Hospital discharge checklist for family caregivers

Paperwork to leave with

Ask for all of it on paper even if there is a patient portal. Portal access often takes days to activate, and the person who needs to read it at ten at night may not be the person whose name is on the account.

• The discharge summary. The document that says what happened during the stay and what changed as a result. This is the one every later appointment will ask about.
• A current medication list. Not the list from admission. Ask specifically for the list as of today, and ask which items on it are new, which were stopped, and which changed dose. Those three answers are the ones that get lost in the retelling.
• Follow up appointments. Which ones are already booked, which ones the family has to book, and the deadline for each. An appointment nobody was told to make is the most common gap in the first two weeks.
• Instructions for anything physical. Wound care, a brace, a catheter, oxygen, a walker. Ask for the written version even if someone demonstrated it, because the person who watched the demonstration will not be the only one doing it.
• A phone number that a person answers. Ask who to call for a question that is not an emergency, during business hours and after them. Write down both. They are usually different numbers.

Questions worth asking out loud

The discharge conversation moves quickly and assumes you already know things. These are the questions that are awkward to ask later.

What should make us call, and who do we call?

Ask for specifics: which symptoms warrant a call to the office, which warrant the emergency room, and what is expected and not worth worrying about. Write the answer down verbatim. It is the single most useful thing to be able to show a sibling at midnight.

What can they do on their own, and what needs a person?

Stairs, bathing, driving, cooking, being alone overnight. This is the answer that determines how much coverage the family actually has to arrange, and it is the one most often assumed rather than asked.

Is any equipment being delivered, and when?

A hospital bed or a commode arriving on a Tuesday afternoon needs somebody in the house to receive it. Get the supplier name and number, not just the promise.

Is a home health visit part of this, or something we arrange?

If a nurse or therapist is supposed to visit, ask who schedules the first visit and by when. Families frequently wait for a call that was never going to come.

Before you leave the parking lot

Take a photo of every page in the folder. Hospital paperwork gets left on a kitchen counter and then travels to somebody's car. A photo means the sibling who is three states away can read the medication list tonight instead of asking you to read it to them.

Then send one message to everyone at once, with the same four facts: what changed, what happens next, who is doing tonight, and what the family still needs to sort out. Sending it once beats answering the same question five times.

The first week, divided up

The first week after a discharge is the week families most often improvise, and improvising is what burns out whoever lives closest. Before the first night, settle four things in writing:

• Who is at the house each day, including which nights have nobody.
• Who is making the follow up phone calls, since these happen during work hours.
• Who is handling the pharmacy, including the refills that are about to lapse.
• Who is the single point of contact for the doctor's office.

The fourth one matters more than it sounds. When three siblings each call the office with a version of the same question, the office starts calling one of them and only one of them, and it will not be the one you agreed on. Pick the contact and tell the office who it is.

If you are working out how to divide the weeks after this one, we wrote a separate guide on building a caregiver shift schedule. And because the medication list is the document that changes most after a hospital stay, there is one on what a shared medication list needs on it.