Renee Kinder

There is no better way to start the week and the slew of incoming emails than with a great belly laugh. One of the first messages in my inbox Monday elicited exactly such a response… 

It stated, “I’ve attempted to reach you, but have had no success. Either you’ve been eaten by alligators or you’re just plain swamped. If you have been eaten by alligators, my deepest sympathy goes out to your family members.”

Clever, right?

Swamped, perhaps, or just becoming like many of us immune in a way to the zoom in/out, constant communication world that we have all been living in over the past three years. The public health emergency has shifted the overall structure of our daily lives, our communication patterns, and created a culture of “always on” when it comes to response time.

Now, with the potential end in sight, we also need to consider how our care patterns may shift in a way to better serve our patients and help them appreciate the world re-opening.

One area that has been on my mind is ensuring the appropriate use of home assessments to promote not just a plan for safe discharge to the least restrictive environment, but also considering patient goals for return to social and community involvement post pandemic.

Taking our clinical practice beyond, “Are you safe for home?” to “Are you safe for return to your fully integrated community?”

Home assessments should move well beyond home type, kitchen set-up, hallway width, bedroom and ADL analysis and shift into our patients’ “real world” in whatever sense neighborhoods and community are important to them. 

No one should risk being home alone and eaten by alligators after all. 

What, for example, are some of the key areas the interdisciplinary team, including rehab providers, need to consider? 

Some ideas to get you started…

  • What is the primary type of home, and that of loved ones?
    • Apartment, Single-Family, One- or Two-Story?
  • For community and home events, what is the preferred entrance and distance from transportation to entrance?
  • Are there steps in the community settings your patients hope to return to? What is the number of steps? What are the various surfaces that will need to be considered for walking or use of other assistive devices?
  • When those we serve enter/exit their home or other settings for activities, what assistance is needed? 
  • When considering the sensory environment for desired settings, how is the lighting? Additionally, when leaving home for time with family members and loved ones, how can we improve the process of individual sensory needs by wearing glasses, hearing aids, and use of other assistive devices?
  • What about travel? (Yea!) Have we considered if medication is accessible and secure? Is the emergency contact information present and accessible? Is the individual able to verbalize what to do in an emergency situation? 
  • And on, and on … I know you all will have many fantastic ideas as you consider what is best for your patient population.

The world is reopening, the end of the PHE is near, and the time is now to consider how we can best support the success of everyone in our communities over the next year and beyond.

Renee Kinder, MS, CCC-SLP, RAC-CT, is Executive Vice President of Clinical Services for Broad River Rehab. Additionally, she serves as a member of American Speech Language Hearing Association’s (ASHA) Healthcare and Economics Committee, is a member of the University of Kentucky College of Medicine community faculty and is an advisor to the American Medical Association’s Current Procedural Terminology CPT® Editorial Panel. She can be reached at [email protected].

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.