What is Transitional Care?

After discharge from the hospital because of surgery or illness, you may not be quite ready to go home. To help bridge this gap, you may go to a short-term rehabilitation facility also known as a transitional care center. 

Short-Stay-Rehab3-RESIZE.jpgTransitional care is designed to help patients get back on their feet safely after a hospital stay because of an illness or surgery – think of it as a stepping stone between the hospital and your home. During your stay, you may receive physical, occupational or speech therapies as needed. Nursing care will help you with things like activities of daily living, wound care and medication management. Upon discharge, social workers will help put in place any services you may need at home to help you continue your recovery.

Answers to Common Transitional Care Questions

Now that you understand what is transitional care, you may have some additional questions. Read below to get answers to some common transitional care questions. If you don’t see the answer you’re looking for, contact us now

What Things Should You Consider When Choosing a Transitional Care Facility?

Patient Room at Birnhak Transitional Care Short Term Rehab

If it is determined by your medical team that you would benefit from a transitional care facility, the hospital social worker will present you with a list of local facilities. Sometimes, you may know that you will be hospitalized and may want to do some research on transitional care facilities in your area before your procedure. It may be helpful if you or your loved one considers the following when making a decision:

  • What is the ratio of nurses to patients?
  • Is there medical staff onsite, including physicians and nurse practitioners?
  • What are the statistics for patient re-hospitalizations?
  • How often will you receive therapy?

What Types of Therapy are Provided in Transitional Care?


During your stay in the transitional care, you may receive therapy to help you regain your strength and help with the overall healing process. The types of therapy you receive will depend on your diagnosis and reason for hospitalization. Therapy may include:

  • Physical therapy: Focuses on improving your ability to move, which allows you to perform the activities of your daily life. Your physical therapist may use exercises and weights to help you increase your muscle and joint strength. If you need to use a cane or a walker, your therapist will work with you to make sure you are able to get around safely.
  • Occupational therapy: Uses your everyday activities to help you rehabilitate. Your therapist will help you modify your daily routine or skills so that you can resume your normal life as much as possible once you return home. Environmental aides may be suggested, such as adding rails to your bathtub, to make sure your home is as safe as possible upon discharge. Occupational therapists can also work with you to modify your favorite hobbies and activities.
  • Speech therapy: Needed if you’ve suffered a stroke or other brain injury. You may also receive speech therapy if you suffered any ailment that may affect your ability to swallow. A speech therapist will help you regain communication skills you may have lost or help you find new ways to communicate. 

When are You Discharged from a Transitional Care Facility?


One of the most common transitional care questions is how long will you be in the facility. How long you stay in a transitional care facility will depend on a number of factors, including what type of surgery you may have had, how well you are responding to therapy, and how stable are any chronic illnesses. 

Once you are able to go home however, there are some things to consider:

  • What resources are available to help you and your loved one after discharge? For example, will you need a nurse to come to your home?
  • What is done to ensure that you will have all the equipment and supplies you need when you return home?
  • What types of therapy, if any, will you need to continue?
  • Do you understand your medications, including what you are taking, why you are taking each one and when you should take them?

Make sure that your care team addresses each of these transitional care questions before you leave. A good transitional care facility should review a comprehensive discharge plan with you before you leave and give you a phone number to use should you have any questions or concerns. 

Choosing a transitional care facility after a hospital stay can have many benefits to your overall recovery. 

If you are interested in learning more about transitional care, including the Abramson Center’s Birnhak Transitional Care Program, please contact us by clicking the link now. An experienced senior care advisor is available to help free, 24 hours a day, seven days a week.