Before Your Parent Leaves Hospital: A Hospital Discharge Checklist for Elderly Parents

What should you sort out before your parent leaves hospital? Find out who is planning the discharge, what your parent can really do on the ward, what help and equipment will be in place, and how the first night at home will work. This hospital discharge checklist for elderly parents takes you through ten steps, one action each, so nothing important is left until the day itself.

Families often get little warning, so use this guide in the days before discharge. For what comes after, see our guides to the first week home after a stroke and hip fracture recovery at home.

Why going home is a risky moment

Going home is good news, but the first few days carry extra risk.

• Weaker muscles. Even a short stay mostly spent in bed or a chair can leave legs weaker and balance shakier than before.
• New or changed medicines. Tablets may have been started, stopped or changed in hospital. Some can cause dizziness or drowsiness.
• A home that isn't ready. The ward has rails, a raised bed and staff nearby. Home may have a low sofa, a steep staircase and a toilet at the far end of the landing.
• Tiredness and confusion. Illness, poor sleep on the ward and a change of place can leave older people tired or muddled for a while.
• A tired family. You may have been visiting every day while juggling work and children. Tired carers miss things, and that's understandable.

None of this means your parent shouldn't go home. It means a little planning now helps.

Your 10-point hospital discharge checklist for elderly parents

1. Find out who your discharge contact is

Know who is in charge of the plan. Discharge planning often starts soon after someone is admitted, and several people may be involved: nurses, doctors, therapists and sometimes a social worker or discharge coordinator. A named person stops questions getting lost between shifts. Age UK's hospital discharge and recovery factsheet explains what to expect from the staff planning it.

Try this: Ask the nurse in charge, "Who is coordinating Mum's (or Dad's) discharge, and how do I reach them?" Write down their name, role and the ward phone number.

2. Get the discharge summary and medication list

Ask for the paperwork before the day. The discharge summary (a letter explaining why your parent was in hospital, what was done and what happens next) usually goes to the GP too. Your parent should also leave with their medicines and clear information about them.

Try this: Ask the ward for a written list of every medicine, with what has started, stopped or changed. Take a photo of it on your phone and check any questions with the ward pharmacist before you leave.

3. Ask what your parent could actually do on the ward

"Medically fit" is not the same as "managing well at home". Ask what your parent has really been doing. Have they walked to the toilet alone, and with what aid? Have they tried stairs? Can they get in and out of bed and on and off a chair (these moves are called transfers) without help?

Try this: Ask the ward physio three questions: "How far can they walk, and with what aid?", "Have they done stairs?" and "Do they need help to get to the toilet, or at night?" Write the answers down.

4. Ask what equipment is needed and who delivers it

Equipment that turns up late is no use on the first night. Many people need a walking frame, a raised toilet seat, a commode (a portable toilet chair), a perching stool or a bed rail. Some items are given on the ward; others are delivered to the home by a separate service. Deliveries don't always match the discharge date.

Try this: Ask, "What equipment has been ordered, who is delivering it, and on what day?" Make sure someone is home to let them in.

5. Check whether a reablement or intermediate care referral has been made

Short-term support at home can make a real difference. Reablement and intermediate care are short-term services (often carers, therapists or nurses) that help someone regain everyday skills and confidence after hospital. Age UK's guide to intermediate care and reablement explains that in England this support normally lasts no longer than six weeks, can be shorter, and is free for up to six weeks. It is not automatic, though: your parent has to be assessed as needing it.

Try this: Ask, "Has a referral been made for reablement or intermediate care? Who is it with, and what day will they first visit?"

6. Set up the route from bed to bathroom

This is the walk your parent will do most, often at night and half asleep. Clear the path of rugs, wires, boxes and pet bowls. Make sure there is a light they can reach from bed, and consider a commode by the bed for the first few nights. Our room-by-room guide to assessing fall risks at home covers the rest of the house.

Try this: Walk the route yourself, in the dark, from your parent's side of the bed to the toilet. Move anything you trip over or have to step around, and add a plug-in night light.

7. Plan the first night

The first night is often the hardest. Your parent may be tired, sore and unsure. Decide now where they will sleep. If stairs are a struggle, a bed downstairs for a short time may be easier.

Try this: Agree who will be with your parent on night one. Leave water, glasses, a phone and any night-time medicines within easy reach of the bed.

8. Plan the journey home and getting in and out of the car

Cars are surprisingly hard after time in hospital. Seats are low and getting in means twisting and bending. After hip surgery, your parent may have been told how far to bend. Ask whether hospital transport is an option or whether you need to arrange it yourself.

Try this: Ask the ward physio to show you how your parent should get into a car. Push the front passenger seat right back, recline it a little, and put a plastic bag on the seat so they can swivel round more easily.

9. Write down who to call if things go wrong

In a worry, nobody remembers phone numbers. Before discharge, your parent should be given details of who to contact for advice after they leave.

Try this: Make one sheet with the ward number, the discharge team, the GP surgery, the community or reablement team, the pharmacy and NHS 111. Stick it on the fridge and take a photo for the family group chat.

10. Book the follow-ups

Recovery doesn't stop at the front door. Your parent may need a GP review, a blood test, a wound check, a clinic appointment or physiotherapy. Some are booked by the hospital; others you arrange yourself.

Try this: Ask the ward, "Which follow-up appointments have you booked, and which do we need to book ourselves?" Then put every date in one calendar.

What to do if things go wrong in the first 48 hours

Even with good planning, problems happen. Trust your instincts: you know your parent best.

Call 999 straight away if your parent:

• has chest pain or is struggling to breathe
• shows signs of a stroke: face drooping, arm weakness, or slurred or muddled speech
• collapses, can't be woken or has a fit
• has a fall with a serious injury, or can't get up and is in severe pain
• is bleeding heavily

Call NHS 111 (or use NHS 111 online) for urgent advice if your parent:

• is newly confused or much sleepier than usual (sudden confusion can be a sign of delirium, a short-term state often caused by infection, medicines or dehydration)
• has a high temperature, or feels hot and shivery
• has a wound that is red, hot, swollen, leaking or smelly
• has a painful, swollen calf, which can be a sign of a blood clot
• is not eating, drinking or passing urine as normal
• has pain that is not controlled by the medicines they were given

Contact the ward or discharge team if the planned care hasn't started, equipment hasn't arrived or you are unsure about the discharge medicines. Many hospitals also have a PALS service (Patient Advice and Liaison Service) that can help when you can't get answers. For questions about tablets, the GP or a community pharmacist can also help. Never change or stop a medicine without speaking to a health professional first.

When to arrange extra physiotherapy at home

NHS rehabilitation after hospital can be excellent, but it is often short. It may be worth arranging extra physiotherapy at home if:

• your parent is walking less or more unsteadily than they did on the ward
• they are scared to move or have stopped going upstairs
• they have had a fall or a near miss since coming home
• NHS support has ended but they are not back to how they were
• you are unsure which exercises are safe, or how much to help

A home visit means the physiotherapist sees the real stairs, the real bathroom and the real chair your parent struggles with. At Rehalign, our physiotherapists visit homes across the West Midlands, including Birmingham, Solihull, Walsall, Wolverhampton, Coventry, Dudley and Telford. If you are wondering what happens at that visit, read about what to expect at a first home visit assessment.

And please look after yourself too. Our guide to caring for a loved one at home has practical ideas to help you keep going.

Book a home physio visit