A Practical Guide to Getting the Information You Need Before Discharge

When your loved one is leaving the hospital, it can feel like everything is happening at once.

You may receive paperwork, prescriptions, instructions, follow-up appointments, and information about your loved one’s condition—all while trying to figure out how you are going to manage everything once you get home.

Don’t be afraid to ask questions.

You have an important role in helping your loved one understand and follow their care plan after discharge. The Agency for Healthcare Research and Quality (AHRQ) recommends involving patients and families in discharge planning and focusing on five key areas: what life will be like at home, medications, warning signs, test results, and follow-up appointments.

Use this guide to help you prepare.

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Start With These 10 Questions

If you only have a few minutes with the healthcare team, start here:

1. What exactly was my loved one’s diagnosis?

Ask the healthcare provider to explain the diagnosis in plain language.

“Can you explain what happened and what we need to know going forward?”

Make sure you understand what has been treated and what still needs attention.

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2. What medications should my loved one take now?

Don’t assume the medication list is the same as before hospitalization.

Ask:

• Which medications should they take?
• Which medications were stopped?
• Which medications changed?
• What dose should they take?
• How often should each medication be taken?
• What is each medication for?
• What side effects should we watch for?
• Are there medications, vitamins, supplements, or foods they should avoid?

AHRQ recommends reviewing the medication list with the patient and family and explaining what each medication is for, how much to take, how to take it, and potential side effects.

If something doesn’t match the medication list from home, ask why.

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3. What symptoms should we watch for?

Ask specifically:

“What warning signs should we watch for after we get home?”

Also ask:

• What symptoms are expected?
• What symptoms are concerning?
• What should we do if symptoms get worse?
• Who should we call?
• When should we seek urgent or emergency care?

AHRQ’s discharge-planning guidance recommends identifying warning signs and providing clear instructions about who to contact if problems occur.

Don’t rely on a generic internet symptom list. Ask what is important for your loved one’s specific condition.

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Questions About Follow-Up Care

4. Who does my loved one need to see after discharge?

Ask:

• Does my loved one need to see their primary care provider?
• Do they need a specialist?
• How soon should the appointment occur?
• Who is responsible for scheduling it?
• Do we need laboratory work before the appointment?
• Is additional imaging needed?
• Does the provider know about the hospitalization?

AHRQ recommends making follow-up appointments clear and ensuring patients and families understand what follow-up care is needed.

Write it down:

Provider: __________________________

Date: _____________________________

Time: _____________________________

Location: __________________________

Phone: ____________________________

Reason for appointment: ______________

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Questions About Test Results

5. Are any test results still pending?

This is an important question that can easily be overlooked.

Ask:

“Are there any tests or results that haven’t come back yet?”

Then ask:

• What test is pending?
• When should we expect the result?
• Who will receive the result?
• Who will explain the result to us?
• Who should we call if we don’t hear anything?

AHRQ’s IDEAL discharge-planning framework specifically recommends explaining test results and identifying who should be contacted if results are still pending at discharge.

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Questions About Care at Home

6. What will my loved one need help with?

Ask what your loved one will be able to do independently and where they will need assistance.

You may need to ask about:

• Walking
• Bathing
• Dressing
• Toileting
• Eating
• Preparing meals
• Taking medications
• Wound care
• Using medical equipment
• Getting in and out of bed
• Transportation
• Household activities

Then ask:

“What happens if we cannot safely provide this care at home?”

This is an especially important question for family caregivers.

Illinois’ Department on Aging notes that transitions from a hospital to home or another care setting can be overwhelming for caregivers and provides resources for planning these transitions.

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Questions About Home Health and Other Services

7. Does my loved one need services after discharge?

Ask whether they need:

• Home health
• Skilled nursing
• Physical therapy
• Occupational therapy
• Speech therapy
• Personal care assistance
• Social services
• Other community resources

Then ask:

“Has this service been ordered, and when will it begin?”

Don’t assume that simply discussing a service means it has been arranged.

Find out:

Who is responsible for arranging it?

