At the comunity level, high priority has to be given to develop a broader array of programs that support family caregivers. In order to assure a high level of care health professionals have to be assertive advocates for family caregivers. For example, insurers and their subcontractors should be held to a high standard of performance and accountability. Manon (1992) demonstrated that the addition of a discharge planning case manager lead to significant reduction in unmet treatment needs.
The process of discharge has to include pertinent information that takes into account the number of community resources, the present condition of the patient, what support there is at home and the degree of technological dependence. It is anticipated that if this is not done, people are re-admitted a substantial costs. Patients that are discharged early are at high risk for readmission. For example, coronary bi-pass patients who are discharged early are at high risk for readmission and there is not adequate planning. Other high risk clients such as psychiatric patients have many issues because of inadequate care in the community. Traditional hospital care has been replaced by care in the home and self help groups, adult day care centers and community centers. Once the patient is recovering, there has to be a focus on wellness. Wellness programs in the community focus on social interactions, stimulating activities and provide respite for the caregivers. Some medical care may be provided.
Discussion with the participants*
Participants will discuss their experiences with respect to discharge planning and preparation for home health care for their patients.
10:40-11:00
Present Condition in Japan
11:00-11:40
Characteristics of Discharged Patients
Patients are more seriously ill when they go home due to early discharges. They have more medical, technical treatment needs such as analgesic pumps, intervenous care and complex wound care. Patients are anxious because they do not have the confidence for their own self care and are worried about adequate services at home. There are more people with co-existing chronic conditions, for example, patients who have spinal cord injuries were traditionally hospitalized are now in home care settings. In North America there are fewer family supports because women are working and there are smaller families availablet in patient support and care. Families are now having to move away from there traditional homes in order to acquire employment. This leaves the remaining patients more isolated in their home communities.
