Even though we are taught that discharge planning starts from the initial evaluation, at times getting to that point can be a scary experience.
Resident fears
Often times the lead up to a discharge date can be a scary situation for a resident. We need to remember that often the incident that made them go to the hospital was a trauma event.
This event could have been getting sick with a slowly debilitating decline, with progression to the point of the body no longer being able to compensate. It could have been a UTI or pneumonia. This decline can be freshly on their minds of how vulnerable they were.
The event could have been a traumatic fall. That fall could have resulted in an injury such as a fracture or a head injury.
Falls can quickly take someone that was completely healthy and independent and suddenly they need help for everything.
Due to this trauma the idea of going home can be very scary. To go from having a call light and nursing on demand to being possibly all alone at home with help being away.
This is a normal aspect of discharge and needs to be acknowledged. As therapists we need to be supportive and encouraging. Part of the process is acknowledging the fear and encouraging them.
Family fears
Sometimes the fear is actually from the family. It could be children or spouses that are expressing fear of discharge. Maybe they are concerned about the residents safety, still requiring some assistance, or realizing that cognition is not what they thought it was.
As therapists we need to support and acknowledge that these fears are normal and take the time to educate the family on tools and support systems that may be available to them. Sometimes we are stuck with the difficulty of having to make them realize that the prior living situation is no longer realistic.
Therapist fear
There are times that it is actually us that have the fear of discharge. We worry about what will happen when they go back to living independently. We worry if we have gotten everything we can out of them to make them as safe as possible. We have trouble letting go and letting them have the chance to either succeed or fail.
Unknown cannot be controlled
Ultimately we cannot control everything. This is true regardless of if we are the resident, the family, or the therapist. Life is unpredictable. All we can do is give it our best effort.
