Many patients lose strength, mobility, and stamina during a hospital stay. To help them get back in shape—or make the most of rehabilitation—after being discharged, caregivers should consider these recommendations.
Plan ahead
Before patients leave the hospital, go over the posthospitalization plans, including follow-up appointments, referrals for rehabilitation, and any changes to medication. Familiarize yourself with possible side effects of short-term medications. “Inquire about opioids and drugs causing drowsiness or side effects like constipation,” says Elizabeth Phelan, MD, professor of medicine at the University of Washington School of Medicine and attending physician at Harborview Medical Center in Seattle. “If any pre-hospitalization medications aren't on the discharge list, ask whether to resume them.” Also, clarify what should be monitored at home (blood pressure, weight, and fluid intake), who should get this information, and the best way to communicate.
Be a second set of ears
Patients may experience fatigue, weakness, or confusion from new medications or sedative agents. Caregivers should be there during the discharge to listen, ask questions, and take notes.
Update the doctors
The patient's primary care doctor and neurologist may know about any elective surgeries, but in emergency situations, they may not. “Ideally, patients should see their neurologists as soon as possible after being discharged from the hospital,” says Michele Tagliati, MD, FAAN, professor and vice chair of the neurology department at Cedars-Sinai Medical Center in Los Angeles. “If they don't have the strength or energy for a doctor's visit, ask if telehealth appointments are possible to discuss a care plan with the neurologist and ask questions that have arisen since discharge.”
Consider rehabilitation
Ask doctors and therapists whether any specific rehabilitation services are needed. If so, inquire about the goals, such as improving strength, mobility, or daily functioning. Research facilities and find out about the staff's training and experience with people who have neurologic conditions. “Share information about medication use during any rehabilitation program,” says Michael Okun, MD, FAAN, director of the Norman Fixel Institute for Neurological Diseases at the University of Florida. “Outcomes are better when medication is given on time every time, so the rehabilitation facilities need to know the schedule.”
Guard against falls
Do what is needed to prevent falls, and be sure your loved one understands the importance of such measures. For example, if patients are discharged with walkers, “be sure they use them consistently until their doctors or physical therapists say they don't need them anymore,” says Dr. Phelan. “If physical therapy is recommended, make sure to follow through.”
Keep them active
Help loved ones resume, or start, a regular exercise routine that enables them to make up for any losses in cardiovascular conditioning, muscle strength, and balance. If they are allowed to walk, encourage them to walk several times per day, increasing the distance and duration gradually over time, says Dr. Tagliati.
Promote good eating
Upon returning home from the hospital, people should avoid fried, processed, and salty foods and focus on fresh fruit, vegetables, and lean sources of protein, says Melissa Mattison, MD, chief of hospital medicine at Massachusetts General Hospital. They should stay hydrated by drinking nonalcoholic and noncaffeinated beverages, she adds.
Read More
