Hospital Discharge & Care Plan Tips with Courtney Nalty

Join Kelly and her guest, Courtney Nalty, Caregiver and Aging Consultant and Founder of Generational Support as they discuss hospital discharge and care plan tips.

In this episode:

🔹 Hospital discharge tips

🔹 Establishing a care plan

🔹 Caregiver toolbox

🔹 How to plan for care to live well


Watch this episode on YouTube:
https://youtu.be/yXgT2iAQIUI


Learn more about Courtney:
https://generationalsupport.com/

For additional information about Kelly, check her out on Linkedin or www.SteadfastAgents.com.

To explore your options for long-term care insurance, click here.

Steadfast Care Planning podcast is made possible by AMADA Senior Care and Steadfast Insurance LLC.

Come back next time for more helpful guidance!

Transcript

Kelly Augspurger: [00:00:02] Hey everyone, welcome to Steadfast Care Planning, where we plan for Care to live well. I'm your guide, Kelly Augspurger. Today with me is Courtney Nalty, caregiver and aging consultant and founder of Generational Support. Courtney, thanks so much for being here. 

Courtney Nalty: [00:00:18] Thank you, Kelly, for having me. Appreciate it.

Kelly Augspurger: [00:00:20] Yes. Well, looking forward to hearing some good tips from you today. We're going to be talking about hospital discharge tips as well as a care of plan. So, Courtney, tell us, we know that when an older adult is in the hospital, it's usually pretty stressful. But when they leave, there are lots of things that people need to consider. So can you give us some hospital discharge tips? 

Courtney Nalty: [00:00:43] Sure, I'd love to. So like you said, it's overwhelming when you're in the hospital and you're helping an older adult navigate the discharge process. And of course, when they're in the hospital, they're going to meet and you're going to meet all kinds of people: nurses, doctors, CNA'S, therapists, discharge planners, social workers. And it's funny, the discharge planner a lot of times shows up the first day and you're like, "Well, how do we even know when I'm leaving?" And so they have to fill out a bunch of paperwork. But really, the best person to meet with is the social worker. Make sure you really get to know them, ask for their name, how to contact them, and really have lots of questions ready and waiting for them. They will be the ones that will help you find home care if it's needed, or if it's needed to move to a community. They'll give them a list of different communities that offer a rehab or respite care or skilled nursing if it's necessary. They also can help with medical equipment and all of those things. So yes, the social worker is the best person to befriend at the hospital.

Kelly Augspurger: [00:01:44] Gotcha. And what about some even tips for the family? What are some things that they need to consider when a loved one is discharged?

Courtney Nalty: [00:01:51] So, yes, first things first is when they're discharged. Where can they go? Can they go home? If they can go home, do they need extra help on a daily basis, whether that's home health or therapy or some other medical assistance, whether it's special equipment or special other types of services, even if they're going home on possibly hospice care, those things need to be asked. And if they are going to a community, you know, finding out whether it could be just a temporary stay in a community, if a rehabilitation, say, for a broken hip, usually you can go for a 30 minute... Don't you wish... 30 day respite care to get back on their feet and go back home. Or, sometimes it's not that easy and they end up needing some full time care for the rest of the time. And so asking those questions what kind of care is needed is really important to figure those things out. And then also knowing if they are going home, what kind of shape is the house in? Is it safe for them? Are the doors wide enough to move through a wheelchair? Is there a ramp on the front if they have multiple stairs, there are a lot of services that can put up a ramp. Even Home Depot has a special service where they can come over and put up a ramp on your front steps. Do they need a bedside commode put in their bedroom? Do they need all the area rugs rolled up? Those kinds of things need to be thought about when going home as well.

Kelly Augspurger: [00:03:19] Which I would imagine a lot of people don't even think about that pre-hospital. You know, if you're just living your normal life and you've been living in your home for a number of years, you probably take for granted being able to go up and down the stairs and in and out of the doorways pretty easily. But then, if an event happens where you do need some care, you've got a medical issue, and now you need a different kind of care than before then, yeah, these are definitely things that are going to need to be considered. I know for myself and I know we've talked about this before, Courtney, I live in an old historic home over 150 years old, and so we have some pretty darn narrow doorways. And I don't know if it would be a logistically possible to widen some of those doorways, but thinking about those things ahead of time is definitely important. But if you can't ahead of time, what are some things that we need to do right away? What about even things like rugs, like simple fixes like that, right? Like things that people can trip on moving those. I mean, those are probably some pretty easy fixes, right?

