Discharge is fast, and everybody in the conversation is looking at the patient. Nobody is looking at the staircase.
Ask these before the date is set, not after.
1. What will they actually be able to do at home?
Not the diagnosis, the function. Can they climb stairs? Stand from a toilet? Step over a tub edge? Walk to a bathroom at night?
Ask the physical or occupational therapist rather than the doctor, because that is the assessment they do.
2. Has anybody assessed the house?
Usually not. A home assessment by an OT is the single most valuable thing in this process and it is frequently skipped for time.
If one is not happening, ask what they would want to know about the house, and answer it yourself with photographs and measurements.
3. What equipment is being ordered, and by when?
Portable equipment can fall inside Medicare’s durable medical equipment category and takes time to authorize. Anything fixed to the building generally does not, which is why a hospital bed is covered and the grab bar beside it is not.
Find out what is on order, what is not, and what the gap is. Our coverage guide explains the line.
4. Where will they sleep?
If the bedroom is upstairs and they cannot manage stairs, decide this now. The options are a downstairs room, a stairlift, or a readmission.
A straight stairlift is two to four hours in a single visit and can frequently be in before a discharge date.
5. How will they get to the bathroom at night?
The trip most people make half asleep, in the dark, several times a week. Lighting on that route, a clear path, and a grab bar at the toilet address most of it.
The CDC puts lighting near the top of what reduces fall risk, and this is why.
6. Who is doing the transfers, and have they been shown how?
If a spouse or an adult child is helping somebody stand several times a day, they need a gait belt and five minutes of instruction. Our transfer aids guide covers what belongs in the house.
7. What is the plan if it does not work?
Who to call, at what point, and what the threshold is. A plan that only covers success is not a plan.
What to have in the house before they arrive
- Grab bars at the toilet and the shower entry.
- A raised toilet seat or frame.
- A shower chair or transfer bench.
- A rollator, fitted so the handles reach the wrist crease.
- Night lighting on the route to the bathroom.
- A threshold ramp if there is a step at the door.
- Rugs removed.
Most of that ships free from our online shop and arrives faster than an appointment. Our room-by-room checklist is the walk-through to do while you wait.
Ask for the therapist’s notes
The physical and occupational therapy notes describe function in specific terms: how far they walked, with what, how many steps, how much assistance.
That is the most useful document you can hand a supplier or a builder, and families rarely think to ask for it.
Discharge dates move forward
Almost always forward rather than back. Start arranging the house when surgery is scheduled or admission happens, not when a date is given.
A straight stairlift can frequently be in within days subject to availability.
The readmission risk
The CDC reports falls as the leading cause of injury death for adults 65 and older, and the period immediately after a discharge is when somebody is weakest in a house that has not changed.
Most of what prevents that is cheap: lighting, rugs, a grab bar, a clear route to the bathroom. None of it needs authorization from anybody.
Who to ask for what
The discharge planner or case manager coordinates and knows what has been ordered. The physical therapist knows about walking and stairs. The occupational therapist knows about bathrooms, dressing and daily tasks. The physician signs what needs signing.
Asking the right person the right question saves days. Most families ask the doctor everything, and the doctor is the wrong person for five of these seven questions.
Write it down in the room
These conversations happen fast, frequently in a corridor, frequently when somebody is exhausted. Take the list, take notes, and read them back before leaving.
Our transfer aids guide and order of work between them cover most of what the house needs, and smaller equipment ships free from our online shop.
Ask about the follow-up too
Who is seeing them next, when, and what has been referred. Home health, outpatient therapy and a physician follow-up are frequently all arranged separately and any one of them can fall through.
Write down the names and numbers before leaving the building. Chasing a referral from home a week later is considerably harder than confirming it while somebody is still in front of you.
Ask for the discharge summary before you leave
Not the paperwork handed over at the door, the clinical summary. It lists diagnoses, medications with doses, what was changed, and what follow-up was arranged.
Two reasons it matters. Medications frequently change during an admission and the list at home is now wrong. And the follow-up arrangements are the thing most likely to fall through, because they were made by somebody who is now looking after a different patient.
Medication reconciliation
Sit down with the old list and the new one and identify every difference. Anything stopped, anything started, anything at a different dose.
Then take both to the pharmacist and ask specifically about dizziness, low blood pressure on standing, and sedation. Several common medicines cause falls, and the fortnight after a discharge is when somebody is weakest.
This is a free conversation and it prevents more harm than most equipment.
Who is coming to the house, and when
Home health, physical therapy, occupational therapy, a nurse. Get names, numbers and expected dates before leaving, and write them down.
If nobody is coming, ask why, because that is frequently an oversight rather than a decision.
The first 48 hours
The riskiest period. Somebody is in an unfamiliar version of their own house, weaker than they were, on different medication, frequently alone at night for the first time.
Plan for somebody to stay if at all possible, or arrange checks. Make sure a phone is on them rather than across the room. Leave a light on.
What to do if it is not working
Agree the threshold in advance: what would mean calling the doctor, what would mean calling an ambulance, and who makes that call.
Families frequently wait too long because nobody wants to overreact. A threshold agreed in daylight removes that hesitation. Our falls guide covers the specific one most likely to come up.