Guiding Souls Home Care does not provide home health or skilled nursing, so this article sticks to what a family can set up, and where to turn for the rest.
What should you ask the hospital before your parent is discharged?
Ask for the discharge planner or case manager. Ask in the morning, since afternoon discharges move fast. Then go through this list with them:
- What is the written discharge plan, and can I have a copy today?
- Is there a full medicine list, with what is new, changed or stopped?
- Which follow-up appointments are booked, and who is driving?
- Does my parent need a walker, commode, shower chair or hospital bed, and who orders it?
- Was skilled care at home ordered, and which agency will call?
- What can my parent do alone, and what needs a person beside them?
That last question matters most. "Needs help" can mean standing by for a shower or lifting from a bed, and the plan for each is different.
Skilled care at home is not the same as home care. Medicare pays for part-time or intermittent skilled care at home, and only after a doctor or provider sees your parent in person and orders it. Your parent must also be normally unable to leave home without help. That covers visits from a clinician or a therapist. Medicare does not cover 24-hour care, meals, or personal care when personal care is the only care needed.
If your parent is a veteran, ask the VA social worker the same questions. The Sacramento VA Medical Center is at 10535 Hospital Way in Mather. Ask too about rides to follow-up appointments, which matter if home is in the foothills.
What should the house and the first week look like?
Walk the house the day before. Look at what your parent will actually do: get out of the car, climb the steps, reach the bed, reach the toilet at night.
Clear the path. Remove loose rugs and cords. Put a night light between the bedroom and bathroom. Move the things used daily, like glasses, phone, pills and water, to waist height. Ask the discharge team whether your parent needs a shower chair or raised toilet seat.
Plan the ride. A long drive from Placer or El Dorado County hills is tiring after surgery. Pack pillows, bring a bag for the medicines, and plan a stop. Fill the new prescriptions on the way, or have someone do it, so the first night is not a hunt for a pharmacy.
Stock the kitchen with food that needs little work. Set up a pill organizer using the hospital's list, not the old bottles at home. Old and new medicines mixed together cause real mistakes.
Then cover the hours. Decide who is there in the morning, who is there at bedtime, and who covers the night. If that person is you, look at California Paid Family Leave, which gives up to 8 weeks of partial pay to care for a parent with a serious health condition. A doctor must certify the need for care, so ask for the paperwork before you leave the hospital.
The home care services page lists help with bathing, dressing, meals, medication reminders, rides and company. Check what any long-term care insurance policy pays too, and whether a veteran qualifies for VA Aid and Attendance, which adds to a VA pension for those who need help with daily activities. Ask the discharge planner about the Home and Community-Based Alternatives (HCBA) Waiver, a Medi-Cal program that pays for care management and services at home for people who qualify.
What warning signs should you watch for in the first days?
Before discharge, ask the hospital team to write down which symptoms need emergency help and which mean you should call the doctor. Call 911 for an emergency.
For everyday trouble, watch for these:
- Your parent skips meals or leaves the food untouched
- Trips to the bathroom are rushed, or avoided
- Pills are in the wrong slots or the bottles are mixed
- Your parent will not use the walker because it feels embarrassing
- Your parent is alone for most of the day
- You are the only plan, and you are already worn out
If you hire help, watch for warning signs there too. Be careful with an agency that will not put a price in writing or explain how and when you will meet the caregiver before care starts. In California, you can check a caregiver's status in the Home Care Aide Registry, which requires a criminal background check run by the California Department of Social Services before registration.
What does a good first visit at the house look like?
Someone in charge walks the route your parent will use: the entry, the bedroom, the bathroom, the kitchen. They ask how your parent got through a normal day before the hospital, what has changed, and what the discharge sheet says.
They should also ask about routines that affect the care plan, such as when your parent wakes, whether the dog needs to go out and who else is home at night. Ask them to check whether your parent needs someone nearby during a shower.
Ask for the hours, tasks and cost in writing, and find out when you can meet the proposed caregiver. Ask for time to read any agreement before signing.
What happens if you call Guiding Souls Home Care?
A person answers (916) 229-8120 at any hour, including weekends and holidays. The first visit to the house is free and carries no obligation. Mereani Blanton, who founded the agency and runs it, does that visit herself on most new cases. We look at the routine and the layout, then put a plan and a clear cost in writing before anything begins. There is no contract, and a caregiver is only placed when the match is right. If you would rather write, the contact page has a form.