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Questions About Medical Equipment

8. Does my loved one need equipment at home?

Depending on the situation, equipment may include:

• Walker
• Wheelchair
• Hospital bed
• Shower chair
• Commode
• Oxygen
• Other medical supplies

Ask:

• What equipment is needed?
• Has it been ordered?
• When will it arrive?
• Who delivers it?
• How do we use it?
• Do we need training?
• Who do we contact if there is a problem?

Illinois’ Department on Aging provides caregiver resources regarding durable medical equipment and transitions from hospital to home.

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Questions About Activity and Diet

9. What can my loved one safely do at home?

Ask:

• Can they walk normally?
• Are there lifting restrictions?
• Can they drive?
• Can they climb stairs?
• Are there bathing restrictions?
• Do they need assistance walking?
• What activities should they avoid?
• When can normal activities resume?

Also ask:

“Are there any dietary restrictions?”

Make sure you understand whether your loved one needs a special diet, fluid restriction, or other nutritional instructions.

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Questions About Who to Call

10. Who do we contact if we have a problem?

Before leaving the hospital, write down the names and phone numbers of the appropriate contacts.

Ask:

“Who should we call first if we have a question after discharge?”

Also ask:

“Who do we call after normal office hours?”

Keep contact information somewhere easy to find.

AHRQ’s discharge materials recommend ensuring patients and caregivers know whom to contact with questions or problems after leaving the hospital.

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Questions Caregivers Should Ask About Medications

Medication changes are one of the most important parts of a hospital transition.

Ask:

☐ What medications should my loved one take?

☐ Which medications were stopped?

☐ Which medications changed?

☐ What is each medication for?

☐ How much should be taken?

☐ When should it be taken?

☐ Should it be taken with food?

☐ What side effects should we watch for?

☐ Can any medications interact with one another?

☐ What about vitamins and supplements?

☐ What about over-the-counter medications?

☐ Where do we get the prescriptions?

☐ Does my loved one need a medication refill?

AHRQ recommends reviewing prescription medications as well as over-the-counter medicines, vitamins, supplements, and other products during medication review.

If your loved one takes multiple medications

Ask whether a medication review or medication reconciliation should be completed.

This can be particularly important for older adults taking multiple prescriptions.

For more information, see:

[Polypharmacy: What Patients and Caregivers Need to Know]

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Questions About the Actual Discharge Plan

Ask:

“Where exactly is my loved one going after discharge?”

Is the plan:

• Home?
• Rehabilitation?
• Skilled nursing?
• Assisted living?
• Another healthcare facility?

Then ask:

“What needs to be in place before they leave?”

This might include medications, equipment, transportation, home services, caregiver support, or follow-up appointments.

CMS provides a discharge-planning checklist specifically for patients and caregivers preparing to leave a hospital, nursing home, or other care setting.

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What If I Don’t Think My Loved One Is Ready to Go Home?

If you’re worried, speak up before discharge whenever possible.

Don’t simply say:

“I don’t think Mom is ready.”

Explain why.

For example:

“She cannot safely walk to the bathroom without assistance.”

“She cannot manage her medications independently.”

“I work during the day and cannot provide this level of care.”

“There is no one available to help with bathing.”

“We don’t have the equipment needed at home.”

Specific information helps the healthcare team understand the problem.

Ask:

“What alternatives are available if home is not safe or realistic?”

You can also ask to speak with the appropriate hospital professional involved in discharge planning, such as a case manager or social worker.

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Don’t Be Afraid to Ask for an Explanation

Medical terminology can make an already stressful situation even more confusing.

You can say:

“I’m not familiar with that medical term. Can you explain what it means?”

or:

“Can you explain that in plain language?”

You are not expected to know every medical term.

AHRQ recommends communicating discharge information in plain language and using teach-back to make sure patients and families understand the care plan.

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Use the Teach-Back Method

One of the best ways to identify confusion is to explain the plan back to the healthcare team.

You might say:

“I want to make sure I understand this correctly. Can I explain the plan back to you?”

