Rehabilitation Center | How To Prevent A Discharge From A Long-Term Facility
What is a care transition/discharge program?
Why do patients in long-term facilities need a care transition/discharge program?
How does the Silverside discharge program work?
The Silverside discharge program provides coordinated care for seniors receiving long-term care services from Silverwood Manor. The discharge team includes a social worker, nurse practitioner, case manager, and physician.
The goal of the Silverside discharge program is to help seniors transition smoothly from their long-term care home to their own home or another type of community living arrangement. Discharge planners work with seniors and family members to develop a personalized plan that meets the needs of each individual.
During the discharge process:
-The social worker helps family members understand the available care home and long-term care services.
-The nurse practitioner provides personalized healthcare recommendations, including medication reviews and screenings.
-The case manager assists with finding appropriate housing, accessing transportation resources, and coordinating financial assistance.
-The physician provides comprehensive discharge instructions and health checklists to help seniors prepare for their new lifestyle.
– The team works together to ensure a smooth and successful discharge.
Silverside will work with your healthcare team to help arrange for appropriate after-care and support services if you are discharged from the hospital due to a care transition. We can also provide information on local resources that may be helpful during this time.
What are the requirements of the Silverside discharge program?
The Silverside discharge program is a voluntary, coordinated system for arranging timely and effective care and services for individuals leaving acute care hospitals or long-term care facilities. The program emphasizes the need to create an individualized plan of care that considers the person’s strengths, resources, and goals.
To be eligible for the Silverside discharge program, you must meet these requirements:
– You must be discharged from an acute or long-term care facility.
-You must have a discharge plan approved by your health care provider.
-You must provide written consent to participate in the Silverside discharge program.
-You must have enough resources to make your discharge as smooth as possible.
– You must be willing to participate in the program.
If you are discharged eligible and decide to participate in the Silverside discharge program, your healthcare provider will work with you to create a plan of care that meets your needs. In addition, the Silverside discharge team can provide information and assistance during this difficult time. The goal is for you to be able to live at home or in a community setting after leaving the hospital or facility.
How is the Silverside discharge program administered?
The silverside discharge program administered by the Department of Veterans Affairs provides supportive care and transitional assistance to veterans to help them return home quickly and successfully. The Silverside discharge program is designed specifically for returning veterans who have difficulty accessing traditional VA benefits or are facing significant challenges due to a physical or mental health condition. The program offers coordinated support from a team of specialists, including case managers, psychiatrists, social workers, and rehabilitative therapists.
In addition to the comprehensive care and support offered through the Silverside discharge program, veterans can also receive referrals to other VA-sponsored programs and services, such as vocational rehabilitation or health care. This coordinated system aims to help returning veterans get back on their feet as quickly and efficiently as possible, so they can begin rebuilding their lives.
When should you use a care transition/discharge program?
When should you use a care transition/discharge program?
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