5 Tips for Managing Diabetes After a Hospital Stay
1. Set Expectations
The day or so before your discharge from the hospital, the doctor who treated you will likely review your hospitalization and how it affects your diabetes and other health conditions, changes to your medication regimen, and what follow-up you’ll need. Your hospital care team will also talk to you about what the natural course of healing should look like, how long you might need care at home, or when you can resume activities such as lifting heavy objects. The team will usually review warning signs of problems and what to do if your recovery doesn’t go as expected.
2. Mind Your Meds
You may have a new medication plan after being in the hospital, either temporarily or long term. You’ll be given a written copy of the new plan so you can refer to it when you go home. Instructions should include how to take your new medication, when to start and when to stop, and how to use as-needed drugs such as pain medications. Someone from your hospital care team—your doctor, pharmacist, or nurse—will review it with you and any home caregivers (family or professional) in person to make sure everyone understands the plan and that you’re able to follow it. Before you leave the hospital, be sure you have a supply of new medication or plan to pick it up from a pharmacy on the way home.
Once you’re home, don’t try to go it alone. Ask a friend, family member, or professional caregiver to help you take your meds as prescribed. “If you are groggy or not safe to take your own medications, you should have someone assisting you,” says Sandra Weber, MD, FACP, FACE, vice president of the American Association of Clinical Endocrinologists and chief of the Section of Endocrinology at Greenville Health System.
3. Keep Records
At discharge, ask for copies of your test results and your discharge summary. Your hospital may provide this information in print or electronic form. If you receive papers, consider keeping all of your hospital records in a three-ring binder, arranged chronologically and by subject (lab results in one section, for instance, and imaging in another), along with other health records. “Bring this to your visit every time you see a doctor,” says Susan Elizabeth Spratt, MD, associate professor of medicine, assistant professor of community and family medicine, and director of diabetes services at Duke University. “He or she may not need it, but it’s always good to have it in case he or she does need to review it.” Flag anything you have a question about—it will help you stay organized and on top of your management.
4. Pay Up
There is no standard for how billing is handled. It’s likely that the hospital’s financial care counselor will talk to you about payment before a planned hospitalization. If you have health insurance, you may need to pay a deductible or co-pay up front, and your insurance will be billed before you see a final bill.
Without insurance, you may need to pay a larger deposit before you’re admitted, says Richard Pugach, a professional health advocate and president and CEO of Health Navigaid LLC. A health advocate familiar with matters of health insurance can assist you in finding the most appropriate health plan for your needs and can help minimize the likelihood of receiving unexpected hospital or physician bills. “A good advocate can help you avoid these situations,” Pugach says. You can hire a qualified advocate through the Alliance of Professional Health Advocates at advoconnection.com. You can also talk to the hospital’s financial care counselors during or after your stay—they’re the hospital’s experts in insurance, Medicare, and Medicaid.
Always review your hospital bills, and speak up if you notice incorrect charges. If you get a bill you can’t afford, talk to the hospital. Many offer assistance programs or will write off the cost as charity.
5. Plan Ahead
Before you leave the hospital, set follow-up appointments with your providers, those in the hospital as well as your usual diabetes care team. Information on rehabilitation, home health assistance needs, and transportation needs should be included in your discharge papers, which you’ll typically receive the day you leave the hospital.
This is also a great time to make an appointment for diabetes self-management education and support, says Jan Nicollerat, MSN, RN, ACNS-BC, CDE, vice chair of the North Carolina Diabetes Advisory Council and a consulting associate at the Duke University School of Nursing. Even if you received diabetes education in the hospital, it’s a good idea to set a follow-up visit with an educator after discharge to make sure you’re on track with your diabetes management. Get a referral from your hospital care team. Diabetes self-management education and support is covered by insurance, Medicare, and Medicaid.