Transitional care is intended to provide and promote the safety of patients between levels of health care and across care settings. It is also about getting the right level of care for patients to support their move back to the community.

Seniors with chronic and acute illnesses and those who have gone through an operation come back to their homes and are vulnerable to breakdowns in care, thus have the greatest need for transitional care services to avoid adverse events and rehospitalization. It is also important to have a single point person to ensure continuity of care and keep watch of the patient’s condition.

Family caregivers play a major and most important role in supporting a loved one during hospitalization and after discharge. They need to be properly communicated with what they need to know during the transition from one care setting to another whether from hospital to rehab or home.

Family caregivers also need a high level of engagement in decision-making about discharge plans and the quality of preparation for the next stage of care, access to essential services, and adequate education on what to expect and need when moving their loved ones home. Caregiving can be rewarding but it imposes a lot of pressure and stress on the family.

Transitional care offers a broad range of services that help minimize negative impacts and experiences for both the patient and the family. Caregivers such as licensed home care aid can help with transitional care to ensure continuity of care and help closely monitor and communicate any change in someone’s health condition. They can help the family prepare for moving a loved one from one care setting to another or when moving back home.

To know more about different home care plans are listed here: Home Care Services

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