Hospital Discharge: The Week Before and the Day Itself

Ask About Discharge on Day One

On the first day, before anything is decided, find out who the discharge planner or case manager is. Ask for the full name, the direct number, and the days they work. Write all three on the front sheet of your folder, not on your phone.

Then ask two questions, and keep asking them:

"What has to be true before my father can go home?"

"What is your current estimate for the date?"

Keep a dated line for every answer you get. Date, time, who said it, what they said. The estimate will move. That is normal. What matters is that you can see the shape of it moving, and that you can say to a sibling on Thursday, "On Tuesday we were told Friday; yesterday it became Monday."

Asking on day one is not pushiness. Discharge planning genuinely starts early, and the family that has already measured the doorway and cleared the hallway is easier to send someone home to. If nobody has mentioned a planner by the second day, ask the nurse at the desk who fills that role on this unit, and write down the name they give you.

The Questions to Ask the Discharge Planner

Write these on one page and take it with you. Work through them in one sitting if you can get one, and tick as you go. You will not remember them in a doorway with a wheelchair waiting.

Every one of these is administrative — who does what, by when, and how you reach them. The medical questions belong to the nurses and doctors; ask those separately and write those answers down too.

• Who is the discharge planner or case manager, and what is the direct number?
• What is today's estimated date, and what would change it?
• Where is my parent going — home, or somewhere else first? Who makes that decision?
• What equipment is being ordered, by whom, and when should it arrive?
• Which supplier, and does someone need to be home to sign for it?
• What services have been arranged, and who will call me to schedule the first visit?
• Which follow-up appointments are being booked by the hospital, and which do I book myself?
• Who writes the prescriptions, and which pharmacy do they go to?
• What written instructions will I be given, and can I have them the day before rather than in the doorway?
• Who do I call at 9pm on a Sunday with a question about the paperwork?
• What number do I call if the equipment does not arrive?
• Will there be a discharge summary I can take with me, and how long until my parent's own doctor receives it?

The Home Check You Do Two Days Before

Do this walk-through with a notebook, before discharge day, not on it. Park the car, then walk exactly the route your parent will walk, at their pace.

Write down what you cannot fix and hand that list to the discharge planner or the occupational therapist. Ask them what they recommend for it. Do not guess and do not improvise — the point of writing it down is that the right professional gets asked a specific question instead of a vague one.

• Walk the route from the car door to the bed yourself, and time it
• Measure the doorway widths if a walker or wheelchair is coming home, and write the numbers down
• Decide which room they will sleep in for the first week, and set it up now
• Move the lamp, the phone charger and a glass of water within arm's reach of that bed
• Measure the height of the bed and the toilet seat — a supplier will ask you for both
• Clear the floor along the route: cords, boxes, the basket at the bottom of the stairs
• Check the lighting on that route after dark, not in daylight
• Put clean clothes and a laundry basket in the room they will actually use
• Take one photo of each room and put it in the folder; you will be asked to describe the home more than once
• Note the stairs: how many, handrail on which side, is there anywhere to sit halfway

Equipment and Supplies: Write Down Who Owns What

Equipment arrives from suppliers, not from the hospital, and the paperwork that comes with it decides who pays and who collects it later. Log every item on one sheet as it is ordered.

Columns:

Item | Ordered by (name and role) | Supplier | Phone | Order date | Expected | Arrived | Rented or purchased | Return by | Returned (date and who confirmed)

When something is delivered, do three things before the driver leaves. Photograph the serial number plate. Photograph the item's condition. Keep the delivery note and staple it into the folder behind the equipment tab.

Then ask the supplier, on the phone, two questions and write the answers on the log: what is the return procedure, and who do I call if it stops working. Rental items have a clock running from the day they land in the hall, and nobody will remind you.

If an item has not arrived by the expected date, call the supplier first with the order number, then the discharge planner. Note both calls on the log with times. A written call history gets a chased delivery faster than a fifth polite phone call with no reference.

The Discharge Day Folder: Collect It Before You Leave

Ask for all of this while your parent is still in the bed. Once the wheelchair is at the door, the moment has gone and you will be chasing paper by phone for a fortnight.

Before you leave, ask one more question at the desk: "Is there anything else on the file that I should be leaving with today?" It is a plain question and it often produces one more sheet.

• The written discharge summary
• Every written instruction sheet, including the ones that look like duplicates
• The medication list as it stands today — this replaces the one you brought in
• The list of follow-up appointments with dates, times, addresses and phone numbers
• Prescriptions, or written confirmation of which pharmacy they were sent to
• The name and direct number of the unit and of the discharge planner
• All equipment paperwork, delivery notes and supplier contacts
• Contact details for any service that is supposed to call you, and when they should call
• The signed property inventory sheet, and the bag itself
• The name of the doctor who signed the discharge, spelled out

Transport, and the First Two Hours at Home

Confirm the ride the day before with a time and a phone number, and confirm again on the morning. Discharge times slip by hours, so whoever drives needs to know that the window is a window.

Ask two practical questions: where is the discharge exit, and where can a car legally wait? Hospitals have a specific door for this and it is rarely the main entrance.

Before you leave home for the last pickup, set the house up: heating on, a lamp on in the hall, food in the fridge, the bed made, a chair by the front door so there is somewhere to sit down immediately on arrival. Put the phone on its charger where it will be reachable.

When you get home, do three things and nothing else. Put the folder on the kitchen table and write the date on the front. Put every bag of medication in one place and leave it there until you have read the list against the labels. Sit down for fifteen minutes before you start unpacking.

The first evening is not the time to fix everything you noticed. Write it on the list. Tomorrow is a whole day.

The Update You Send That Evening

One message, to everyone, on the evening of discharge. It stops six separate phone calls and it puts the same facts in front of every sibling at the same moment.

Seven lines, and no more:

Home at: time
Sleeping in: which room, and why
Next appointment: date, time, who, and whether it is booked
Equipment: what is coming, from whom, expected date
Waiting on: the things that have not arrived yet
What I need this week: one specific request, with a date and a duration
Next update: the day you will write again

The sixth line is the one that works. "Can you take Dad to cardiology on the 14th at 10:40, about two and a half hours door to door?" gets an answer. "Could really use some help" does not, and then you are angry with someone who genuinely did not know what to offer.

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