Question

Ms.B o 85 4/0ld Italian who inmprated to tmeeica 50yeaw ago" She was Ainuitted to the lorpital with exacubahin CHEU Her Co-morhidithies are DM and ostegperardr. ahile Yu he Hopital her daushter puinay care giler syffers MI and now riaperating at home Ms. B lues wih' her dauhter puhana and her pon ea' low Joha. farhara o regueshay yu the CAJE MANAGER manje for her mother to the band to nohab center The hequest ú Sp Baibara cloible bunden on hér husband Yoru call tam meatin and amaunce the ruquest. Mu.B has fradikunal Medicare , ab elijchle for Mediaid The family has not conypleted a Midicuil applicátui tecaue Huy were unauare f M Br blipibilit Queihin what benefit ill cärplehng he madiaid aplah pow hare r the transihun f Ma. b "badk 6 the çommunity 7 Braid en Tranabial Cua Medel fomulate full plan with 6thçrode educanin from Italy. seaperate from he MI and not plaee may

Answer 1

● Some of the benefits which can be achieved are getting the transitional care at home (An assistance or a train health care professional to meet their ADL,medication ,to get cultural competent care ,can reduce the risk of getting admitted again in to the hospital in a shorter span of period,dietary needs can be met etc.,)

She will receive a quality care

●The case manager after getting a nod informs to the Community Transion care center.There should a clear references given by the provider when they move into community. A transition care coordinator takes the time of this in making sure the patient is appropriately transmitted from healthcare sector to rehsbilit as soon center and then to the home.They aide in checking out the availability of the concerned care and making necessary arrangements and providing them with complete information. They establish a communication with the patient and family member.In simple when this is approved the Transitional care nurse assess the patient ,then plan a care in regards to the specific needs of patient and making home visits daily and assessing girls profess and addressing any issues.