A Family's Hospital Discharge Checklist

Discharge day goes smoothly when the questions are asked before it — not in the car park afterwards. This checklist covers the five stages families actually face: what to get from the hospital before discharge, deciding where your parent goes next, the journey itself, the first 72 hours, and who to call when something isn't right. Work through it while your parent is still on the ward, when the people with the answers are a corridor away.

A hospital discharge checklist is the set of questions and documents a family secures before an older person leaves hospital — discharge summary, medication list, follow-up plan, functional limits and red-flag symptoms — so that care continues seamlessly wherever the person goes next.

Before discharge day: what to get from the hospital

Ask the ward, the treating doctor, or the hospital's discharge planner or case manager:

• The written discharge summary. Diagnoses, what was done, medication on discharge, and the follow-up plan. Ask for a copy in your hand, not just one "sent to the GP".
• The complete medication list — with changes explained. Which medicines are new, which old ones have stopped or changed dose, and why. Hospital admissions frequently reshuffle medication, and the old pillbox at home is now wrong. Ask for enough supply, or scripts, to bridge until a pharmacy visit.
• All follow-up appointments. Which specialists, when, and who books them — the hospital or you. Write them down before you leave.
• What your parent can and can't do unaided. Get specifics, ideally from the physiotherapist or nursing staff: Can she walk to the bathroom alone? Manage stairs? Bath or shower without help? Be alone at night? This single answer drives the destination decision below.
• The red-flag symptoms. For this admission, what should make you phone a doctor, and what should send you straight back to hospital? Ask for them plainly and write them down.
• Any equipment or wound care needs. Walker, commode, dressings — and who is supposed to change dressings after discharge.
• Medical aid loose ends. If a case manager was involved, confirm any authorisations for step-down care, rehab or home nursing are in place before discharge day.

The destination decision

The honest question is not "do we want him home?" — everyone does — but "can he manage what home demands, today?" Set the hospital's can/can't-do-unaided answer against the reality of the house: stairs, the bath, cooking, nights alone. If they match, home it is, with the preparations below. If they don't, going straight home is the option most likely to end in readmission, and a bridge is needed: a step-down or sub-acute facility, a rehabilitation unit, a short respite stay in an assisted-living home, or serious home-care support. Our guide to step-down care options after hospital compares them; if the discharge date is close and nothing is arranged, see short-notice placement — and note that a care home's assessment can often happen while your parent is still on the ward.

If home is the destination, prepare it before arrival, not after:

• Clear walking routes; loose rugs up; a lamp reachable from the bed.
• Essentials — phone, water, medication — within reach of where they'll actually sit and sleep.
• A first shop done: easy meals, plenty to drink.
• Any equipment (walker, raised toilet seat, commode) delivered and in place.
• A plan for nights: who is in the house, or how help is summoned.

Discharge day and the journey

• Confirm the discharge time that morning — and expect it to slip; bring patience and water.
• Collect, physically: the discharge summary, medication (checked against the list, item by item), scripts, sick notes, and any personal belongings and valuables handed in on admission.
• Plan the transport soberly. An ordinary car is fine for most people, but consider how they'll get into it, and out at the far end — and up whatever steps await. If they cannot safely transfer into a car, ask the ward about ambulance or medical transport rather than improvising.
• Have someone at the destination before they arrive — lights on, bed made, kettle ready. Arriving to an empty, cold house undoes a lot of good recovery.
• Timing matters: a morning discharge gives you a full day of open pharmacies and reachable doctors. Avoid arriving home at 8 pm on a Friday if you can.

The first 72 hours

Most post-discharge problems show themselves in the first three days. The watch-list:

• Medication, exactly as per the new list. Set up the week's pillbox from the discharge list — not from the old boxes in the cupboard. If anything is confusing, phone the pharmacist; that is what they are for.
• Food and fluids. Appetite is often poor after hospital. Small, frequent meals and constant fluids beat grand cooked dinners. Watch that drinking actually happens — dehydration sneaks up quickly and looks like confusion.
• Movement, with someone nearby. Encourage gentle moving about — recovery needs it — but shadow the risky moments: getting up from bed or chair, the bathroom, the first bath or shower, and anything at night.
• Watch for the red flags. The list the hospital gave you, plus the universal ones: new or worsening confusion, fever, a fall, breathlessness, chest pain, a wound that becomes red, swollen or oozing, or simply "much less themselves" than yesterday.
• Book the follow-ups now. GP within the first week or two is wise even when not instructed; specialist appointments as directed. Booked, in the diary, with transport figured out.
• Watch the carer too. If one family member is carrying the recovery, the first 72 hours will show it. Relieve them early — before exhaustion, not after.

Questions families actually ask

What should I ask the hospital before an older parent is discharged? Ask for the written discharge summary, the complete medication list with any changes explained, all follow-up appointments and who books them, a plain-language account of what your parent can and cannot do unaided, and the specific red-flag symptoms that should trigger a call or a return to hospital.

What is a hospital discharge summary and why does it matter? The discharge summary is the written record of the admission: diagnoses, treatment, medication on discharge and the follow-up plan. It is what the GP, a step-down facility or a care home works from — without it, everyone after the hospital is guessing. Ask for a copy before you leave the ward.

What are the most important things in the first 72 hours after hospital discharge? Medication taken exactly as per the new list, proper meals and fluids, safe movement with someone nearby (especially at night and to the bathroom), watching for the red-flag symptoms the hospital named, and making sure follow-up appointments are actually booked. Most early problems appear in these first days.

Who do I call if something goes wrong after discharge? For emergencies — chest pain, sudden confusion, a fall with injury, trouble breathing — call an ambulance or go straight to the emergency department. For worrying-but-not-emergency changes, call the GP, or the ward or treating specialist's rooms if the concern relates directly to the admission. Decide these numbers in advance and put them on the fridge.

Who to call when something's wrong

Decide this before you need it, and put the numbers on the fridge:

• Emergency — call an ambulance or go to the emergency department: chest pain, difficulty breathing, sudden weakness or slurred speech, a fall with injury or where they can't get up, uncontrolled bleeding, or sudden severe confusion.
• Same-day call to the GP (or the treating specialist's rooms, if it's clearly about the admission): fever, worsening pain, wound trouble, new confusion that isn't sudden or severe, not eating or drinking, or your own strong sense that something is off. That instinct is data — say it plainly: "She was in hospital until Tuesday and she's not right."
• The pharmacist: for any medication muddle — doubled-up medicines, missed doses, side effects. Faster than a doctor's appointment and often exactly the right person.

If recovery at home isn't working — the help needed is simply more than the household can give — that is information, not failure. A respite recovery stay can still be arranged after discharge, not only before it: you can phone +27 63 583 2543 to ask about current availability at Dayspring Gardens, or arrange a visit or ask about availability online. And when the immediate recovery settles and longer-term questions remain, the Choosing Senior Care guide will help you take them one at a time.