hospital care

Leaving the Hospital After A Fall or Injury

Often my blog ideas come straight from a new client who is frustrated and needs an advocate. Frustrated with the amount of information given to them. Often clients are needing information about leaving the hospital after an illness or injury.

Being your own advocate is difficult when you are the patient. Having a caring advocate is important. You may have a friend or loved one be the advocate.

Start as soon as possible researching the needs.

1. Is home alone an option? If not will someone be there to care for the patient? Are there monies to cover home care or insurance coverage for help at home?

2. Is a skilled nursing facility (SNF) needed? Start researching SNF’s to get answers to important questions. Based on insurance or cash pay call or Google local choices and see which options best fit your needs.


1. DISCHARGE TIMELINE: When is the patient expected to be transferred to the SNF? Ask about the possibility of nursing home care as soon as the patient is hospitalized to have time to research SNF’s and to prepare for this transition.

2. SNF CHOICES: Which facilities are available to the patient and do they have an open bed? Can the patient request a single room, and is there an extra fee?

3. TRANSPORTATION TO THE SNF: How will the patient be transferred to the SNF? If transportation by ambulance is needed, are the charges covered by insurance?

4. SNF REVIEWS: Consult Nursing Home Compare for SNF information. Google the name of the SNF and read any online reviews or comments. Contact your state Department Of Health and ask for the most recent inspection results.

5. SPECIAL NEEDS: Ask the hospital discharge planner or case manager if the patient has special needs that the SNF will need to provide, such as a special diet or onsite physical therapy (PT) or occupational therapy (OT) services.

6. VISITING THE SNF: The patient’s advocate should try to visit the SNF choices in person. Check the toilet and shower facilities, cleanliness, patient activities and food selections. What is the caregiver to patient ratio – especially during evenings and weekends?

7. PATIENT RISKS: Nursing home patients may be at an increased risk of infection, overuse of antibiotics leading to “superbug” infections that may not be curable, falls, malnutrition, dehydration, medication interactions and side-effects, pneumonia and depression. Report any unusual symptoms you may observe in your loved one.

8. COORDINATION OF CARE: Which staff member is responsible for coordinating the patient’s care? Who is the physician in charge and how can he/she be contacted if there is a concern? Will the patient’s regular doctor visit the SNF? How are emergencies handled?

9. VISITING POLICIES: Does the SNF have a written visiting policy? If so, ask for a copy. Can approved visitors stay all night? Is there a policy for bringing food or other comfort items from home?

10. INSURANCE COVERAGE FOR SNF’s: Are there any needed services that are not covered by insurance? Is there supplemental Medicare coverage that needs to be billed? What is the protocol if the patient meets or exceeds their insurance maximum?

©2015 The Empowered Patient Coalition. An Empowered Patient ® Publication in collaboration with Julia Hallisy, D.D.S. and patient advocates Judy Wehrer and Paula Jean.

The Folly Of Driving to the ER

Hugh, a gentleman of about 68 years, lived alone. Hugh wasn’t feeling well. It was just a general feeling that something – who knows what? – just wasn’t right.

After a short while, Hugh walked over to see Phil, his next door neighbor. Phil agreed to drive Hugh to the Emergency Room.

It took them about 30 minutes to get there. Hugh signed in, and together he and Phil sat down in the waiting room. Within 15 minutes, Hugh keeled over, out of his chair, and onto the floor. He had “coded.” 

Nurses and doctors immediately rushed over with the “crash cart” to jump start Hugh’s heart; they brought him back from the brink of death. He was immediately admitted to the hospital and had surgery that afternoon…

But Hugh died a few days later, never having regained consciousness from the attack he had suffered in the ER.

Hugh was my friend. He was my neighbor. He left behind his wonderful dog, his adult children (who all lived out of town and we didn’t know them), and many of us who just adored him.

Now we are all angry at Phil.

You might wonder why we would be angry at Phil. Afterall, Hugh asked Phil to drive him to the ER. What a neighborly thing to do – right?

No. Wrong. Absolutely WRONG!

The thing is – Phil has had two heart attacks himself. He should have known better than to drive Hugh to the hospital himself. He should have insisted on dialing 9-1-1.  And that is why we are angry at Phil.

When you, or someone you care about has odd symptoms that could involve something life-threatening, never drive them to the ER yourself.

Let’s suppose Phil had insisted on dialing 9-1-1.  Let’s even suppose Hugh had dialed 9-1-1 himself.  The EMTs would have arrived very quickly, and realized immediately that Hugh was in the midst of a heart attack, or cardiac arrest. They would have treated him immediately, stabilized him, and then transported him to the hospital. There would not have been that delay in getting treatment which was then too little too late. It’s entirely possible Hugh would have survived and we would all still have our friend among us.

I know… you’re thinking “Yeah, but what if it’s nothing?  How embarrassing and possibly expensive that would be!”

That’s very true. That’s your choice. Let it be “nothing” and reluctantly pay the bill.  Or find out it was something – and be happy to live long enough to pay the bill.

I know which one I would choose! Both those possibilities are better than not surviving at all.

There are so many people, especially those of us who are a little older, who know whether we are at risk to suffer a heart problem, or a stroke, or some sort of episode that can ride that line between life and death. Every one of us needs to talk to our loved ones and neighbors to be sure they know to dial 9-1-1.

If you aren’t sure if you are one of those folks, who needs to know the difference,  I won’t make decisions for you; instead I will help you walk through scenarios yourself so your friends or loved ones will know what to do – or so you will know what to do for them.

Don’t risk death!  Dial 9-1-1. The life you save may be your loved one’s – or your own.

Posted by: AdvoConnection