Transitional Care in BrightStar Care of Gainesville / Woodbridge

When you or a loved one are recovering from a hospitalization or are being discharged from a rehabilitation center such as a skilled nursing facility (SNF), you may need short-term transitional home care. Our nurse-led care and team-focused approach are designed to optimize your health and well-being.

Even if your loved one is receiving skilled nursing care from another agency (such as a Medicare-approved group), the companion care and personal care services we offer through BrightStar^® Home Care BrightStar Care of Gainesville / Woodbridge provide a wonderful supplement. These services can help meet basic needs such as light housekeeping, companionship, family respite, dressing, personal hygiene and ambulation (walking and moving around).  

Professionally delivered care can help reduce undesirable outcomes such as re-hospitalization, medication errors and falls; it may even reduce long-term healthcare costs by helping to prevent the health conditions from getting worse.

Short-Term Transitional Home Care Services

A Registered Nurse (RN) from BrightStar Home Care BrightStar Care of Gainesville / Woodbridge oversees the plan of care to help provide a safe transition back home. Our team provides a wide range of services to support a variety of health needs such as:

• COPD (Chronic Obstructive Pulmonary Disease): We’ll coach proper inhaler use, provide medication reminders and support habits to improve wellness.
• Diabetes: We will conduct foot inspections and perform blood glucose level checks, as well as provide family education.
• Heart Attack/AMI (Acute Myocardial Infarction): We’ll provide education and support to develop new lifestyle habits that promote heart health.
• Heart Failure: We’ll help manage medication adherence, diet and exercise.
• Pneumonia: We’ll provide RN-led medication management, help manage oxygen therapy and offer personal care.
• Post-Operative: We will assist with surgical recovery in the comfort of home.
• Stroke: We will help with activities of daily living (ADLs) like eating, dressing and mobility, as well as promote fall safety, offer medication reminders and provide transportation to physician appointments or therapy (physical, occupational and/or speech).
• Therapy for Post-Op or Stroke: We also have physical, occupational and speech therapists who can provide rehabilitation in your home.

Care Paths Deliver Superior Outcomes

One of the unique services we offer is Care Paths for Falls and Change of Condition. Although care paths are fairly common, we’ve taken this approach farther by building person-centered and condition-specific Care Paths based on your loved one’s unique needs, current conditions and past medical history.

Using our proprietary technology, our caregivers are able to help predict and prevent a fall or worsening of your family member's current condition. When a change of condition is identified, we will communicate that information immediately to the supervising nurse at BrightStar Home Care BrightStar Care of Gainesville / Woodbridge and/or your loved one’s physician so any needed action can be taken.