Navigating healthcare and the transition home

The idea for Home Field Advantage came from an astounding realization I experienced over and over again while working as an Occupational Therapist in an acute rehab hospital:

People don't know they have a choice. 

The unfortunate reality in our country is that healthcare revolves around profit. Reimbursement levels have changed drastically in the last 20 years, especially in the last ten. Medical technology and research has created advancements in treatment and rehabilitation but no advancement can alter the fact that some patients just need more time. 

Over and over I saw patients that could have discharged home had they been given extra days or maybe a week, discharged to a subacute facility. On the surface it sounds logical, they aren’t ready to go home so a next level down will give them time. The reality is the longer a person spends in the healthcare continuum, the longer they are likely to stay there. What about their home setup informed the therapists’ recommendation? Was it the stairs to enter the home? or their ability to access their first floor bathroom?

For example- Say a patient entered the hospital after a fall at home on the ice in their driveway and broke their hip. Prior to the fall they had been living independently, or with a minimal amount of services. Now they transition to acute rehab and work on improving strength and safety with the goal of going home. At the end of their rehab stay that person is still having trouble using the stairs. Instead of a home visit, because those are few and far between, they are discharged to a subacute facility (skilled nursing) to continue rehab and probably stay between 30-90 days there before heading home. If they stay the entire 90 days, plus the few weeks in rehab and the hospital, this person hasn’t been home for 4-5 months. In those 4-5 months the patient’s family has been educated on assisted living facilities (ALF) and begins to push for their parent to transition to an ALF after discharge. 

Sometimes this is a necessary outcome. But what if someone had gone through and assessed the patient’s home while they were in the hospital or rehab? If the patient wanted to go home, how would the family know what changes to make to facilitate a home discharge? Time and time again I had patient’s family members bring in pictures of their homes to ask for advice. It’s a start, but you can’t truly judge the space unless you are in it or unless you have a background in rehab. 

The term “home field advantage” refers to the advantage anyone enjoys from familiar surroundings or circumstances. We spend our lives making our home a safe and comfortable place. Our ability to safely access this space should not be hindered by a change in function if we are able to adapt the environment. 

I started Home Field Advantage to work with families. 

To help people stay in their homes longer and in a safe capacity. 

To empower families to make fully informed decisions about discharge planning.

To help people plan for the future. 

We are all going to age. 

It is never too early or late to make changes. 


* The picture with this blog is me and my grandparents. They were the first HFA assessment and the push to help me understand the impact this could have on other families.