Ways Transitional Care Services Can Assist in Home Recovery

elderly care

It is a long journey from hospitalization to complete recovery since getting discharged from the hospital does not mean you’re already in tip-top shape. There is always a risk for readmission, so you have to come up with a plan to prevent this probability. Thankfully, transitional care helps with your seamless adjustment from the hospital, rehab center, or other care facilities to home health.

A lot can happen while a patient is recovering from surgery or illness at home. Find out some of the distinct ways transitional health services can aid in achieving the optimal recovery of their health.

It Is Designed to Nurse a Newly Discharged Patient Back to Health

The goal is to avoid readmission, and that can only be achieved by making sure you are receiving the best health care in your home. Professional transitional care services lower your chances of getting health complications or being readmitted as they exist solely to perform all the necessary procedures to assist patients efficiently.

If you need more specialized care after hospitalization, your doctors will assign you a complex discharge plan. Your transitional care nurse makes sure your family members or caregivers carefully follow your discharge plan. If you are living by yourself, your aide will make sure you’re as comfortable as possible and that you understand what you need to do to heal well.

It Supports Family Caregivers

If you still need medical care even after being discharged, you are most likely in the caring hands of your family caregivers. Not all family caregivers are trained to perform medical health care, so this is where a transitional care team can assist the family. 

Even though most family caregivers are busy with work or other duties, they are willing to learn whatever they need to deliver the proper health care to their recovering loved one. The transitional care team will conduct home visits to educate the caregiver, along with other family members, on healthcare strategies and how to apply them to specific situations. This dedicated team is medically knowledgeable and can answer any question your family members may have on caring for you while you’re in recovery. 

It Deploys Professionals to Monitor the Patient’s Health

It is the transitional care nurse’s duty to check in on the patient at home after discharge. If you had surgery and need a home health aide in Denver, for example, they will monitor how well your surgical wound is healing. Are there any infections? If you had an organ transplant, is the body accepting the new organ or are there signs of organ rejection? Your transitional care team will be able to detect such early signs. 

The best thing about having a personal home health care team is the streamlined reports about your progress to your doctors, caregivers, and family members. This allows your care providers to give you the highest possible care you need toward better health.

It Enables Patients to Follow Therapy Regimens and Take Medication on Time

Home health visits do not have a minimum or maximum limit. For this reason, your transitional care nurse can visit you as frequently as your situation requires. Maybe you have an underlying chronic condition that demands routine physical therapy.

A transitional care nurse will assist you and your caregiver by making sure you follow any required physical therapy and administering the proper way of taking your medication. Your nurse will also help you use any medical devices you’re unfamiliar with or scared to use by yourself.


After discharge, most patients have dedicated caregivers who look after them. Some can even manage to take care of themselves. However, since transitional care has aspects that call for medical assistance at home, getting the services of a transitional care nurse or team ensures you receive the home recovery care you deserve. 

If you are looking for the highest quality in-home health care in Denver, you can put your trust in Gateway Home Health. We have highly trained clinicians and therapists that provide transitional care with great respect for human dignity. We always work hard to exceed the expectations of our patients, families, caregivers, and physicians. Contact us today!

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