Rehab not one-size-fits-all, say experts

by Deirdre Bardolf Editor

Having a loved one go to the hospital for surgery, or having to go yourself, can be a stressful time, especially as the patient gets older. Caregivers have an increased responsibility, as do care providers and the needs evolve with age. And what comes next, the transition of care postsurgery, is almost as important as the actual procedure itself.

Discharge planning is key and ensures that patient recovery continues and that they get the care needed to return to health. The transition of care can include going back to the home, where there is a myriad of ways to be nursed back to health, or being admitted to a residential nursing facility or an alternative: a short-term rehabilitation center, many of which are in Queens.

Hospitals in New York are actually legally obligated to give patients the opportunity to name a caregiver who is willing to be a part of planning for the time following discharge. In 2015, the New York State CARE Act, short for Caregiver Advise, Record, and Enable, was signed into law and requires hospitals to give patients the opportunity to name a family caregiver willing to be part of planning for discharge and providing care at home, according to the United Hospital Fund. New York joined over 30 other states that adoped similar legislation.

“That helps ensure good follow-up, adherence to the plan of care and help, and then we also help with figuring out what is the best place for the patient to go, either home or to a rehab facility,” said Dr. Isabella Park, associate medical director and direct of geriatrics and palliative care at Long Island Jewish Forest Hills. “And when we’re giving options for rehab, then giving choices about which rehab facility they would prefer,” she said.

There are several questions to consider when choosing between home or a rehab center, she said: “What is home like? What are your needs? What is already in place?”

Older patients often do best at home, in familiar surroundings, she said, but that might not always be an option.

Home physical therapy can be useful if patients have trouble getting to a facility, said Dr. Emily Fatakhov, a doctor of rehabilitation and physical medicine and sports medicine at Mt. Sinai Queens, but it can limit treatment options. “Home care, while convenient, is definitely more limiting in terms of the modalities they can use. They don’t have any equipment. It’s a lot of whatever they can do in the confines of their own home,” she said. “So, it’s good on one level and not great, long-term, on another level.”