Caregivers helping seniors after hospital stay by providing transitional care services

"Ready-Set-Go Home" Program Reduces Hospital Readmissions 

Transitional care assistance from a home health aide supports your loved one's recovery plan

Your senior loved one's health can be extremely fragile after a stay in the hospital, whether it was due to illness or surgery. For many seniors who don't have adequate assistance transitioning home from the hospital, the 30 days following their release can hold an exceptionally high risk of readmission. But what if instead of sending seniors back home all alone with confusing post-treatment instructions and to-do lists, there was a “Angel” to watch over them when a family member can't? A caregiver to guide them through the transition from hospital to home to healthy again? That transitional home care is actually available AND affordable! Visiting Angels in Palm Beach Gardens, a private duty Home Health Agency, is reducing readmissions through our innovative “Ready, Set, Go Home!” Program.

What Causes Readmission?

For a recently discharged senior, the reality is that coming home can be full of uncertainty about how to manage their condition all on their own. The "Ready-Set-Go Home" transitional care program, available to our clients in Palm Beach Gardens and the West Palm Beach area, was designed with the unique needs of seniors in mind. 

Some of the challenges seniors without transitional care may face include:

  • Difficulty managing a disease or illness at home, underestimation of the level of assistance needed
  • Exhaustion due to disrupted sleep and eating schedules while in the hospital, or back at home
  • Poor understanding of, or lack of follow-through with discharge instructions
  • Lack of adherence to medication regimen - not taking at appropriate time, missing doses, or stop taking it altogether
  • Inability to make it to follow up physician appointments post discharge
  • At risk for falls in the home, requiring home safety check and supervision
  • Cognitive impairment and in need of non-medical assistance, with no family or friends nearby 

Transitional Care for Palm Beach Gardens Seniors 

At Visiting Angels in Palm Beach Gardens, we know that preparation and prevention are two of the very best medicines there are! That's why we offer the following options to begin our transitional care before your loved one is discharged from the hospital. 

  • At the hospital – We collaborate with the discharge planner to help ensure success at home. We review with the client pertinent items such as symptoms to report, times and dates of physician follow up appointments or therapy appointments, medications and their proper administration, special dietary needs, medical equipment needs, etc. When there is cognitive impairment, we coordinate and communicate with the family members as well.
  • At the client’s home – Our caregivers are trained to understand the importance of reporting changes in health status or medication reactions promptly, so any problems can be addressed as early as possible. In addition to hands on care and assistance with the ADLs, our CNAs and HHAs facilitate medication and medical supplies delivery, prepare meals or arrange for food delivery services, offer medication and appointment reminders, help with housekeeping, encourage light exercise when appropriate, and provide transportation as well as accompaniment to appointments.
  • At the Visiting Angels office – As the client is transitioned home, our staff has tools and company resources to identify and daily track clients who are at high risk for readmission. We are the eyes and ears that monitor the client’s engagement with their plan of care and recovery. We pay attention to client preferences and satisfaction, and thus have more success in stabilizing them and assuring the best possible recovery.

Across the West Palm Beach and Palm Beach Gardens communities, we offer "Ready-Set-Go Home" transitional care for seniors who need a helping hand coming home from the hospital. To learn more, call Visiting Angels in Palm Beach Gardens today at 561-328-7611.

FL HHA Lic#299994617

Each Visiting Angels agency is a franchise that is independently owned and operated. The Franchisor, Living Assistance Services Inc., does not control or manage the day to day business operations of any Visiting Angels franchised agency.