ModuleDraftFallsMental health
Persona: Social workers/case managers — stroke discharge planning + social determinants
Care coordination module: discharge destination options, caregiver capacity assessment, equipment/home safety coordination, insurance/benefits navigation, and SDOH screening themes.
ClinicianClinicianIntermediate25 minClinical (pro)
Educational only
Educational only — eligibility criteria and local resources vary.
Get help now
If there is immediate danger (unsafe home situation, abuse risk, suicidal ideation, or acute neurologic decline): activate local emergency/social work escalation pathways immediately per policy.
Key takeaways
- Compare discharge settings (IRF/SNF/home health/outpatient)
- Assess caregiver capacity and burnout risk
- Identify core SDOH barriers impacting recovery
- Build a practical resource/referral plan
Discharge settings
- IRF vs SNF vs home
- Eligibility themes (concept)
- Tradeoffs: intensity vs access
Caregiver capacity
- Who can help?
- Training needs
- Respite planning
Home + equipment coordination
- Safety plan
- Transport
- DME documentation
SDOH screening themes
- Housing
- Food access
- Transport
- Language access
- Costs
Resource plan
- Stroke support groups
- Community services
- Financial assistance pathways
Practice check
What you’ll practice
These questions are untimed. After you answer all of them, you’ll see your score and a clear next lesson or reference step.
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