10 Tips to Ease the Transition Home

1. Prepare before leaving the hospital. Taking the time to get organized before heading home is important. 

• Identify a primary care doctor if you don’t have one and schedule any follow-up appointments to avoid gaps in your care. You may also need to see other specialists, including a physiatrist, neurologist, orthopedist, wound care expert, cardiologist, pulmonologist, or urologist. You also can take advantage of Shepherd Center’s Rehabilitation Medicine Clinic for ongoing evaluations.
   
• Create an emergency card that lists your medical conditions, current medications, allergies, healthcare providers, and emergency contacts. Keep one copy with you and another one at home.
   
• Fill your prescription medications and order any medical supplies (bowel and bladder aids, tracheostomy supplies, skin needs, etc.)
   
• Set up transportation to and from your medical and/or therapy appointments and recreational activities. If you have Medicaid, you might be able to use Medicaid Transportation. Find out if you have access to paratransit transportation services.
   
• Know the symptoms to watch for to determine if your health is deteriorating and who to call.
   
• Know what is and isn’t covered by your insurance plan. Case managers at Shepherd Center can provide information and guidance on how to access funding based on your condition and finances.
   

2. Map out a schedule and stick to it. Even if you aren’t quite ready to return to school, work, or parenting, having a routine with tasks to work on every day can be very motivating. When initiating new outings, give yourself an extra 30 to 60 minutes until you fine-tune your routine.

3. Follow the exercise program recommended by your therapy team. Doing so will help you maintain and continue to build strength and range of motion.

4. Survey your home environment. Take a look around to make sure your home is safe and accessible.

• Are there rugs that could get caught in your wheelchair or serve as a tripping hazard?
• Can you reach things like your phone, medicines or a cup for water?
• Do you have an emergency plan in place?

5. Know how, when, and why you are taking each of your medications.

• Talk with your health team if you have concerns about your medications (for example, cost, side effects, remembering to take them, etc.). Consider using a pill box to stay organized.
• Check out MyChart, an online tool that helps you access your medical information and manage your care.

6.  Post reminders around the house if memory is an issue. Leave notes or set alarms to help you remember what you are supposed to do before you cook, when to take your medicine, etc.

7. Build your team. Make a list of family and friends who can help you — even if it's just to listen.

• Tap into the peer support program at Shepherd Center. It can be helpful to talk with someone who has faced a similar injury and made the journey back home and to their community.

8. Check in with yourself or your loved ones and stay engaged. Recovering from a spinal cord injury, brain injury, or other complex injury or illness can take an emotional toll. 

• You will likely have good and bad days. Remember that you don’t need to do it alone, and there are counseling services to help. 
• Make sure you are taking part in activities that give your life meaning. You can often do more than you think you can. Your therapists can show you how.
• Shepherd Center also offers virtual and in-person Health and Wellness Clinics. Visit shepherd.org/rec-therapy/events to find an event near you.

9. Be proactive about potential complications after injury or illness.

• UTI Prevention and Management: Know the signs and symptoms of a urinary tract infection (UTI), such as cloudy or strong-smelling urine, fever greater than 101 degrees, blood in the urine, leaking between ICs, burning pain when you urinate, feeling like you have to urinate all the time, or autonomic dysreflexia of unknown cause. 
• To help prevent UTIs:
  • Drink plenty of water to flush the bladder. 
  • Maintain good hygiene. 
  • Perform your bladder program as prescribed and do not allow the bladder to get too full. 
  • Take your temperature if you suspect a UTI and call your primary care provider (PCP) to request a urine culture. If you have a Foley catheter or suprapubic tube (SPT), the catheter must be changed before collecting a urine specimen for the urine culture. 
• Symptoms of Autonomic Dysreflexia (AD) may include: 
  • Severe, pounding headache 
  • High blood pressure (a 30-40 point rise above your normal) 
  • Sweating, goosebumps, or red blotches above the level of injury 
  • Stuffy nose
• Common causes of AD include: 
  • A full bladder, full bowel, bladder infections, skin pressures/sores, tight clothing, ingrown toenails, and stimulation during bowel programs. 

If you experience symptoms of AD: 

• Get help immediately. 
• Sit up if you are lying down. 
• Check your bladder and perform your bowel program. 
• Check your skin and toenails for pressure areas or irritants. 
• Loosen tight clothing. 

10. Speak up and advocate for yourself. Let someone know if your needs aren’t being met. For ongoing support and resources, check out the Family and Patient Education at myshepherdconnection.org.