I have done home assessments for patients leaving a facility to determine whether they are safe enough to return to their environment. I have walked through fifth wheels, mobile homes, two-story mansions and a clapboard hut built by the owner. Most environments are safe for people to return to and usually it is an easy-to-fix item like new batteries in a fire alarm that ensures a safer return.
I do have a checklist that I go through as well as some questions that are not on the list but just as beneficial to my determining if a patient is safe before discharging back home. Based on my assessment and recommendations or adaptations of their home environment, patients can go home. When you think about it, this is a huge responsibility.
But when I think about the acute-care patients leaving a hospital or when a patient mysteriously gets a discharge order without any home environment assessment, what I do could very well save their lives. There are scores of patients who had not thought about the smoke detector, tightening the banister or using a high-rise commode and shower bench. Even a simple adaptation like moving a table or using a nightlight can reduce the risk of falls for some patients.
Where a patient sleeps seems to be an ongoing battle. My thinking is that patients have to get up and out of wherever they sleep as easily as possible. Some patients don't care. If a bed is too high or a recliner too low, that is how it is going to be. Provided they can get up and out and do so safely, they will not change it. Even a suggestion of sleeping in the room closer to the bathroom can be blasphemous. I never understand it.
Maybe we are setting our profession up for lawsuits if we do not consistently do more home assessments prior to discharge. Even with a checklist, there are multiple things that need to be seen in person. Is the house infested with vermin? Is there more than one exit in case of fire? Is their neighborhood safe for them to return to? Do they have a phone and does it work? And how often do we talk to patients about medical alert services prior to discharge? Or should we simply wave goodbye to them because they are on their own once they leave our facility?