Courtney Nalty: [00:04:14] Definitely, walking through the house and just thinking of yourself sitting in a wheelchair, with a cane, or a walker. What kind of things could be trip hazards? If you see on the floor that an old rug, you know, a lot of them curl up on the corners. Can you tape that down, or do you think it's just best to just roll it up and put it away for the time being? Are there cords a lot of old houses? Kelly You probably understand, just like I do. A lot of old houses only have a few outlets per room. Yes. And so you might have extension cords reaching all across the room, down hallways. Is there a way to figure out how to remove those extension cords and make it a little bit safer with no more tripping hazards? Also finding great lighting? Do you need to add? Do you need to find somebody to put up new lighting and hallways to make it brighter and easier to see. Also, nowadays they have those great suction lights that you can just tap and you can put those at floor level to brighten up the walkway to make it safer. And then bathrooms and closets and then the kitchen, all the the main places people usually go around in their home.

Kelly Augspurger: [00:05:23] Right. What about even thinking about insurance, Courtney, when discharged from the hospital, are there certain things that people need to keep in mind with their medical insurance if they have long term care insurance? You know, that's another conversation, too. But even with medical insurance, you know, if you are being admitted into a rehab place, what are things that people should probably ask their insurance company or talk to the hospital about at time of discharge? 

Courtney Nalty: [00:05:49] Absolutely. Find a medicare agent. Usually the hospital discharge planners and social workers and doctors and nurses don't really quite understand what each insurance company can offer. And also, there's just so many. It's hard to keep up. But somebody that is a professional in that industry has to keep up on a daily basis. So finding a medicare agent in your area, the social worker can help you find that. Then asking them, all you do is provide what your current medical needs are, give a little history about your finances and they can assist you and guide you on what kind of care you can receive, what you won't be receiving, what you'll be paying out of pocket, those kinds of things. And they're also elder law attorneys are very helpful with that as well. They keep up with Medicare and Social Security that assist with the expenses of leaving a hospital.

Kelly Augspurger: [00:06:40] Sure. Because I would imagine those can rack up pretty quickly depending on what your situation was. That could be a very, very large bill. So you want to make sure that the insurance company is billing you properly, but you know what coverage you have. So, yes, definitely working with a professional Medicare and health insurance agent in order to know what you have and, you know, what facilities, or communities will accept your coverage is really important. Right?

Courtney Nalty: [00:07:05] Thankfully, we have people like you, Kelly, because long term care is a wonderful addition to have, and then your knowledge and wanting to learn more. It's so great that you do this to help your clients out. It really is huge.

Kelly Augspurger: [00:07:18] Thanks. Yeah, I mean, people need to be educated. They need to understand the differences and the nuances and how these work because it is a bit complicated. So it is definitely a good thing to work with someone that is experienced and has the expertise in that. And now for a brief message from our show sponsor, the Steadfast Care Planning podcast is sponsored by the CLTC Certified and Long Term Care Training Program, which gives financial advisors tools to discuss extended care planning with their clients. Look for the CLTC designation when choosing an advisor. Courtney, let's move on to a care plan, or what we call in the long term care insurance world: plan of care. Can you give us some tips on what people should consider when establishing a care plan?

Courtney Nalty: [00:08:05] Absolutely. So I have on my website a list called the Caregiver Checklist, where it's the first thing I think it is the best place to start, where you figure out all the different professionals that need to be in your care group, care plan team, we call it. And that would need to be an attorney, it would need to be the power of attorney, financial advisor, insurance agent, doctors, therapists, pharmacists. You should have their information on how to contact them in case you have questions about their particular industry. And from there, then you need to start also thinking about the house that somebody's living in. If they plan to age in place, as we call it, is the house safe and is it going to be easily adaptable with time if there are certain things that need to change, as you said, with an old house, can you figure out how to widen doorways if you need to? Can you figure out to put in a downstairs bathroom if there isn't one, or a higher toilet in the downstairs bathroom? Is there a ramp that's going to eventually need to be put in the front walkway to get to the front door? All those things. It's really great to just start thinking ahead of time. You don't have to do it, but it certainly will help in the end. It's better,

Courtney Nalty: [00:09:22] as you know, the old adage, if you bring an umbrella, it's not going to rain. So wouldn't you rather just fix up your house and then not have to worry about it later on as opposed to scrambling, leaving the hospital, knowing that there is somebody in a wheelchair and that they have 16 steps to get to their front door, those kinds of things. So yeah, having that in mind and then, you know, talking with the physician about, and the attorney, with the older adult you're helping, what are their wishes at end of life? We don't want to admit it, but we can't live here forever. So we have to start thinking about do we want to be on life support? As they call it. Do we want to be resuscitated if we become unconscious and stop breathing? Do we want all of these different things to happen? Do we want a tracheostomy? Do we want to be fed through a tube? You know, those things need to start being talked about and thought about because in the end, it's your life and you should have a say in it. And it's also difficult for a loved one, or a power of attorney to make the decision on your behalf. Oh, absolutely. You know, so having all of... There's so much when it comes to a care plan to think about.

