Newsletter - RightTransition and In the Community

For patients who are discharged from a hospital or care facility, having a trained caregiver at home can mean the difference between staying at home and being readmitted. A mix-up in medications, little food in the fridge and lagging energy to bathe and dress are among common post-discharge challenges for patients. Lack of transitional care or care provided in the home by untrained caregivers can lead to medical complications, readmission to the hospital and even death.

While many individuals do remarkably well transitioning home after a surgery, illness, injury or other medical condition, elderly people often struggle to navigate the activities of daily living. One of the greatest challenges with care transition is helping patients understand their discharge plan, then helping them transition back into the home safely where they feel comfortable taking ownership of their care.

Right at Home’s RightTransitions® in-home care can step in and directly help patients make a healthy, smooth transition to their home again. The RightTransitions® nonmedical care services include everything from grocery shopping and healthy meal preparation to hygiene care and transportation.

RightTransitions® provides a professional caregiver in the home who acts as the eyes and ears for the entire interdisciplinary care team that consists of the hospital, home health agencies and other care professionals. This care team holds weekly face-to-face meetings to improve communication and coordinate patient care.

“Our Right at Home caregivers make it possible for post-discharge patients to make safe transitions from hospital to home,” said Mark Ross, Right at Home of East and South Atlanta Agency Director. “We help ensure that our clients receive an additional level of support once they leave a hospital or other care facility, and we help them successfully transition to their own home and stay there.”

When a patient moves from one facility to another, including a transfer home, it can be difficult to coordinate information about the patient’s treatment. But the RightTransitions® program can help ensure all stakeholders are kept up to date on the patient’s care — the goal being to keep the patient at home and out of the hospital. The services of the RightTransitions® customizable care model can include:

• Conducting frequent follow-ups with families and discharge planners.
• Helping the patient comply with the care plan prescribed by the healthcare providers.
• Coordinating communication between providers.
• Watching for red flags – reporting concerns to the clinician.
• Providing transportation to/from medical appointments.
• Supporting patient self-management.
• Preparing nutritious meals.
• Running errands.
• Managing everyday health reminders.
• Keeping the home clean and safe.

Right at Home South Atlanta In the Community

Our office has had the privilege of participating in many local golf tournaments this fall. We participated in the 29th Annual Bill Taylor Classic Golf Tournament which raised funds for Piedmont Newton Hospital Auxiliary, the 2019 Conyers-Rockdale Chamber of Commerce Golf Tournament and the 19th Annual Henry County Chamber Golf Classic at Crystal Lake Golf & County Club.

Our Registered Therapy Dog, Myla, continues to make the rounds visiting hospitals, nursing homes, and senior centers in our area. Recently she spent the day with Dr. Ross at The Retreat Nursing Home and Jasper Memorial Hospital and then spent time at the Golden Crest Assisted Living residents along with Community Outreach Liaison for South Atlanta, Jack Moon, and Agency Director, Mark Ross. Myla loves to put a smile on everyone's face!