Hospital to Home Transition Care in Chicago and Nearby Suburbs
The hospital discharge was fast. Let’s make coming home feel safe.
A safe discharge does not end at the hospital door. Livewell Home Care provides coordinated, non-medical support that turns discharge orders into a calm, confident first week at home. Your plan can combine hospital discharge to home coordination, companion care, and personal care, with visit notes and regular updates to your family.
Serving Winnetka, Wilmette, Kenilworth, Glenview, Northbrook, Glencoe, Highland Park, Evanston, Lake Forest, Park Ridge, Chicago, Hinsdale, Western Springs, Riverwoods, Burr Ridge, Long Grove, Deerfield, and surrounding areas.
What Is Hospital to Home Transition Care
Hospital to Home Transition Care is short-term or ongoing in-home support after a hospital or rehab stay. Caregivers follow a written plan that covers safety, personal care, meals, medication reminders, appointment support, and communication with your family and providers. The goal is fewer complications, fewer readmissions, and faster return to routine.
Discharge to Home Coordination
Before discharge
- Confirm discharge date and transport plan
- Review discharge summary, activity restrictions, and follow up instructions provided by the clinical team
- Prepare the home with clear pathways, lighting, and basic supplies
Day of discharge
- Safe transport home and pharmacy stop if requested
- Medication pick up and organization support per the family plan
- Set up of equipment such as walkers, shower chairs, or commodes
First 72 hours at home
- Vital routine setup, including meals, hydration, toileting schedules, and rest periods
- Reminder support for new medications and timing
- Appointment scheduling and calendar creation for follow-ups and therapy
- Observation of red flags and immediate communication to the family or home health
Common coordination tasks
- Review wound care or therapy instructions with family
- Create a simple daily checklist the client can follow
- Share visit notes to keep everyone aligned
Helping Seniors Live Well.
We’re here to help your loved one feel safe, supported, and cared for around-the-clock. And when families face caregiver burnout, we provide the steady, compassionate support they can count on.
Personal Care Support
- Bathing with safety checks, water temperature setup, and waterproof dressing protection if present
- Dressing with adaptive clothing and energy pacing
- Grooming and oral care to prevent infection and maintain comfort
- Toileting and incontinence care with gentle skin protection
- Safe transfers from bed to chair, chair to toilet, and in and out of the shower using gait belts and approved techniques
We understand that home care is about trust. That’s why our caregivers are carefully selected, trained, and supported to ensure you receive care from people who are as compassionate as they are skilled.
Companion Care and Daily Support
- Meal preparation that follows diet guidelines such as low sodium, diabetic friendly, or texture modified when provided
- Hydration reminders and snack setup
- Light housekeeping and laundry to reduce clutter and fall risk
- Errands such as grocery and pharmacy pickups
- Transportation to follow up visits with optional escort and note sharing if authorized
- Encouraging gentle activity and rest balance to promote healing
Medication Reminder Framework
- Create a simple list of new, changed, and discontinued medications
- Encourage the use of a pill organizer that the family or home health fills
- Reminder prompts at the correct times and documentation of taken or declined doses
- Observation of side effects such as dizziness, swelling, confusion, or GI changes, and timely updates to the family
Safety First Setup
- Clear walking paths and remove small trip hazards
- Add night lights for bathrooms and hallways
- Place frequently used items at waist height
- Post an emergency contact sheet near the phone
- Keep mobility aids within reach and adjusted to the correct height
At Livewell Home Care, we believe home is more than a place — it’s where comfort, familiarity, and independence thrive.
Red Flags To Report Promptly
- Shortness of breath, chest pain, sudden confusion, or fever
- Increased pain that is not controlled by the current plan
- New swelling, redness, or drainage at an incision site
- Falls, near falls, or sudden change in walking ability
- Sudden change in urine output or bowel patterns
Coverage Options
- Hourly support for routines and appointments
- Overnight awake caregivers when nights are challenging
- 24-hour or live-in coverage when continuous presence is preferred
- Flexible schedules that adapt as recovery progresses
Who Benefits From Hospital to Home Support
- Adults recovering from surgery, stroke, heart events, or pneumonia
- Individuals with new medications or equipment at home
- Families who want structured support to reduce readmission risk
- Clients who need help rebuilding daily routines safely
Our Process
- Free in-home or virtual consultation
- Written transition plan aligned to discharge instructions
- Caregiver match and start of visits
- Regular updates to family and coordination with home health, therapy, or hospice when involved
- Plan reviews and adjustments as needs change
Service Area
Winnetka, Wilmette, Kenilworth, Glenview, Northbrook, Glencoe, Highland Park, Evanston, Lake Forest, Park Ridge, Chicago, Hinsdale, Western Springs, Riverwoods, Burr Ridge, Long Grove, Deerfield, and surrounding areas.
Contact Us!
When you fill out this form, you can expect to receive a call and email from our professional staff. We will reach out to you and answer your questions.
FAQs: Hospital to Home Transition Care
Most clients start within 24 to 72 hours after an assessment. Same-day or next-day start is often possible if schedules allow. We can also schedule caregivers to meet you at discharge.
Bring the discharge summary, new prescriptions, updated medication list, wound or therapy instructions, follow-up appointments, hospital ID bands if needed for reference, and any equipment paperwork. Make sure house keys, a safe entry plan, and a ride home are confirmed.
With your permission, we align tasks with discharge orders and therapy goals. We share observations on meals, hydration, mobility, mood, and red flags, and we accompany them to follow-ups when requested.
Livewell provides non-medical support such as personal care, meal prep, medication reminders, safety setup, errands, and transportation. Home health is clinical and may include nursing, PT, OT, or speech therapy ordered by a physician. Families often use both for the best outcome.
Yes. We help position walkers, shower chairs, and commodes, and organize daily routines. Families or licensed providers manage pillbox setup and changes. Caregivers provide reminders and document taken or declined doses per the plan.
We establish routines for meals, hydration, rest, and activity, support follow-up appointments, watch for red flags like fever, shortness of breath, uncontrolled pain, or confusion, and notify family or home health promptly so problems are addressed early.
Many clients use support for one to two weeks after discharge, while others prefer 30 to 90 days until strength returns. Private pay is common. Long-term care insurance often reimburses non-medical home care. Medicare does not pay for custodial care. Medicaid and VA benefits vary by eligibility and location. We can assist with a benefits check.