Transitional care management can improve outcomes, and at Village Caregiving, our staff are primed to offer seniors the support they need to confidently return home and to the rest of their lives.
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We understand the unique challenges that accompany returning home after a hospital stay, and our transitional care team is available 24/7 to meet the needs of you and your loved ones.
Transitional care refers to the professional care a person receives when they are discharged from a hospital or care facility. Village Caregiving’s experienced senior transitional care team specializes in personalized home care that recognizes the unique challenges of recovering at home and the benefits of doing so anyway. We work with you and your goals to support a smooth adjustment process goes as smoothly as possible through active listening, emotional support and physical help in managing your day-to-day activities.
Returning home, especially if you are still going through recovery, can be a challenging time as you relearn how to navigate your home and life. Transitional care professionals are trained to ease this adjustment by supporting you as you do so and helping you have a smoother and more comfortable recovery while:
It is easy to confuse the two, but transitional care is vastly different from hospice care. While hospice focuses on end-of-life comfort, transitional care helps you reach the goals of recovery and getting back to your life. It may also be referred to as post-hospital care, and it is best suited for:
The first days of transitioning home can be overwhelming, but rest assured that Village Caregiving is here to support you from the very beginning. To establish your home care after surgery, we will guide you through our:
When you reach out to our local Village Caregiving team, we will respond as soon as possible to schedule an assessment with a nurse or Executive Director.
During your consultation, your provider will help articulate your needs and understand the best way we can help.
Every client is personally matched with a caregiver or caregivers who suit their preferences, and they will arrive for their first shift fully prepared to help.
We coordinate communication between our caregivers, your family and your medical team regularly to maintain transparency and adjust care where necessary.
When you need elderly care after you are discharged from the hospital, Village Caregiving is the largest privately owned home care organization in the nation. We have locations across many states to serve you and your community every day. Here’s what sets us apart:
From Assessment to Implementation
Village Caregiving’s comprehensive approach to ambulation starts with an in-home assessment to understand client needs and abilities. Our caregivers work closely with clients to tailor each service to promote mobility and independence. We use mobility assistance tools like walkers and canes to support your loved one each day. As our services continue, our team will reassess client needs, optimizing care as each client’s needs adjust.
We also understand the importance of a strong patient-caregiver relationship. Our dedicated family caregivers work to promote trust and communication with clients. We work with your pace and preferences to create trust. With Village Caregiving, older adults can feel confident in their ability to move, improving their confidence and well-being.
At Village Caregiving, your transitional care needs are our top priority. We understand the importance of reestablishing your life at home and recovering in comfort, and everything we do is carefully curated to meet your specific goals. If you’re interested in learning more about our post-hospital care services for seniors, you can contact us online or reach out at 304-962-5877. Find your peace of mind with our professionals now.
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Understanding the process and impact of transitional care can help you decide whether your loved one needs additional support. Here are answers to some of the most frequently asked questions about transitional care.
Transitional care is a support service that helps patients safely and comfortably transition from a healthcare setting, such as a hospital or rehab center, back to their home.
The primary purpose of transitional care is to reduce rehospitalizations after treatment and to ensure a smooth recovery. Transitional care specialists provide continued home care, education and coordination during the transition back into home life.
Many insurance plans and private insurance companies often cover some or all transitional care services during recovery. However, the exact coverage can vary based on your specific plan, the services you need and whether these care services are considered medically necessary.
The best option is to check directly with your insurance provider about their transitional care coverage and the services it includes.
The length of transitional care at home depends entirely on the individual’s condition, their specific support needs and how quickly they recover. Recovery periods can even vary for the same treatment, so each case is unique.
Recovery can range from a few weeks to several months, and transitional care can last the entire duration of the healing process. Transitional care plans are flexible, allowing providers to adjust their approach and services as your loved one regains independence and becomes more confident in their home again.
Yes, a home care organization such as Village Caregiving can absolutely help with transitional care after discharge from rehab. Transitional care is beneficial after discharge from any healthcare facility, including rehab centers, skilled nursing facilities or hospitals.
We aim to provide support for patients returning home by managing ongoing recovery, medications and daily tasks, regardless of where you previously received care.
Yes, caretakers design transitional care plans that are flexible and adaptable, tailored to the patient’s recovery in real time. If recovery takes longer than initially anticipated, caretakers will customize the care plan accordingly.
Care plan adjustments could include extending the duration of services, increasing the frequency of visits, adjusting the types of support or coordinating with doctors to reassess the care strategy.
Yes, ideally, transitional care starts as soon as a patient is ready to go home after treatment. For the safest and most effective transition, it’s best to arrange for transitional care services to begin immediately upon your loved one’s return home, often on the day of discharge.
Starting upon discharge ensures immediate support for daily tasks, medication management and patient safety. The sooner a patient and their family have the support they need, the sooner recovery can begin.
