For many people, a stay in the hospital is only the first leg in a long journey back to home and health. In between frequently requires one to reside in a rehabilitation facility. (We used to call them nursing homes.) This stint typically lasts several weeks, or until Medicare runs out – whichever comes first! The general concensus of rehab patients that I have interviewed is that the physical therapy is great, the accommodations are less than great, and they can’t wait to get back home!

The reality for some patients is a permanent decline in health and ability to care for themselves at the conclusion of rehab. It is important to adequately plan for supplemental home health care to begin once the patient goes home. In some cases, the home needs to be modified for increased safety, decreased mobility, space for medical equipment and supplies, and access for a wheelchair or walker. Safety issues might require the removal of throw rugs or the repositioning of furniture. Any time a person needs the assistance of another person or equipment to move about, then all pathways and doorways need to be widened. This may include removing doors and door moldings. Shower doors should be removed to make room for two people to enter and exit, while one holds onto the other. Tubs can be cut down into walk-in showers. Grab bars should be added in multiple locations by the commode and in the shower. A hospital bed should replace the standard bed if the patient is unable to get out of bed or unable to walk without maximum assistance from another person. Stairs should be avoided and may necessitate use of an alternative entrance to the home.

It is very difficult for a patient to simultaneously accept loss of health, home modifications, and reliance on another person for everyday activities. Families and friends need to emotionally support the patient during this difficult transition. Part of that support includes helping the patient accept the new situation and focus on the positive aspects. If the patient resists some of these changes, families should never back down on safety and health related issues. The bottom line is that if a patient refuses to allow for adequate home safety modifications and/or refuses assistance from a caregiver , then that patient should remain in a supervised care facility.

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