Hospital-to-Home Care

Personalized and high-touch care and coordination to support the safe and efficient transition from the hospital or other care facility to the comfort of home.

When you’re dealing with a complex or terminal illness, it can be so meaningful to be at home, in familiar surroundings, around family and friends. Leaving the hospital or other care facility can be scary and stressful because there’s limited access to adequate and responsive in-home medical care to ensure that you or your loved one can remain at home – comfortably and safely.

How do you find help you can trust? Can you continue treatments that were being given in the hospital, like IV fluids, antibiotics, etc.? Who will you call when questions or concerns arise?

These are just a few of the questions that might keep you awake at night when you or a loved one is preparing to transition home from the hospital or care facility.

At Empowered Endings, our compassionate and experienced doctors, nurses and doulas orchestrate your transition home, where you and your family can relax into the personalized, high-touch care of the most carefully vetted in-home providers in your community.

Our team is here to help get you home with the right support to keep you safe and comfortable while we support your family and loved ones in caring for you.

We then stay by your side to guide the journey so you and your loved ones have access to the care you need when you need it and the answers you need when you need them. We advocate for you and collaborate with our community partners to provide solutions that honor your goals, values, and wishes.

Personalized Care to Meet Your Needs Through the Transition from Hospital-to-Home

Assessment and Recommendations:

An expert physician consultation, which includes an extensive in-person visit to:

✓ Establish a connection and learn about the values, goals, and wishes of each patient;

✓ Review the current circumstances, including the medical conditions, resources, and needs;

✓ Recommendations regarding treatment and care options for the patient and the family;

✓ A limited amount of post-visit coordination and follow-up to ensure that appropriate connections are made and questions are addressed;

✓ A thorough review of records and coordination with current medical providers is available at an additional cost.

Discharge Coordination:

Everything included in the Assessment and Recommendations plus:

✓ Collaboration with healthcare providers at the hospital or facility to facilitate discharge from there to home;

✓ Oversight of care and coordination of all supportive services needed to optimize in-home care;

✓ Communication with patient and family members throughout the process to ensure a smooth and anxiety-free transition;

✓ A limited amount of post-discharge coordination and follow-up to confirm appropriate ongoing care is in place and to make any additional referrals or necessary changes.

Ongoing Care and Support:

Everything included in the Assessment and Recommendations as well as the Discharge Coordination plus:

✓ Ongoing oversight and coordination of care, including 24/7 availability, in-home visits, communication with collaborating providers, and referrals to supportive resources, such as holistic and integrative therapies, nursing support, and more;

✓ Routine and urgent physician visits with your personal doctor, available 24/7 by phone, text or email;

✓ Routine and urgent nursing visits as needed to explore and address any changing needs, ensuring patient comfort as well as family support and education throughout the journey;

✓ Wrap-around mental, emotional, spiritual, and social support for patients and their loved ones, including access to counselors and doulas who are accessible 24/7 to provide intimate guidance aligned with the patients’ and families’ goals, wishes, and values.

*Routine physician, nursing and counselor, and doula visits are scheduled and priced on the basis of each patient and family’s level of need.

Contact Us to Learn More About Compassionate Care With Empowered Endings:

Please use this form for general information only—don’t share any personal health information. We can make a personal appointment to discuss private patient information.

Bob and Elizabeth are just very gentle souls. There was no pressure and shared with my wife Rachel and I the many options you have to consider. It felt just like someone putting their arms around you.

[Dr. Bill Parker]

For us as a family, Bob and Elizabeth gave us the tranquility and support that we needed at that moment. It made a total difference in the way my Dad passed away. It allowed me to be the daughter and not a nurse.

[Eva Goldstein]