When a loved one transitions from the hospital to home or to a new healthcare center such as a long term care center, the most important expert for families to communicate with is the case manager. Each hospital and healthcare center has a case management team. This team is responsible for their patients’ medical success, compliance and smoothly transitioning from one care setting to another. Case managers often work behind the scenes, arranging care, medical equipment, transportation and even providing patient education.
In order to have open communication about their loved one’s care, families can schedule a time to meet with the case manager. If families are out of state, conference calls can be arranged. When a case manager knows the unique needs of your loved one, this will help them make the best decisions for a successful discharge plan from one setting and help set the stage for a well rounded care plan going forward. For example, If a 90 year old man is being discharged home after recovering from Pneumonia, it would be helpful for the case manager to know if he has family to help him with shopping, meals and medication reminders. If a patient does not have a support system at home, the case manager can arrange home care services to assist him until he is strong enough to care for himself at home.
Bayshore home care is one of the few home care agencies in Tampa Bay to have a team of nurse case managers working in Pinellas County, Pasco County, and throughout Tampa. As home care experts, the case managers at Bayshore Home Care work closely with community services, hospitals, rehabs and hospice to coordinate and meet all of the needs of their patients when they return home from a medical event. If your loved one is currently in the hospital or rehab and will be discharged home, contact Bayshore to arrange a consultation with one of our nurse case managers.