Transitioning From Rehab Care Back to Home: Roger’s Story

Man walking with a care manager in his home

When you or a loved one is ready to go back home after a rehab care stay, you may find yourself overwhelmed with the transition. Personalized care management services like Waverly Connect offers may be the ideal solution to ensure a seamless change for everyone involved.

This blog shares Roger and Esther’s story about Roger’s move from an inpatient rehab center back to the home they shared. Learn more about the process and how Waverly Connect brought peace of mind to the whole family.

From Inpatient Rehab Care Back to Home: Roger’s Story

Roger had a stroke a couple of months ago. He successfully completed a rigorous rehabilitation schedule in an inpatient rehab center. Roger was very fortunate in that it was a mild stroke. Still, he did have some residual mobility challenges, including experiencing difficulty standing for too long with his left leg being weak. 

He also had remaining speech deficits to work through. Roger is being released to go home in the next couple of days and is very excited to get to his own home.

Esther, his wife, is home waiting for him with arms wide open. She has been able to visit him often and participate in some of the rehab appointments so she can support him when he returns. She can’t recall the last time they spent this much time apart.

Sandy, their daughter, has been making sure that they can see each other for lengthy visits during his recovery. She knew it would be important for their mental health to stay connected, and keeping his attitude optimistic was a priority for his healing process. He was initially frustrated with the rehab work, but remarkably, his outlook remains positive.

Sandy had to jump in and assist post-stroke, assuming the role of caregiver for both parents. She found Esther was independent and wasn’t about to let this get her down, but there were tasks around the home that Roger had previously done for her, so Sandy filled in for Roger and did a few extra to help her mom. 

Explore how care managers can help you navigate the challenges of caring for aging parents >>

Coordinating Care Management Services With Waverly Connect

Sandy’s friend had mentioned that their family utilized assistance from an Aging Life Care Manager®, also known as a Geriatric Care Manager, for her parents and gave Sandy Waverly Connect’s information. Sandy reached out and discussed her parents’ current situation, and she asked if a care manager could attend the discharge meeting with her and her parents at the rehab center. 

The Waverly Connect care manager knew the social worker at the rehab facility and was happy to see they were involved in the discharge meeting. The social worker stated that the staff had become very fond of Roger and were excited that he could go home, but they would miss his infectious energy. 

During the discharge meeting, the team discussed his progress and remaining needs. The Waverly Connect care manager arranged in-home physical therapy to continue for Roger and scheduled a meeting with an occupational therapist to assess speech therapy and other needs he might have. The rehab team was happy with the plan.

The Waverly Connect care manager met with Sandy and her mom separately to discuss a plan for how things could be set up at home to make Esther’s life easier. Esther is healthy but not as physically strong as she once was, and Roger did most of the heavy lifting around their home. 

The family discussed with the care manager what they thought life would be like once Roger was home. Sandy and Esther talked about what would need to be done around the house, including shopping, caring for Roger when Esther needed to leave home, and transportation for appointments. 

They checked the house to make sure it was ready for his return, removing any clutter that would get in the way of his walker and moving a few pieces of furniture to make it easier for him to get around. Additionally, they looked at the bathroom and kitchen safety elements and discussed what modifications were necessary. The Waverly Connect care manager assured Esther she knew a couple of companies and would check with them about cost and timelines.

Learn what services care managers can provide >>

Ensuring Peace of Mind With Care Management

Sandy had been worried about how things would go when her dad came home, but now felt at peace knowing Waverly Connect could provide assistance, support, and resources as needed. She thought she would have to be a caregiver for all their needs and was willing to do so because of her sense of duty. However, Sandy was relieved that she could take on just the amount she could handle and ask Waverly Connect to help with any challenges.

Another key part of Waverly Connect’s work is respite care for Sandy and Esther. Respite care is when someone helps care for Roger while they need to be away or they need a break from caregiving. This type of service is a very important part of being a caregiver as it gives you the chance to rest and re-energize.

Contact Waverly Connect for Support and Guidance

Waverly Connect provides a comprehensive service for you and your loved one. We start with a thorough assessment and then create a personalized care plan to help you navigate the next steps successfully. 

Moreover, we are committed to providing ongoing professional monitoring to ensure that your loved one always has the support of a skilled advocate with extensive experience in senior care.