Going Home: Discharge Planning & Transition
Discharge Planning & Going Home
Preparing for discharge is an important part of your recovery. This guide will help you understand the discharge process and ensure a smooth transition home.
1. Doctor's Approval
Your doctor must write discharge orders confirming you are ready to go home
2. Medication Review
Pharmacist reviews your take-home medications and provides instructions
3. Discharge Instructions
Nurse reviews all care instructions, follow-up appointments, and warning signs
4. Final Preparations
Gather belongings, arrange transportation, and complete discharge paperwork
Important Tips
- Ask questions if anything is unclear
- Request a copy of all instructions
- Have a family member present during discharge teaching
- Keep all discharge papers in one safe place
What You Will Receive
- Written summary of your hospital stay and treatment
- List of new or changed medications with instructions
- Activity restrictions and guidelines
- Diet recommendations and restrictions
- Follow-up appointment information
- Warning signs to watch for
- Emergency contact numbers
Medication Tips
- Take medications exactly as prescribed
- Do not stop medications without consulting your doctor
- Use a pill organizer to stay organized
- Set reminders on your phone
- Keep an updated medication list with you
- Store medications safely and properly
Before You Leave
Scheduling Follow-up Appointments
- Primary care physician: Usually within 1-2 weeks
- Specialists: As recommended by your care team
- Lab work or tests: If ordered by your doctor
- Physical therapy: If prescribed for recovery
Before You Leave
- Schedule all recommended appointments
- Get contact information for all providers
- Understand what each appointment is for
- Ask about transportation if needed
At Home
- Keep a calendar of all appointments
- Prepare questions before each visit
- Bring all medications to appointments
- Do not skip follow-up appointments
Call 911 Immediately If You Experience:
- Chest pain or difficulty breathing
- Severe bleeding that will not stop
- Signs of stroke (face drooping, arm weakness, speech difficulty)
- Loss of consciousness or severe confusion
- Severe allergic reaction
Call Your Doctor If You Have:
- Fever over 101°F (38.3°C)
- Increasing pain that does not improve with medication
- Signs of infection (redness, swelling, drainage)
- Nausea/vomiting that prevents taking medications
- New or worsening symptoms
- Concerns about your medications
How Decisions Are Made
- Your care team will assess your medical needs and functional abilities
- Social workers help coordinate and arrange appropriate care
- Insurance coverage varies for different types of care
- Discharge planning begins early in your hospital stay
Home Health Care
Medical care provided in your own home by licensed healthcare professionals
- Nursing care and wound management
- Physical, occupational, or speech therapy
- Medication management and education
- Medical equipment and supplies
- Health aide services for daily activities
Skilled Nursing Facility (SNF)
Short-term rehabilitation and medical care in a specialized facility
- 24-hour skilled nursing care
- Intensive rehabilitation therapy
- Medical monitoring and management
- Medication administration
- Preparation for return home
Acute Rehabilitation Hospital
Intensive inpatient rehabilitation for patients recovering from serious illness or injury
- Intensive therapy 3+ hours per day
- Multidisciplinary team approach
- 24-hour rehabilitation nursing care
- Physical, occupational, and speech therapy
- Goal: maximum functional independence
Assisted Living Facility (ALF)
Long-term residential care for those who need help with daily activities
- Assistance with daily living activities
- Medication reminders and management
- Meals and housekeeping services
- Social activities and programs
- 24-hour staff availability
Hospice Care
Compassionate care focused on comfort, dignity, and quality of life for people with terminal illnesses