"What if".... the silent killer

How many major decisions- which college to attend, beginning or ending a relationship, taking a new job, moving to a new city- have you looked back at and thought "what if I made the other choice?"

Take that feeling and think about what it would mean to make a major decision on someone else's behalf. Should your parent go home? Can your spouse be home alone during the day while you're at work? Does your grandmother need to move to an assisted living facility? 

Ick. 

Decisions made with (or for) a loved one are packed full of guilt. Did you make the right choice? Did you get all the information about what the discharge plan was going to mean for them? For you? Will they be safe?

In a time of google, WebMD, and numerous chat sites, it seems as though the internet has the answer. If you search for "is my parent safe to stay home" the results include tips for talking with your parents not about staying in their home, signs it's time to move to assisted living, and the dangers of leaving parents home alone. These websites do not inspire a lot of confidence, maybe rightfully so, but every house is different and every person is different. There is no formula to be applied or googled to let you know that the right choice has been made. This is why home assessments used to be a more prominent component of discharge planning for patients while in acute rehab. 

As you (or your loved one) progresses through a hospitalization they will inevitably come to this fork in the road- home or not. So now that a home evaluation by the hospital therapist is a less likely option, how can therapists gather information to inform their recommendation? In the hospital therapists ask family members to take measurements of areas in their home- height of furniture, bathroom dimensions, stair height, to try and piece together information. This could work for a simple question (can they get in or out of the house for example), not the “whole person” approach to deciding whether or not someone can continue to stay in their home or how best to adapt it.

Going through a home with a trained therapist yields much more information, how that person moves in their own space, what tricks they've been using to get by if their health has declined, how to adapt areas in their home to suit them. Living in New England and going in and out of dozens of homes has honed my troubleshooting skills when it comes to making a 100+ year old house work for clients.  

My goal as an acute rehab therapist was to get as many people home as safely possible. Home Field Advantage is an extension of that goal in a collaborative model with clients and family. Not every person will end up at home though. It is my hope for these individuals and their families to not have these lingering "what if" feelings. If you are unsure if you or your loved one will be safe in your home, I would like to help. To make an informed decision, one that you can be at peace with, knowing you’ve considered all options, you need all sides to the story. If home is no longer an option following an illness or injury helping a family know that they made the right choice, is paramount to the discharge location. 

If you are struggling with whether your loved one can return home after a hospitalization, or ways to troubleshoot their safety and function at home, I would love the opportunity to help.