Senior Rehabilitation Care After a Hospital Stay

Senior rehabilitation after hospitalization

After hospitalization, senior loved ones often need further care. This may be hard on your family and other supportive help.

It is important to understand the options for rehabilitative care and how your loved one can return to their most vital self. This can make your choices easier and help to prevent them from hospital readmission.

Options for care extend along a continuum including home health services, skilled nursing, and assisted living communities. All are aimed at supporting your loved one’s health and independence in the best way possible.

Home health services

Home health services can include a variety of care services given at home for illness or injury. Some examples of home health services include wound care, monitoring an unstable medical condition or illness, nutrition education or therapy, giving IV fluids or injections if needed, or an educational follow-up to hospital stays.

Skilled nursing

Skilled nursing care can only be given by licensed nurses usually in a hospital or assisted living facility or nursing home. Skilled nursing is carefully regulated by governmental agencies to ensure your loved one’s best care. While skilled nursing staff may accomplish many of the goals that home health services do, access to better monitoring and round-the-clock supervision for patients may make skilled nursing a better choice. Rehabilitation centers can provide specialist therapies in-house, making progression easier to monitor.

Examples of skilled nursing specialists that a doctor may prescribe for your loved one include physical, occupational, or speech therapy, wound care, monitoring of vital signs, and training patients in the use of medical equipment.

Assisted living communities

Assisted living communities offer long-term stay many assisted living communities provide short-term care for seniors after hospitalization. Assisted living communities can allow for you or your loved one to continue with their health therapies while also getting help with other daily living needs such as bathing, dressing, laundry, and meals.

Assisted living facilities can organize transportation to medical appointments, monitor and give medications, and manage care for seniors who might not be able to manage at home. Assisted living facilities may have access to skilled nursing care.

Questions to ask about your hospital discharge plan

Discharge planning for your loved one after a hospitalization can greatly reduce the chances of needing to be readmitted later or further illness. You may have other questions but the following list can help to prepare proper after-care. Use these categories together with family, friends, and medical personnel who will be involved after the hospitalization to finalize what care will be needed.


  • What is the diagnosis and prognosis for further illness?
  • What follow-up appointments are needed to address progress after hospitalization?

Managing Medications

  • How do we manage medications after discharge? This includes planning to get medications before leaving or picking them up before reaching home. Create a plan or use a service to ensure that medications are taken properly.
  • How do the various medications interact with each other and what foods, etc. should be avoided or taken to ensure proper absorption of medication?
  • What side effects should be watched for?

Care Monitoring

  • Is it safe for your loved one to be home alone?
  • If not, what services are available to help family members and friends with providing care? What resources are available to evaluate the home for fall and safety issues?

Physical limitations

  • What physical limitations are there and for how long i.e. limitations on driving, walking, bending, etc.?
  • Are there exercises or therapies that will help to counter these physical limitations?
  • Who will provide and arrange for those therapies?
  • What limitations and expectations are there for bathing and other self-care?


  • Is your loved one expected to maintain a healthy diet by themselves or will meal preparation help be needed?
  • How will groceries be obtained?
  • Can they cook meals unaided?

Equipment and Transportation Needs

  • What transportation services are available to help your loved ones keep their appointments or obtain medication?
  • What mobility equipment will be needed i.e. wheelchairs, walkers, cane, grabbers, support bar, raised toilet seat?
  • How are these obtained?

Long-term planning

  • What expectations are there for the future health of your loved one once they have recovered?
  • What long-term plans might have to be made?

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