The stay may have been overnight, a week or much longer but there is something refreshing about finally going home. However, your feelings of relief at leaving the hospital may be mingled with uncertainty about how to care for your loved one without the help of professionals 24/7. The right follow-up care is essential.

The best way to prevent re-admission after a hospital stay begins with one simple piece of paper called a discharge plan.

Understanding the Discharge Plan

Every patient should receive written discharge instructions before being allowed to leave the hospital. There should be some standard components to a hospital discharge summary according to The Joint Commission, an independent, not-for-profit organization certifying nearly 21,000 health care agencies in this country,

  1. Reason for hospitalization.
  2. Significant findings.
  3. Procedures and treatment provided.
  4. Patient’s discharge condition.
  5. Patient and family instructions (as appropriate).
  6. Attending physician’s signature.1 It’s more than likely you know why the hospitalization was needed and the name of the doctor caring for your loved one. Hopefully you have had the treatment provided and the diagnosis fully explained. Numbers 4 and 5 are the most essential to your loved one’s continued improvement: the condition and follow up instructions.
    1. Understand the discharge plan. A variety of items are on a discharge plan: follow-up appointments, dressing changes, eating or drinking restrictions, if the person may be left alone or a host of other instructions. It is vital to fully understand “what next” directions.
    2. Be an advocate. This is the time for you to advocate for your loved one. Ask questions about directions or information you do not understand. Remember to allow time to completely comprehend all instructions.
    3. All questions are appropriate. Sometimes a language barrier creates confusion about after-care. Request a translator to have instructions rephrased. Ask for clarification of medical terminology. It is important you understand the best way to care for your loved one after leaving the hospital.
    4. Verify follow-up appointments. Check to see if follow-up appointments have already been scheduled or if you need to do the scheduling. In some instances, the hospital staff will take care of follow-up appointments. Know the dates, places, times and names of health care providers. For example, do stitches need to be removed? When? Does a follow-up test need to be performed to ensure improvement? When? Is physical or occupational therapy needed? When? Where? Why?
    5. Inquire about home health care. If your loved one is going to need home visits from a care provider, this should be arranged before leaving the hospital. The social workers will have recommendations for local care agencies to contact regarding any services you may need now or in the future.
    6. Take your medicine. If the cost of your prescriptions are prohibitive discuss options with your MD or pharmacist. Low cost drug programs are available. Many seniors have Medicare D to supplement the cost. Fully understanding and executing follow-up care instructions is the key to continued health after a hospital stay. Knowing appointments and services needed streamlines recovery. Being pro-active will help you or your loved one recover and be on the path to better health and well-being. Remember – Knowledge is power.


1 http://www.ahrq.gov/downloads/pub/advances2/vol2/advances-kind_31.pdf