After a hospital stay, returning back home to senior housing can be difficult and present new challenges for your elderly loved ones.

"A visit to the hospital can change everything," says Kelly Mazza, senior executive director of The Arbors at Shelburne, a senior living community in Shelburne, Vermont.

Elderly individuals can face a roller coaster of emotions during the transition. If a senior has become more frail or lost their independence, getting re-acclimated may require more services, such as physical therapy and assistance with daily activities from the facility, which in some cases can increase the cost of care.

Keeping in touch with the community

A proactive step is for family members to keep in touch with the senior housing facility while your loved one is in the hospital. Although emotions and stress may be high as someone nears the time of being discharged, it is a good idea for family members to get educated on how their injuries and illnesses could change their care, how those changes will impact costs and how the community may be able to help.

"The most successful transition back from a hospital to any type of senior housing happens when family is engaged and openly communicating what they want, instead of staying on the sidelines," Mazza says.

Nurses with assisted living and skilled nursing facilities can be in contact with the family and the hospital, including physicians, social workers and therapy departments, to assess the needs and how the community can meet an individual's needs. Caregivers should be proactive to ensure this communication among the care team is happening.

Transferring to different care levels

Sometimes an individual needs to move to a different level of care, says Kimberly Otte-May, regional executive director of the Lighthouse of West Bend, a senior living community near Milwaukee that offers independent living, assisted living and memory care.

For example, someone living in an independent living apartment may now need to move into an assisted living setting. Or, an assisted living resident may require skilled nursing. This move might be temporary, while the person requires more care during the recuperation period. Or if the elder has suffered substantial physical or mental damage, and is less able to care for themselves, the move might be permanent.

Physical therapy and medical equipment

The family and community also need to discuss what equipment, such as a wheelchair, or medications may be needed.

One of the big changes is that more assisted living facilities have on-site therapy departments, often by contracting out with therapy groups. Instead of an individual having to leave the community for occupational or physical therapy - being transported to a doctor's office or hospital for those sessions - they receive those services at their own community.

Watch for rise in emotions and troubling behaviors

A recent study found that elderly individuals who are hospitalized have a higher risk of cognitive problems following their hospital stay. Researchers with Rush University Medical Center in Chicago found that the rate of cognitive decline - affective memory and thinking - more than doubled in older patients who were hospitalized.

Robert Wilson, a Rush neuropsychologist and the study's author, says in a USA Today story that the rate of decline after hospitalization would be "equivalent to being more than 10 years older." The research was published in the journal Neurology. Wilson also called hospitalizations a "risky" experience for the elderly.

A lot of times, an individual doesn't come back home with the same needs. "That can be a challenge for them," Mazza says. "They may have been rather independent. Now they may have to rely on others to help."

Emotions that may manifest when elderly individuals get re-acclimated to senior housing after a hospital stay are:

  • Frustration
  • Agitation
  • Defiance
  • Fear
  • Disorientation

If these behaviors are present, families need to work with and trust the community and its workers to address the challenges. Some people may have to re-learn how to perform basic activities or get around the community, especially if they are now in a wheelchair.

When individuals are in a hospital for a prolonged period, they may lose their sense of time, says Otte-May. The sense of disorientation will lessen once they get back into their routine and structure, she says.

Special needs for Alzheimer's and dementia

For individuals with dementia or Alzheimer's, the transition can be even more difficult. Mazza says continuity and structure is important. "When they leave one setting and come back, it is very difficult for them to get acclimated," she says. The staff at the senior living home should work closely with both the resident and the family to get the senior re-acclimated.