There is the list from before the hospital. The list the hospital gave. The list the nursing home starts. The list the pharmacy sends. Somebody has to make them the same list, and then be there when the first dose is due.
Before they leave. We stand with the hospital staff and match the lists. What they were taking before the hospital, and how they took it. What was ordered. What they were given. What is in the bag. One medicine can be by mouth at home, and another that does the same job, through a trach after — a tube in the neck. A different name and brand. The same job. If the earlier one is never stopped, both stay on the list. Not even you will know.
When they land. We match that list to the nursing home, and we get the hospital papers into the new chart. The new place is not starting from a blank page.
When the first dose is due. We come back, the same day or the next morning. We read the chart. We look at your person. We see whether the dose was given.
Again, still inside 48 hours. The pharmacy order is in. The medications have arrived. The doses are on time. We watch how the new medicines affect them. We watch for an early change. Pain level, breathing, airway clearance, oxygen, feeding — we look at whether it is actually happening. If a dose was not given, or the feeding, the oxygen, or the airway clearance is not happening, we get the nurse or the director of nursing, and they do it.
There is a lot we are not allowed to tell you about these 48 hours. What we can tell you is that you need a Bodyguard for this window. These 48 hours are when a decline starts. We are there to see it early. We see how they leave — the hospital, or the first facility — and we see how they arrive. That record is kept for you. One flat price. We leave and we come back. The drive back is included.