Then explain:

• The diagnosis
• The medications
• Follow-up appointments
• Home care
• Warning signs
• Who to contact

If something is incorrect or unclear, ask for clarification.

This isn’t a test.

It’s a safety tool.

AHRQ specifically recommends teach-back as part of effective discharge communication.

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Write Everything Down

Discharge day is not the time to rely on memory.

Keep one notebook, folder, or electronic document containing:

Medical Information

• Diagnosis
• Procedures
• Important test results
• Pending tests

Medication Information

• Medication name
• Dose
• Time
• Reason for medication
• Changes from previous medications

Appointments

• Provider
• Date
• Time
• Location
• Phone number

Contacts

• Primary care provider
• Specialists
• Hospital contact
• Home health
• Pharmacy
• Equipment provider

Care Instructions

• Diet
• Activity
• Wound care
• Equipment
• Warning signs

AHRQ’s patient discharge guide is designed to help patients track medications, appointments, important phone numbers, and other information after leaving the hospital.

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Your Quick Hospital Discharge Question List

If you’re standing at the hospital and need a quick reference, ask:

☐ What is my loved one’s diagnosis?

☐ What treatment was provided?

☐ What medications should they take?

☐ Which medications changed or stopped?

☐ What is each medication for?

☐ What side effects should we watch for?

☐ Are any test results still pending?

☐ Who will follow up on those results?

☐ What symptoms should concern us?

☐ When should we seek emergency care?

☐ Who should we call with questions?

☐ Who do we call after hours?

☐ When are the follow-up appointments?

☐ Who is responsible for scheduling them?

☐ Does my loved one need home health?

☐ Does my loved one need therapy?

☐ Does my loved one need medical equipment?

☐ What will my loved one need help with at home?

☐ What activities or foods should be avoided?

☐ What does the caregiver need to know?

☐ Can I explain the discharge plan back to you?

☐ Do I have written instructions and contact information?

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Remember: Discharge Is a Transition, Not Just an Exit

Leaving the hospital is only one step in your loved one’s healthcare journey.

The transition home—or to rehabilitation, skilled nursing, assisted living, or another care setting—can involve multiple providers, medications, services, appointments, and decisions.

Good questions can help you feel more prepared.

And you don’t have to ask them alone.

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How a Patient Advocate Can Help

A patient advocate can help patients and families organize questions, understand healthcare information, prepare for appointments, communicate concerns, and navigate complicated transitions of care.

At Our Father Patient Advocacy, we help patients and families better understand, organize, and navigate their healthcare.

Depending on your situation, services may include:

• Hospital discharge preparation
• Healthcare navigation
• Care coordination
• Appointment preparation
• Medical record organization
• Medication information organization
• Caregiver support
• Provider communication support
• Healthcare education

Our role is not to replace your healthcare providers or make medical decisions for you. We help you become a more informed and organized participant in your healthcare.

Need Help Navigating a Hospital Transition?

Visit ourfatherpa.org and use the Contact Form to tell us about your situation.

You can also send us a message 815-912-0202.

You don’t have to navigate healthcare alone. You deserve an advocate.

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More Caregiver & Hospital Transition Resources

Continue learning:

[Hospital Discharge Checklist for Family Caregivers]
A practical checklist of what to know, ask, and organize before your loved one leaves the hospital.

[What to Do When Your Parent Comes Home From the Hospital]
Important steps for the first days after your loved one returns home.

[How to Prepare for a Hospital Discharge]
How caregivers can begin preparing before discharge day.

[What If I Don’t Think My Loved One Is Ready to Leave the Hospital?]
What caregivers should consider when they have concerns about a safe transition.

[Hospital to Home: A Caregiver’s Guide]
Understanding the transition from hospital care to home care.

[What Is a Safe Hospital Discharge?]
Understanding the components of a well-planned discharge.

[How a Patient Advocate Can Help With Hospital Discharge]
How advocacy may help families navigate a complicated hospital transition.

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References & Resources

Important: The information on this page is for educational purposes and does not replace individualized medical advice from a qualified healthcare professional. In an emergency, call 911 or seek emergency medical care.