Kelly Augspurger: [00:10:28] That's right. And I think you nailed it on the most important piece is it's really those important people in your life, those professionals. And I love that you even said pharmacists. That's an individual that I wouldn't have thought about before in a care plan. But that would be really important because, after all, they are filling your prescriptions. And if you have questions or you have new medications added and different medications can interact differently with each other. And so you want to make sure you have a good relationship with your pharmacist, or pharmacy, so that you feel comfortable asking these questions and you're getting the expertise that you need. But having those professionals in your life and they're documented, you know, the contact information, their names, you know, address, phone number, emails, those types of things really important for your family. I mean, at this point, you may not be able to contact them. So let's face it, this is really for your family. This is probably for your spouse, your partner, your adult kids, whoever in your life, you know, is important to you, your loved ones. They're probably going to be the ones that are making these phone calls and talking to these people. So you want to make sure that they have the correct information, the right contact information, so that, you know, they're in the loop and they know what's going on as well as, you know, who's going to provide care. Something important to think about. Is that going to be a family member? Is that going to be a professional? You know, is it going to be a home care agency? Have you looked at assisted living facilities in your area, continuing care, retirement community? CCRC's - a lot of different communities that are available. If home care is not the best fit for you, but figuring out where do I want to receive care and then how are you going to pay for that, right, Courtney? So... 

Courtney Nalty: [00:12:03] Yeah, just so much to think about. We don't realize it until it happens and then you get overwhelmed and stressed and that's when you feel like your plate is overflowing and, you know, starting to think ahead really will just make so much easier in your life.

Kelly Augspurger: [00:12:17] Yes, we're going to reduce stress, reduce consequences physically, financially, mentally and emotionally. If we have these conversations now and we start to do this planning now so that it doesn't come down to the crisis, and at that point, your family is going to be scrambling because if you haven't had this conversation, you haven't done the planning, they're going to have to figure it out on the spot. And what are they going to do? Are they going to go to Google, you know, and and research in the moment. And there's so many emotions, you're probably not going to make the best decision at that point when it's in a crisis. So doing this ahead of time; really important. Those are great, great tips for a care plan. What about I know you have a really great caregiver toolbox, Courtney. What is in that and how can it help people?

Courtney Nalty: [00:12:58] That's what we just talked about. It's basically creating a care plan. It's figuring out all of the things that you need to know, whether it's pre-planning, like we were talking about, or if all of a sudden you find yourself in an emergency situation instead of not knowing where to begin. I know for me, when I'm overwhelmed with so much information, I just shut down and I just can't even focus correctly. So I created this caregiver toolbox. It's basically me as a caregiver consultant, all the things that if I sat down and had a meeting with somebody, this is the process I would go through. So I created it so that you don't have to hire...well, you can hire me if you want, or another caregiver consultant, but it's a great start and will help guide you and alleviate the stress and overwhelming by focusing on one question at a time, one checklist at a time. And so that's what it is. It goes through professionals. It goes through modifying a house. It goes through figuring out looking at assisted living and nursing homes. It helps you with figuring out how to modify bathrooms and all the other things. So that's what it's all about.

Kelly Augspurger: [00:14:06] Yeah, valuable tools, take advantage of that. Is that something that's on your website, Courtney?

Courtney Nalty: [00:14:10] It is, yes.

Kelly Augspurger: [00:14:12] Okay. Any other advice on how people can plan for care to live well?

Courtney Nalty: [00:14:15] Just like you said, plan really is...and then not stress. And to know that you're not alone. There are millions of baby boomers out there. And, of course, there are millions of power of attorneys and caregivers that are helping those boomers every day. And so you're not alone. There are plenty of support groups to go and visit in your town. You can find them through religious organizations. You can find them through the Alzheimer's Association. So I do recommend finding a support group, find that cheerleading team to help you on and share ideas with. But preparing and planning ahead of time really, really will save you some stress.

Kelly Augspurger: [00:14:55] I agree, and don't be isolated. Yeah, like you said, lots of resources and groups out there so you don't have to go it alone. There are people that can help you and want to help you. So reach out to them. Reach out to people like Courtney. Well, Courtney, where can people find more information about you and how you help people?

Courtney Nalty: [00:15:11] My website is GenerationalSupport.com. And you can email me also at: Courtney@GenerationalSupport.com.

Kelly Augspurger: [00:15:23] Fantastic. Well, Courtney, thanks so much for joining me today. Thank you for your expertise. Really appreciate your time. Have a great day and live well.

Courtney Nalty: [00:15:32] Thank you, Kelly, for all that you do. I really appreciate it.

Kelly Augspurger: [00:15:35] Thanks. Bye, Courtney.