One thing that is constantly seen in a skilled nursing setting is the need to say goodbye. This is especially true when the main focus of your building is short term rehabilitation.
Ready to say goodbye from the beginning
When there is a strong focus on short term rehabilitation, the whole essence of what you are doing is preparing to say goodbye. All of our goals are set up to achieve the highest functional level to return home or return to their previous assisted living facility. The beginning of the plan of discharge starts at the initial evaluation.
Sometimes hard for family to comprehend
Some families get taken aback when we are talking about discharge from the very beginning. If they have not had the experience of what happens in today’s short term rehab it can be confusing to them. Often times they hear that magic number of “they have 100 days of coverage “.
Most if not almost all of the residents we see now get no where near to that length of time. With more intensity of treatment and increased focus on functional mobility we can achieve higher outcomes in a quicker pace of time.
Of course not everyone fits in the box but a large proportion of rehab now is three to four weeks and off to the next level of care. This could be home with home health or assisted living with home health. Some even can now achieve bypassing home health and transition to outpatient therapy.
Unfortunately some families think that the resident will be fully recovered and absolutely back to prior level of function when they go home. They do not realize that is no longer the case with short term rehab. Our job is to get them to the next step.
Sometimes goodbyes are difficult.
With the amount of one on one time we get to spend with our residents, we get to establish a relationship with them. We get to know their stories, their families, their happy times and even regrets!
This can sometimes make it difficult to say goodbye when the goals are met. We have become second family and very rarely get to see them again after they leave. Some touch your lives more than others and can really make it hard to say goodbye.
Unfortunately we also are dealing with geriatrics with some significant co-morbidities. Occasionally we don’t get to say goodbye. These can be the most difficult. As we leave for the day or the weekend and something unexpected happens. They might go out to the hospital or unfortunately pass away. These can be the most difficult and can hurt the most.
Sometimes the goodbye is different
Unfortunately every once in a while it is not a resident that we need to say goodbye to. Sometimes the goodbye is to a co-worker.
Hopefully these instances are few and far between. It can be really hard to say goodbye to a co-worker. This is especially true the longer and closer you work with them.
Thankfully it is not always a sad time. It could be for a promotion or just bettering themselves overall. We need to support previous co-workers because you never know when you will cross paths again. The skilled nursing world, and especially the Therapy world that choose to work in a SNF, is very small. There is always the chance of crossing paths again on the future. So celebrate the good times, morn the hard times and losses. But remember you never know how much you might have touched someone’s life.
