Ready-Set-Go Home with Transitional Care

Here is a startling statistic: One out of every five seniors is readmitted to the hospital within 30 days after being discharged. A key explanation for such quick readmissions is a lack of a detailed transitional care plan before being discharged from the hospital. At Visiting Angels^® Athens, we have developed a comprehensive transitional care plan called Ready-Set-Go Home to help address this issue.  

Before your family member is discharged, a Ready-Set-Go Home transitional care provider will meet your family member and their medical team to ensure that there are detailed post-hospital care instructions. Once at your family member’s home in the Athens-area, our professional caregivers provide non-medical transitional care, successfully helping your loved one avoid an unwanted, expensive hospital readmission.

Understanding Why Transitional Care is Needed

Experience and research tell us that hospital readmissions are triggered by:

• Exhaustion. Resting while in the hospital can be difficult if not impossible. Unfamiliar surroundings, chaotic schedules, and constant interruptions can create anxiety, confusion and exhaust seniors.
• No discharge plan. While still in the hospital, Visiting Angels Athens will provide a Ready-Set-Go Home Discharge Planning Guide to be completed by your medical team before going home. The Guide will be an invaluable transitional care resource.
• Difficulty managing at home alone. After returning home, many seniors struggle to return to their routine while trying to recuperate from a hospital stay. Compassionate caregivers from our Athens office can provide non-medical transitional care that includes light housekeeping, bathing and dressing assistance, preparing nutritious meals or prescribed diets, even driving to medical appointments.
• Medications. After going back to their Athens home, seniors may forget to incorporate new prescriptions into their daily routine. Our transitional care professionals can arrange prescription delivery and ensure medications are taken regularly.
• Failure to follow medical instructions. Using the Ready-Set-Go Home Discharge Planning Guide, our Visiting Angels Athens professionals ensure that transitional care instructions are followed.   

At Visiting Angels Athens, our transitional care program successfully eliminates most readmissions with a triple play strategy:

1. At the hospital – With your permission, your Visiting Angels Athens transitional care professional will work with your medical team to complete the Guide, creating a helpful resource with detailed instructions.
2. At home – A transitional care professional from our Athens office can provide non-medical transitional care so seniors can recover in the comfort of their home. We monitor medications and fluid intake, prepare meals, and ensure that all discharge instructions are carefully followed.
3. At our Athens office – Committed to eliminating readmissions, our office teams will do whatever it takes to help your family member and their transitional care professional. For instance, our office team can arrange delivery for prescriptions, prepared food, and special equipment.      

Call Visiting Angels Athens today to schedule a no-cost transitional care consultation. We are proud to serve families in Athens, Bethlehem, North High Shoals, Watkinsville, and Good Hope, GA.