Elderly patients being discharged from a hospital may need additional nursing care and therapy before returning to home. Transitional Care Units (TCUs) at a nursing home offer this additional care to focus on their special treatment needs and offer holistic care incorporating functional and psychosocial factors, in addition to geriatric medical expertise. This short stay represents a crucial opportunity for restoring an elderly patient’s health and well-being. That’s why Genevive offers a geriatric-focused physician and nurse practitioner model that works with the facility staff to provide medical care from initial evaluation through discharge to home in the community.
Bridging The Gap
Genevive providers collaborate with our partner facilities to care for patients who need extra care and rehabilitation during a transition in life. Elderly patients with acute illnesses may not be well enough to return home when discharged from the hospital. They are often transferred to a Transitional Care Unit (TCU) at a nursing home, where the model of care should fit their special treatment needs. That’s why Genevive's on-site provider team works closely with the facility staff care model to cover all the patient’s needs from initial evaluation through discharge to home.
Always By Our Patient's Side
Genevive’s providers are available for patient needs twenty-four hours a day, seven days a week. We are available for patients from the moment they arrive at the TCU, performing medical, functional, and cognitive evaluations. In-depth medication reviews focus on geriatric pharmacology, understanding many medications' unique risks and benefits for frail patients. Genevive providers work closely with the patients and their loved ones, communicating these medication changes.
Full-Scale Care
At the same time, we know there is much more to caring for the elderly than just medications. Understanding the extent of cognitive and functional factors is equally important and best accomplished by integration with other professional disciplines. Your Genevive physician or nurse practitioner collaborates with the other TCU professional disciplines, including nursing, physical and occupational therapies, and social service. Identifying clear goals of care, developing a safe discharge plan, and communicating that plan back to the community physicians are standard expectations for our providers and the TCU team, ensuring a comprehensive approach to care.