When Home Care Ends: What Then? Elements for Home Care Providers




This is a list of recommended elements of any discharge from home care. Review how your agency handles discharges to home: are all these elements included? Is the method effective (is the way you share this information working)?

Before the home care case is closed, make sure that the patient and family caregiver have information about:

  • Summary of care
    • Date/reason for the start of care
    • Current status/disposition
    • What care was provided
    • What education was provided
  • Estimated date of ending services
  • Diagnoses (all)
  • Medication Management
    • Comprehensive list of all medications, including OTCs, supplements and herbals, and instructions for their use.
    • How to obtain refills
  • Medical equipment (who to call for supplies and servicing)
  • Exercises and physical/occupational therapy follow-up
  • Community services
    • Transportation resources in the community (including phone numbers)
    • Other sources for aides
    • Adult day care
    • Support groups/counseling
    • Respite care
  • Foods and diet
  • Activity restrictions
  • Medical test results still pending
    • When due
    • Who to call for results
  • Appointments
  • Name and number to call with medical questions
  • Caregiver’s questions answered?

These materials can help family caregivers understand and recall essential discharge information.

All Next Step in Care materials are available for free at www.nextstepincare.org in English, Spanish, Russian, and traditional Chinese.

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