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Following a hospital stay, your recovery at home depends very much on why you were admitted in the first place, whether that’s due to a planned surgery, a medical event or an illness. But in most cases, you’re likely to need some assistance for at least the first few days. You may need help positioning pillows or ice packs, keeping track of new medications, navigating the new-to-you hurdles in your home (think climbing stairs or bathing with a cast) or help preparing meals.
One of the biggest misconceptions people have about their loved one leaving the hospital is that being discharged must mean they’re “fine,” says Sondra “Sam” Cradduck, gerontologist, psychologist, licensed assisted living administrator, owner of More Than Heart (providing family and caregiver training) and founder of The Living Room, a non-medical senior home care agency in California. “But discharge doesn’t mean recovered. It means stable enough to continue healing somewhere else.”
And tackling that healing without proper support can be overwhelming and anxiety-inducing. Whether you live alone and need someone to check in on you, or your family or partner needs backup, experts share the benefits of in-home care after a hospital stay, the risks of insufficient support, what in-home caregivers can do and how to find the right fit for you.
Key takeaways
- Being sent home from the hospital means you’re medically stable, not fully healed. Most people need extra help in the first days or weeks to manage pain, mobility limits, medications and daily tasks safely.
- Home care helps people regain independence faster by supporting nutrition, mobility, medication management and more. Studies show it can also lower readmission rates and improve overall patient satisfaction.
- Skipping post-hospital help carries real risks. Without adequate support, patients face higher chances of falls, missed medications, infections and hospital readmission. The burden can also fall heavily on family caregivers, increasing stress and burnout.
Why do you need in-home support after a hospital stay?
Depending on the reason for your hospital stay, you might have multiple options for post-hospital care, such as skilled nursing facilities or rehab centers. But experts agree that when it’s possible for you to recover at home, that has the best outcomes.
However, Michael P. Johnson, research and innovation advisor at BAYADA, a home health care nonprofit, notes that many people refuse in-home help because they “don’t want to be dependent on somebody” or they feel like they’re “giving up or giving in.” He encourages people to think of it a bit differently instead: The goal is to get you independent more quickly.
In fact, Johnson gave the example of a project BAYADA did with a hospital in North Carolina as proof of this fact. Individuals who would have qualified for an inpatient skilled nursing facility were instead brought home and had access to home health aide services.
They started with round-the-clock care for the first couple days (if needed), and then slowly decreased that time over approximately three weeks. The result for these patients was that they “had better outcomes, fewer readmissions and better patient satisfaction,” says Johnson.
While recovering at home is important, it’s also important to remember that you’re coming home in a new body to a new home, of sorts, adds Johnson. While you’re in the hospital, rooms are designed to be hazard free: Stairs are the ideal height, there is smooth flooring and guardrails are installed everywhere. When you get home, you may have weakness in areas of your body, and parts of your house may feel challenging or even dangerous.
In addition to encountering challenges in navigating your home, Cradduck adds that after a hospital stay people may go home with:
- Weakened strength and balance (even after just a few days in bed).
- New medications with complicated schedules and side effects.
- Pain and fatigue that makes normal daily life hard.
- Mobility limitations — stairs, showers and getting in/out of bed can suddenly be unsafe.
- Fear and anxiety (for the patient and the family).
- A caregiver gap — families still have jobs, kids and life responsibilities.
This is where an in-home aid can help.
What are the benefits of in-home support post-hospital stay?
Now that you know why appropriate support is necessary after a hospital stay, what are some of the benefits of in-home care?
Emotional security
When it comes to healing after a hospital stay, Johnson drives home the phrase, “there’s no place like home.” Because your mental state is linked to how you feel physically, being in a place you’re comfortable can improve your recovery, whether that’s because you’re able to sleep with your favorite pillow or have your dog with you, he adds. And having extra support during your recovery can make going home post-surgery a possibility.
Consistent healing support
“Recovery requires fuel,” says Cradduck. “And many people don’t eat or drink enough after discharge.” Having a caregiver in-home means you’ll have support in the form of “simple meals, hydration reminders and gentle movement that keeps the body from deconditioning,” she adds.
Decreased fall risk
Falls are one of the top reasons people end up back in the hospital, says Cradduck. Having a caregiver there to help with safe transfers and give walking support ensures you or your loved one don’t do too much too soon, she adds.
Medication support
If you are on medications before you enter the hospital, you might feel like you have your schedule down pat, but hospitalizations often result in medication changes and additions. This can be overwhelming for even the smartest, most capable people, Cradduck says. Having someone in-home can help ensure you take your meds on time, with food if needed and without the risk of double-dosing, she adds.
Additionally, home care can aid in medication reconciliation and readjustment, Dr. Michele Bellantoni, professor of clinical medicine and clinical director of the Division of Geriatric Medicine and Gerontology at the Johns Hopkins University School of Medicine adds.
For example, she recalled conducting a home visit for a patient who had been discharged after treatment for pneumonia and an emphysema flare. During this visit she discovered that her blood pressure was high and that she hadn’t been taking her blood pressure medication, due to it not being noted on her paperwork and the resulting errors of communication.
If you need help managing your medications, here are some medication management tips from experts.
Professional oversight
Having a professional in your home during your recovery means problems are more likely to be noticed early, says Cradduck. She adds that a caregiver will be on the lookout for warning signs, such as:
- Shortness of breath.
- Increased swelling.
- Confusion.
- Fever.
- Wound concerns.
- Dizziness.
