The hospital discharge checklist for elderly parents

This is the checklist we wish every hospital handed out. It is organised by when things need to happen, because a discharge is not a moment, it is a month. Print it, or copy it into a shared note the whole family can see and tick off.

• Discharge summary requested, and confirmed to be going to the primary care doctor.
• One reconciled medication list in hand: new, changed, stopped, and everything she was already taking. Discrepancies raised with the nurse or doctor before leaving.
• Prescriptions sent to a pharmacy that has them in stock and is open when you get there. Ask whether the hospital can dispense the first doses.
• Follow-up appointments booked, with dates, times and addresses, especially anything within 7 to 14 days. Phone numbers for any that still need booking.
• Home health: agency name and number, confirmation they received the referral, expected first visit date.
• Equipment: what, from which supplier, delivered when. Ask what to do if it does not arrive.
• Warning signs written down, split into “call the doctor” and “call 911”.
• After-hours phone number that will be answered.
• Diet and activity restrictions, in writing.
• Inpatient versus observation status confirmed; if a skilled nursing facility is planned, confirm the qualifying stay.
• Transport home arranged. Ambulance or wheelchair van if needed; a car if she can transfer safely.
• Someone at the house for at least the first night, and ideally the first 48 hours.

• Equipment in place before she arrives, or arriving the same day. A hospital bed set up. A commode in reach.
• First-night medications sorted into a pill organiser, with the list beside it.
• Food in the house that fits any diet restrictions, and something easy for tonight.
• A clear path from the door to the bed to the bathroom. Rugs up. Lights on.
• Phone charged and within reach. Emergency numbers on the fridge.
• The discharge folder in one place, and a photo of the medication list on your phone.

• Home health has called and the first visit is scheduled. If not, call them, then call the hospital case manager.
• Every piece of equipment has arrived and works. If not, call the supplier, then the case manager.
• Pills in the house match the list. Anything extra or missing raised with the pharmacist or doctor.
• Primary care office called to confirm they have the summary and to book or confirm the follow-up.
• The first specialist follow-up confirmed.
• She is eating, drinking, urinating and moving roughly as expected for her condition. Anything not, called in.
• The family knows who is doing what for the next week.

• Every follow-up appointment kept, or rescheduled the same day if missed.
• Condition-specific monitoring in place: daily weights for heart failure, blood sugar for diabetes, breathing and sputum for COPD, wound checks after surgery.
• Home health visits happening as planned, and the family knows what the nurse or therapist is seeing.
• New symptoms called in early. The rule in the first month is call when unsure.
• Medications reviewed again at the first follow-up, because the hospital list and the doctor’s plan may differ.
• The caregiver has slept, eaten and had at least one conversation about something else.