Eden Health offers Home Health, Home Care, Palliative Care and Hospice services under one roof. With Eden Health, you can be sure that your healthcare professionals are some of the most competent and passionate in their field. We will work with you to achieve your health and wellness goals. The Eden Health Care Continuum is designed to follow patients with complex needs from one care setting to the next while also improving continuity of care. This is a low-cost, low-intensity, evidence-based intervention comprised of a home visit and contact via telephone/virtual visit.
For patients transitioning directly from the inpatient setting (hospital, SNF, etc.) to home, the Eden Health Care Continuum is designed to help you play a more active role in your health care and prevent the likelihood of rehospitalization. This 3-phase journey follows you every step of the way to make sure you are receiving the right level of care to get you back to your highest level of independence and quality of life.
Your transition coach first visits you in the hospital/SNF to arrange a post-discharge home visit and to provide you with a personal health record. This record, which you will be instructed to share with future health care providers, includes a list of your health problems, medications, allergies, and warning signs/symptoms to closely monitor.
During your post-discharge home visit, which will take place 48-72 hours after your discharge from the hospital/SNF, your transition coach will:
- Review your prescribed medications to confirm there are no dangerous interactions.
- Discuss your medication regimen with you.
- Teach you how to effectively communicate your needs to your healthcare professionals.
- Review “red flags” or warning signs/symptoms in your health record, including how to manage them and when to contact a doctor.
After your home visit, your transition coach follows-up with at least one telephone call during the first four weeks after your hospital discharge to make sure you have received necessary medical services, medications, and equipment, and to discuss and answer any questions you may have about recent medical appointments.
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Eden Health’s telehealth program engages you in your plan of care, allowing us to record your vital signs, watch educational videos and communicate with your Eden Health care team all from the comfort of your home.
Telehealth also enables Eden Health to customize care plans to every person’s individual care needs, remotely track a patient’s health status and communicate with patients via phone, video, chat, or text messaging.
Telehealth uses simple technology to connect you with all of the members of your care team to help you get the attention you need conveniently and in the comfort of your home.