- When “something just feels off.”
Additionally, Bellantoni warns of hospital-acquired delirium, which can occur in older adults post-hospitalization. So it’s important to also consider if an “older adult’s cognitive function is adequate to be unsupervised at night,” or if they will wake up in the middle of the night very confused. Catching these issues early can prevent complications and readmission.
“The person who’s healthy is carrying twice the load, and so you’ve got to really think about them holistically — not just the patient but the family member.”
— Michael P. Johnson, research and innovation advisor at a home health care nonprofit
What are the risks to not having in-home support post-hospital stay?
If you’re considering foregoing extra or any help at all post-hospital stay, here are a couple factors to consider.
Readmission and the risks that come with it
Not having appropriate care at home can increase the risk of readmission, if, for example, you or your loved one miss medication doses, develop an infection or suffer a fall. Not only does readmission carry a higher price tag with it, but you also risk exposure to germs and illnesses when you’re in the hospital. These “nosocomial infections” (infections contracted in a healthcare setting) are one of the highest risks of being in a hospital, Johnson says. On the flipside, if you’re home, your risk of illness goes down.
In addition to the financial and physical concerns associated with readmission, there can be an emotional toll when you’re readmitted to the hospital. Not only is it distressing to leave the comfort of your home when you don’t feel well, but if your loved one has dementia or a similar condition, returning to the hospital could be disorienting and distressing.
Overwhelm for family caregivers
If you have family or friends who are stepping in to help during your or your loved one’s recovery, it’s important to recognize how much work that can be. Taking on a caregiver role while also juggling daily responsibilities can be overwhelming, particularly if you’re doing it solo or if the needs are extensive.
In these situations, “the person who’s healthy is carrying twice the load, and so you’ve got to really think about them holistically — not just the patient but the family member,” says Johnson. If you’re able to bring in a professional caregiver to alleviate some of that weight, you lessen the chances of overwhelm and burnout.
What do in-home caregivers do?
In-home caregiver needs fall into one of two camps: medical or non-medical. If you primarily need help navigating activities of daily living, you likely hire a personal care assistant (non-medical). However, some people may need private nursing care (medical).
Non-medical care
Non-medical care from a homemaker could include assisting with the following, according to Cradduck:
- Safe mobility, such as walking assistance, transfers and fall prevention.
- Bathing and hygiene.
- Dressing.
- Meal prep and hydration.
- Medication reminders and routine support.
- Light housekeeping.
- Transportation to follow-up appointments or physical therapy.
- Keeping the home calm and organized so recovery isn’t stressful.
- Encouraging movement without pushing too hard.
- Monitoring symptoms and communicating changes to family.
Medical care
In contrast, medical care could include:
- Administering medications.
- Wound care.
- Injections.
- Tube feedings.
- Physical or occupational therapy.
“The first 72 hours at home are the danger zone. That’s when confusion, falls, missed meds, dehydration and ‘I thought I could do it myself’ moments happen.”
— Sondra “Sam” Cradduck, gerontologist and psychologist
How to find the right in-home caregiver for post-hospital care
So you’ve decided to hire an in-home caregiver. What now?
Figure out your needs
The level and length of care you will need will depend on your circumstances, but that’s where you should start, says Cradduck: the “why.” Why do you need help? What are you worried could go wrong at home? Do you anticipate needing medical care, or will personal care be sufficient? Do you have family and friends who will help fill care gaps, or do you need to hire someone for longer periods of time? Answering these questions will help you determine what kind of care you’re looking for and for how long.
Know your coverage and budget
For most people, hiring in-home care will be an out-of-pocket cost. However, other possibilities include long-term care insurance, veteran’s benefits or Medicare/Medicaid. Since this can vary by state, it’s important to check your individual options.
If insurance coverage or costs are a concern, Cradduck recommends families “start with a short schedule (like mornings and evenings) during the highest-risk period, then scale down.” She adds that the first 72 hours at home are the danger zone. “That’s when confusion, falls, missed meds, dehydration and ‘I thought I could do it myself’ moments happen.”
Research and ask questions
As soon as you have options in hand, Johnson recommends checking them out on the Better Business Bureau (BBB). This gives you a snapshot of the quality of the business. Note: Home care agencies can be found on the BBB, but private caregivers will not be found on this website.
Then brush off your interviewing skills and ask these questions from Johnson and Cradduck to determine if they’re a fit:
- What does training look like, initially and on an ongoing basis?
- What kind of oversight/support does the home health aide have? For example, how often does somebody from the agency check in?
- What are the limitations on how many hours an individual home care worker can work? If there’s no limitation, they could be burning themselves out.
- What is their experience with post-surgical recovery?
- Are they comfortable assisting with mobility and transfers?
- Have they completed CPR/first aid training?
- Is there backup coverage?
- What will communication look like? Will there be daily updates, logs, etc.
- What is their process for finding a good fit?
And lastly, don’t forget to conduct background checks and ask for references.
Don’t settle for a poor fit
Knowing how important the mental component is to healing, it’s important that the person who is caring for you is someone who makes you feel calm and relaxed in their presence. Finding the right caregiver can be the difference between feeling like opponents and feeling like teammates.
So don’t feel bad if the person who is initially assigned to you is not the right fit. When pairing people with a caregiver, Johnson says that they make their best guess, but sometimes they’re wrong. It’s important to not settle for someone you’re not comfortable with. After all, he concludes, “when you find the right person, there’s a little bit of magic to it.”
