Acute & Rehabilitation Care Support & Discharge Planning
Overview
When a loved one is hospitalized due to an acute illness it can be a time of great stress and uncertainty. Having a knowledgeable advocate who is familiar with the intricacies of the medical field, patient rights, insurance and community resources can provide the reassurance you need to get you through this difficult time. We are available to support you through this process every step of the way, from the Emergency Room evaluation thru Discharge Planning.
The transition from hospital to home or another care setting is a critical phase in this process. Aging with Grace Care Management is available to assist you and your loved one with Discharge Planning to ensure a smooth and secure shift. This may include selecting a rehabilitation facility or arranging home health services, medical equipment, follow-up appointments, and any necessary modifications to the home environment.
We work closely with families to ensure that the transition is not only smooth but also aligns with the long-term care goals of the client.
Our second step involves coordinating the required post-discharge care. This may include arranging home health services, medical equipment, follow-up appointments, and any necessary modifications to the home environment. We work closely with families to ensure that the transition is not only smooth but also aligns with the long-term care goals of the senior.
Who is this service recommended for?
Individuals currently in a hospital or rehabilitation setting
Caregivers needing support advocating for someone who is in a hospital or rehab
Individuals planning for a future hospitalization or rehab stay
Aging individual or caregivers needing assistance planning for post-hospital care
How it works
Initially, we meet with the client and their family to understand their concerns and goals. We then engage with the hospital’s medical team to understand the specific needs and recommendations for the individual. This includes understanding medication, rehabilitation needs, and any special care instructions. Once the needs of the client are assessed then our care managers will assist you with formulating a plan for next steps. Aging with Grace Care Management is also available to implement, monitor and adjust the plan as needed.