CARE ACT: A Safe Hospital Discharge

Last fall New York became the 18th state to pass a Caregiver Advise, Record and Enable (CARE) Act. Hospitals and family caregivers.New CARE Act aims to help family caregivers

Last fall New York became the 18th state to pass a Caregiver Advise, Record and Enable (CARE) Act. The new law, which went into effect in April, requires hospitals to effectively communicate with and support family caregivers when a patient is discharged. The goal is to improve post-hospital care and prevent unnecessary re-hospitalizations.

Specifically, the CARE Act requires hospitals to:

  • Record the name of the family caregiver in the patient’s medical record
  • Inform the caregiver when the patient is to be discharged
  • At least 24 hours before discharge, consult with the caregiver and provide them with a discharge plan describing the patient’s care needs
  • Instruct the family caregiver about the medical tasks he or she will need to perform for the patient at home, including a live or recorded demonstration from a hospital employee, and
  • Provide the caregiver and patient with the opportunity to ask questions and receive answers about after-care in a culturally competent manner in the patient’s and caregiver’s primary language(s).

As ICS Transition Team Director Stephanie Reynolds explained in this recent interview, most hospital re-admissions can be prevented by making sure the patient gets the services and supports they need when they return home. For millions of Americans, a family caregiver is the person providing many or all of those services and supports. Even when the patient receives professional services from a home care aide or visiting nurse, many family caregivers still play an essential, hands-on role.

The CARE Act legislation was developed by the American Association of Retired Persons (AARP) because, as the organization points out, many family caregivers today are expected to help their loved ones with complex medical tasks that at one time were only done by professionals.

As Elaine Ryan, AARP VP for State Advocacy explains in this video, she understands the problem first hand, having spent years taking care of both her parents.

“Each time Mom or Pop was discharged from the hospital, I was handed a dizzying list of responsibilities; medication changes, wound care, nebulizers and more became part of our reality. But the tasks were intimidating. I didn’t have medical training, and the consequences of making a mistake in their care weighed heavily on me.”

In fact, according to AARP, almost 20 million family caregivers in America have performed medical or nursing tasks for loved ones including managing special diets, giving injections, operating monitors or other specialized medical equipment and many other tasks, in most cases without any medical training.

What the CARE Act requires – notifying the family member and making sure they are capable of effective after-care – may seem like common sense, but very often it just doesn’t happen. That probably explains why one poll found that 92 percent of New Yorkers over 50 supported passage of the CARE Act.

As hospital staff and family caregivers learn of the legal requirement to give notice and instruct family caregivers ahead of a hospital discharge, it should go a long way to improve the care patients receive at home and prevent more unnecessary re-hospitalizations. And that’s important because, as ICS’s Stephanie Reynolds says, “hospitals are the worst places for sick people. We want to keep them home, where they belong.”

You can read more about the ICS Transition Team here. You can learn more about New York’s CARE Act here.

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