Many of us these days are fortunate to have parents who are living actively and independently into their eighties and nineties.  But an illness, a sudden fall, or an operation can quickly throw the family equilibrium out of balance, posing challenges and causing stress.

Here’s a familiar scenario.  Your elderly mother is recovering from surgery, and the hospital has just informed you that she is being discharged in a few days.  So soon?  How is Mom going to manage back at home?  Anxiety kicks in and your mind is whirling.

No need to panic—you don’t have to handle this by yourself. This is the time to request a family conference with the hospital social worker, who will help you develop a discharge plan.  There are many practical considerations, as well as emotional issues, to deal with before and during this transition. 

Discuss the possibility of rehabilitation services with the doctor and social worker.  Ask about rehab when the patient is admitted to the hospital, as well as when preparing for discharge.  Physical inactivity and prolonged bedrest during a hospitalization can cause marked increase in heart rate and blood pressure, and rapid loss of muscle strength, resulting in weakness and fatigue.  Rehabilitation can restore those functions to a significant degree, enhancing the patient’s mobility, independence and safety.

If your Mom is returning to independent living in her own home or apartment, an evaluation by an occupational therapist can be very helpful.  An O.T. will visit the home to ascertain the safety of the physical environment, and will make concrete suggestions to improve it.  Some things to look at include:

• Does the bathroom have safety bars? 
• If there are stairs, will Mom be able to walk up and down? 
• Is there access for a wheelchair or a walker? 
• Is there enough light? 
• Are the smoke detectors functioning? 
• If Mom has been resisting your urgings to pick up those scatter rugs she could
  trip over, she may now be more open to accepting an objective professional’s
  recommendation to secure or remove them.
• For Mom’s safety and your peace of mind, consider getting an Emergency
  Response System, which can be worn on the wrist or as a necklace.  The
  O.T. can tell you where to get this device. 
• Will your Mom need help at home with bathing and dressing? 
• What about the very important tasks of ordering prescriptions and making sure the
  right medicines are taken at the right times?
• How will food shopping get done? Is Mom able to prepare meals?  You may want
  to consider Meals on Wheels, or a program that provides volunteers to help with
  grocery shopping and transportation to medical appointments.

What if your Mom can’t wait to get out of the hospital and says, “Don’t worry; I can manage perfectly fine on my own”?  Many elders are reluctant to get help, cherishing their privacy and independence, or worrying about the cost, which can be considerable. A social worker or geriatric specialist can help you open this conversation.  The keys to successful communication at this time of transition are mutual respect, acknowledging changes, and taking the time to prepare and make decisions.  Take a realistic look at your parent’s living arrangements.  This may be an opportunity to consider moving from complete independence to a living situation offering more support. 

The hospital social worker can help you find some resources and appropriate in-home services, and Jewish Community Services also can provide valuable information.  Call 410-466-9200, or visit http://www.jcsbaltimore.org.

By Janet B. Kurland, LCSW-C, Senior Care Specialist, Jewish Community Services, with Gail Lipsitz, JCS Coordinator, Public Relations