We’re Here for YouA Specialized Dimension of CareIllnesses Treated in a Kindred HospitalMedical Procedures in a Kindred HospitalThe Role of the FamilyThe Importance of Realistic ExpectationsThe Importance of Family InvolvementThe Importance of Advance DirectivesAs Recovery Begins
As a patient, or the loved one of a patient being admitted to a Kindred Transitional Care Hospital, you may be feeling a mixture of conflicting emotions.
You may feel relieved that care will be provided by a team of clinicians with special expertise.
You may be concerned at the prospect of a long-term hospitalization and about the sometimes confusing healthcare system.
You may be apprehensive about being admitted to a hospital that specializes in treating critically ill patients with multi-system failure or other serious disorders.
At the same time you may wonder just what makes a transitional care hospital different from a conventional short-term hospital. To learn more, watch our video. Kindred Healthcare’s Family Education Program is designed to help you deal with those feelings and provide honest answers to your questions about what happens in a transitional care hospital.
Our aim is to help you understand the unique place a transitional care hospital holds in the continuum of care as well as to offer empathy for what you are experiencing and education about what to expect.
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Kindred hospitals are a special kind of hospital that treats a special kind of patient.
Kindred hospitals are designed to treat seriously ill patients who require a long-term acute care (LTAC) via a longer hospital stay than the typical short-term acute care hospital. Our specialized services and extended care are tailored to medically complex patients who are unable to recover completely in a short-term setting. These patients often suffer from multiple organ system failure or conditions such as:
Most Kindred hospitals also have services found at short-term acute care hospitals, including diagnostic services, one-day surgery and physical therapy.
The difference is that caregivers at a Kindred hospital are skilled in caring for patients who have more serious, long-term health issues that require the care of an interdisciplinary team.
In some cases, the patient’s regular physician will continue to see the patient if he or she is moved to a transitional care hospital; in other cases, the patient’s care will be transferred to a physician who is skilled in caring for the patients who require long-term acute care. Nursing staff levels are comparable to those at a short-term hospital, but the transitional care hospital care model is designed to allow nurses to spend more time with the patients they care for.
Patients in a Kindred Hospital are usually referred from a traditional short-term acute care hospital because they require long-term care, therapy and recovery. These patients often have complicated health issues that come with multi-system failure. The majority of our patients are discharged home or to a lower level of care. Some, however, are so severely ill, or are so weakened by multiple illnesses and organ failure, that their final days are spent in a transitional care hospital or in hospice care.
Some of the more common illnesses we treat include:
Multi-System Failure. This term describes a breakdown in the function of organs including, but not limited to, the heart, lungs, kidneys, liver and skin. Often the failure of one organ leads to limited performance in another, and becomes a complex medical issue treated with therapy, medication, technology and equipment.
Chronic Obstructive Pulmonary Disease (COPD). The fourth most frequent cause of death in the U.S., this refers to a group of lung diseases which interfere with normal breathing by affecting the airways of the lungs and is usually caused by smoking. Types of COPD include chronic bronchitis, emphysema and asthma. These patients also require prolonged ventilator assistance.
Emphysema. This disease is caused by smoking and slowly destroys the lungs over a long period of time. It progresses with periods of lung inflammation and infection and leaves the body with less and less lung capacity to combat the next episode, and less capacity to provide oxygen to the blood. Patients with emphysema often require prolonged ventilator assistance and then, at the appropriate time, ventilator weaning.
Wounds. These can be a result of an accident, surgery, infection, circulation problems or skin tissue breakdown. Treatment can include pressure-relief surfaces, debridement (removing dead tissue to encourage healing), whirlpool irrigation and growth-promoting dressings.
Stroke Trauma and Other Neurological Injuries. These conditions can include decreased mobility, loss of strength or dysphagia (swallowing disorders) and are treated with physical and occupational therapies and speech-language pathology as well as required medical procedures.
There are a number of other reasons a patient is admitted, including to receive IV medication or antibiotics, or for intense rehabilitation.
Because of the special nature of the care involved, and because of the special care challenges of long-term acute care patient, certain medical procedures are common. Here are a few examples:
Urinary catheter. Very often, because of a medical condition or incontinence, our patients need assistance in draining their bladders. A urinary catheter (often called by its trade name, a Foley catheter) is a tube inserted into the bladder. It also helps patients avoid infections or wounds caused by dampness.
IV catheter. This small plastic catheter, usually placed in the arm, is inserted to allow medication or fluid to directly access the patient’s blood stream.
PICC line. A Peripheral Inserted Central Catheter line is inserted into the upper arm to allow dispensing of medication or to take blood samples.
Tracheostomy. A device inserted through a small hole at the base of the throat that gives patients easier access to ventilator care, helping avoid the irritation and complications of tubes placed in the nose or mouth.
Feeding tube. Nutrition is an important part of a long-term acute care patient’s recovery, and if a patient cannot swallow, he or she is fed through a tube inserted through the nose or directly into the stomach.
These procedures and instruments are necessary for quality healthcare, but are not without risks, in particular the possibility of irritation or infection. Precautions are taken and care is monitored closely, but there is always a risk of displacement or infection because patients so often already have compromised neurologic and immune systems.
The average length of stay for a long-term acute care patient is about four weeks, although recovery time varies according to the patient’s condition. Whatever the length, however, family involvement in the patient’s recovery and healing process is essential. As a family member or loved one, you provide a valuable service to the patient and the interdisciplinary team by offering support as well as background information.
Your contribution also includes a clear understanding of your loved one’s prognosis and care plan as outlined by the physician. You can help by telling the care team about your loved one’s history and characteristics – the more the team knows about him or her, the more effective the treatment.
It is also essential for you to realize that when a patient is admitted to a transitional care hospital, his or her condition is very serious – serious enough to require special treatment and technology. It may take time to fully understand your loved one’s condition and to balance optimism with reality. But a realistic assessment of the patient’s condition is just as important to the patient’s recovery as loving support.
A stay in a transitional care hospital can be an emotional roller coaster for you and your loved one. And the fact that the recuperation period is usually measured by weeks and not days increases the stress and feelings of upheaval.
Hospitalization for a serious illness often requires family members and loved ones to face serious choices. While family support during a loved one’s hospital stay is important, it is also important that you relax and unwind whenever possible. Taking time to take care of yourself will make you better able to support and care for your loved one.
The ideal outcomes of a long-term hospitalization at a transitional care hospital is that the patient returns home and returns to his or her previous level of independence.
Although that is frequently the case, some patients enter the transitional care hospital in a weakened condition and never fully recover. Others experience a serious health setback or complicated multi-system failure and struggle to regain even limited independence.
In those cases, an advance directive can ensure that a patient’s wishes are directly and clearly understood by the patient’s physician, hospital staff and loved ones. These directives can be changed at any time by any patient or a loved one who has healthcare durable power of attorney.
These are the three kinds of advance directives:
Far from being “morbid” or “defeatist,” advance directives offer many patients a sense of control while giving their loved ones peace of mind.
It’s important to note that laws about advance directives vary by state, although living wills are legal in most areas. It’s also recommended that the directive is notarized, and that the directives are discussed when your loved one is first admitted to a transitional care hospital rather than later in the stay.
The hospital’s medical staff can help you with more information about advance directives and where they can be obtained.
The transfer of your loved one to a transitional care hospital means a move to a setting where concentrated, long-term attention will be given to his or her unique medical condition by a team of physicians, nurses, therapists, dietitians and clinician with special expertise.
Here are some final points to remember:
We are committed to caring for your loved one and helping him or her to recover to the fullest extent possible.
We’re here for you.
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