What is Transitional Care?

July 12, 2023

Transitional care is an essential service for individuals and families who require additional support following a hospitalization or stay in a skilled nursing community. Transitional care helps patients establish goals, create action plans, and set up resources to ensure a safe transition from the hospital to home. It’s important to understand what transitional care is and who it is designed for.  

What Is Transitional Care?  

Transitional care is an umbrella term that encompasses a range of services designed to help individuals and families make successful transitions from one stage of health care to another. The goal of transitional care is to help individuals manage their health and maintain their independence by providing them with the resources they need as they move through different stages of treatment. Transitional care can be tailored to fit individual needs and includes services such as physical therapy, occupational therapy, social work, nutrition counseling, medication management, and more. Transitional care also includes follow-up visits with primary healthcare providers and specialists.  

Who Is Transitional Care For?  

Moving on from one health care setting to another can be a tricky situation for anyone, and that's where transitional care comes in to play. This type of care provides essential support for people as they navigate their way from a hospital or nursing home back to their home, or even as they move into an assisted living facility. It can be a true lifeline, helping to ease the transition and ensuring that individuals have the proper resources and guidance they need to move forward with confidence in their health and wellness. 

It’s also beneficial for those managing chronic illnesses or major medical events such as strokes or heart attacks because it provides continuity of care during times of change. Additionally, transitional care can be used by caregivers too; caregivers often need assistance in understanding how best to manage their loved one’s condition at home after discharge from the hospital or rehabilitation center.  In short, anyone who needs assistance with creating a plan for transitioning from one form of health-related situation to another can benefit from transitional services.   

At BrightStar Care our team works closely with your medical providers throughout your transition process so that you get the personalized attention you need during this critical time. Our team will coordinate follow-up appointments with all involved parties so that there is continuity between each step in the process, allowing you or your loved one's recovery journey go as smoothly as possible while providing peace of mind for everyone involved.  

Short-Term Transitional Home Care Services Offered by BrightStar 

Our BrightStar Home Care team of registered nurses are dedicated to helping you transition safely back home. With a wide range of in-home services, we provide personalized plans that ensure your health needs are met with the utmost care and accuracy. Our team provides for health needs such as: 

  • Chronic Obstructive Pulmonary Disease (COPD) 
  • Diabetes 
  • Heart Attack/AMI (Acute Myocardial Infarction) 
  • Heart Failure 
  • Pneumonia 
  • Post-Operative 
  • Stroke 
  • Therapy for Post-Op or Stroke 

Transitional care management includes multiple services to ensure proper healthcare delivery for patients. It involves obtaining and reviewing patient discharge information, assessing the need for further diagnostic tests and treatments, providing education to the patients and caregivers, establishing referrals to and arranging for community resources, scheduling follow-up visits with various services, and coordinating care with home and community-based clinical service providers.  

A critical aspect of transitional care is the reduction of unnecessary hospital readmissions and medication management. BrightStar Care seeks to make the transfer from hospital to home as seamless and efficient as possible, ensuring patients are comfortable and well taken care of throughout the process. 

BrightStar Care transitional care services are conveniently located around the country, allowing you access to the help you or a loved one need when you need it most.  

In-Home Transitional Care Services 

When it comes to transitional care services, there are many benefits to receiving care in the home. One major benefit is the convenience it provides. With in-home transitional care services, the individual and their family members don't have to worry about the potentially hefty cost of a nursing home or rehab facility. They also don't have to worry about transportation to and from the hospital or rehab center, as they can receive care right where they live. This can be especially important for individuals who have limited mobility or who have difficulty getting around. 

Another benefit of in-home transitional care services is the level of personalization that can be provided. At BrightStar Care, we understand that no two individuals are the same, and their care needs vary. Through our transitional care services, individuals receive personalized care that addresses their specific needs, including personal services such as light housekeeping, meal prep, and medication management. This level of customization allows individuals to receive the care they truly need, promoting a faster and more comfortable transition back to home and routine. 

In addition, receiving care in the home can be less stressful for both the individual and their loved ones. Receiving care in the home allows the individual to have greater control over their surroundings, which can be especially important for those who may have anxiety or other conditions that can be exacerbated by an unfamiliar environment. Similarly, this can provide much-needed peace of mind for family members, who can rest assured that their loved one is in a familiar, comfortable environment that promotes healing. 

Choose BrightStar Care Today for Your Transitional Care Services! 

Transitioning between different stages of health-related situations can be overwhelming without proper guidance and support; this is where transitional services come into play! At BrightStar Care® our team works closely with you or your loved one during this critical time so that you receive personalized attention every step along your journey back home! With our help, you can ensure that your recovery goes as smoothly as possible while providing peace of mind for everyone involved! Contact us today if you have any questions about our transitional services! We look forward to hearing from you soon!