Acute Care and Then What?

After a 911 event like a stroke or car accident, the person becomes a patient who needs medical evaluation and care in a hospital setting. Of course, the patient needs to be evaluated and stabilized.

Soon after, the Acute Medical Rehab team may be consulted by the hospital team. This may include a swallow evaluation (by SLP/Speech-language Pathologist) for safe oral intake as well as a simple cognitive and/or communication evaluation. The PT (physical therapy) may be asked to evaluate the patient’s strength, mobility, and function while the OT (Occupational therapist) may be consulted on upper body function/mobility/strength for self-care activities, including feeding, grooming, and dressing. This can all happen in the first few days and will contribute to the next steps.

All of these medical and therapy evaluations as well as the patient’s previous medical issues, contribute to the patient’s options, e.g., the next step. What’s the discharge plan? In fact, from the moment a patient enters the medical system, discharge plans are in the works. Can this patient return to their previous setting? Is this patient a rehab candidate? What are the patients’ resources, e.g., family and insurance?

My experiences working in health care started in 1990 at the University of WA Medical Center. Back then, medical and subsequent acute rehabilitation stays were usually weeks to months, rarely days. Some medical social workers walked with the family and supported them in considering the next steps. Minutes were not calculated in every interaction. Today. The average hospital and following rehab stay is 12.4 days. The social workers are called discharge planners, and they rarely can take the time to sit and talk with the family.

This partially explains why I have become an Aging Life Care Consultant, a private pay advocate who can step in and help you and your family navigate healthcare options. I believe health care is more confusing and expensive, and therapists and medical providers are no longer encouraged/reimbursed for helping their patients weigh their choices or seek resources particular to their needs. I am saddened by this change, but I am here to help.