Questions to ask before hospital discharge

Discharge tends to be announced rather than planned. Somebody says she can go home tomorrow, and the questions you needed to ask occur to you in the car park.

This is the list to take in with you. Ask the clinical questions of the treating team and the practical ones of the ward social worker or discharge planner. Ask early, because most of these take a day or two to act on.

This is general information, not medical or financial advice. Anything specific to the person belongs with their treating team, their GP and My Aged Care.

About the discharge itself

• What has actually changed since they came in?
• What are they able to do independently now, and what can they not do?
• Is this expected to improve, stay as it is, or keep declining?
• Is there anything they should not do at home, and for how long?
• Who decides they are ready to go, and has anyone assessed the home?
• What would make you delay this discharge?

About medications

• Which medications have been started, stopped or changed?
• Is there an up-to-date list, and will the GP get a copy?
• Should any of the old packets at home be thrown out?
• What is each new one for, and what should we watch for?
• Who writes the next script, and when does the current supply run out?
• Would a pharmacy blister pack make this safer?

About getting around

• Can they manage stairs, and a step up to a front door?
• Can they get on and off a toilet and in and out of a shower unaided?
• Is any equipment needed, who supplies it, and when does it arrive?
• Has a physiotherapist or occupational therapist seen them?
• Is there anything at home that now needs moving, raising or removing?

Take our home safety checklist home with you and do the walk-through before the car arrives, not after.

About washing, dressing and eating

• Will they need help showering, and for roughly how long?
• Can they dress themselves, including shoes and socks?
• Are there any changes to what they should eat or drink?
• Can they prepare a meal safely, including using the stove?
• Has their appetite changed, and should anyone be tracking weight?

About follow-up

• Which appointments are needed, by when, and who books them?
• Is the GP expecting them, and how soon should they be seen?
• Are any tests or scans still outstanding?
• What are the warning signs that should trigger a phone call?
• Who exactly do we ring after hours, and is there a number for the ward?

About help at home

• Is there anyone at home overnight, and does that matter here?
• What help do you think is needed in the first two weeks?
• Can the hospital start a My Aged Care referral before we leave?
• Is short-term restorative care appropriate, and who arranges it?
• Is a community nurse visiting, and for what?
• What happens if the family cannot cover the first fortnight?

If a Support at Home arrangement already exists, ring the provider from the ward rather than after discharge. Support can often be increased quickly. Our post-hospital support page explains what that looks like on our side, and the companion guide, coming home from hospital, covers the fortnight itself.

About cost

• Is anything being arranged that we will be charged for?
• Is any of this time limited, and what happens when it ends?
• Who do we speak to about aged care costs?

Do not accept an estimate from anyone in the corridor. Aged care contributions are means tested and change, so get the figures for your own circumstances from myagedcare.gov.au or 1800 200 422. Our funding pillar explains how the assessment and the contributions fit together.

What to leave with

Ask for all of it in writing, and check you have it before you leave the ward.

• The discharge summary, including the current medication list
• A copy going to the GP as well as to you
• Follow-up appointments, with dates or with who is booking them
• Instructions for any wound, dressing or equipment
• A phone number to ring if something changes
• The name of the discharge planner or social worker you dealt with

Two things worth saying out loud

Say who is actually going to be there. Discharge planning often assumes a family that is more available than it is. “I work full time and I live forty minutes away” changes the plan, and it is not a failure to say it.

Say it early if home is not safe yet. A discharge that cannot work is much easier to change three days out than on the morning. Be specific about why, because “I am worried” moves nobody and “she cannot get up the back step and there is no one there at night” moves everyone.

If a discharge is coming and you would rather talk it through with someone, get in touch. A real person answers.