained about something earlier and a ultrasound could not be done because the insurance co did not allow it. That baby might have been saved. He said we are the highest country in the world for infant deaths. We pay the most for health insurance and get less for the cost.

We need to advocate for ourselves. Go with our gut feelings. We know our own bodies better than anyone.
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