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Leaving the Hospital

Your care doesn't end when you are discharged from the hospital. Whether your recovery continues at home, or in a rehabilitation facility, it is the hospital's and your doctors' responsibility to adequately prepare you.

Your Doctors. Before leaving the hospital, ask your doctors what to expect during the course of your recovery. This includes both your treating physician and your primary care doctor if he or she will again oversee your care during recuperation. Be sure to write down any questions you have for the doctors as they occur to you and ask these questions when you talk with them. If possible, the family or friend who will spend the most time with you during your recovery should be with you during these discussions.

Among the matters your doctors should explain to you are:

• What to expect, over what time-period, with regard to your condition and to your recovery from surgery or other hospital procedure or treatment.
• If you had surgery, what steps are involved in wound (incision-site) care.
• Whether you should limit physical activity and/or whether you need to do specific exercises.
• What warning signs or symptoms you should look for regarding complications or set-backs, and what to do if they occur.
• What medications you will be taking, their dosages, purposes, and side-effects.
• Whether there are any restrictions about what you can eat.
• Whether you will need any medical equipment, and, if so, how to use it.
• What assistance you may need during the course of recovery, where you can receive it, and who should provide it.
• What follow-up examinations and tests you might need, and how often you will need to see each treating doctor.

For a full discussion of the matters you need to discuss with your doctors, read Speak Up: Planning Your Follow Up Care, a brochure published by the nonprofit Joint Commission on Accreditation of Healthcare Organizations.

The Discharge Planner. Most hospitals have a specially trained discharge planner. This planner consults with your treating physician to prepare a written "discharge plan" for your care after you leave the hospital. The discharge planner also explains the plan to you, helps to arrange the support you may need to follow the plan, and shows you how to perform the tasks you will handle yourself.

Assessing Your Needs. Before your discharge, the discharge planner talks with your doctors about your condition and recovery. The planner also speaks with you and your spokesperson about where you will be during your recovery and who will be helping you. From these discussions, the discharge planner determines whether you need to be placed in a nursing or other rehabilitation facility, or if you can be cared for at home. The discharge planner also determines whether you will need visiting nurses or therapists, medical equipment, or a comprehensive home care service to help with bathing, dressing, and other care needs. Once those needs are determined, the discharge planner can make the arrangements for these facilities or services. Most discharge planners are very busy and must find placements quickly for patients who need care in nursing homes or other rehabilitation facilities. It pays to do your own research on the quality of any facility you are asked to use. For quality of care ratings of long-term-care facilities, visit California Nursing Home Search.

The Written Discharge Plan. After the assessment is completed, the discharge planner will write up a discharge plan that outlines the details of your follow-up care, including:

• A list of the medications you are to take, and their dosage;
• A description of the medical equipment you require;
• Continuing wound care or other treatments you need;
• Limitations on diet, movement, or other activities;
• Follow-up therapy and doctor visits that are or should be scheduled; and
• Determining which outside agencies, if any, will help with your care, and what their responsibilities are to be.

You are given a copy of the discharge plan, which you should keep available at home. Copies are also given to your treating physician and to any facility or service arranged by the discharge planner.

Instructions About Care at Home. The discharge planner will arrange to have a nurse or hospital technician demonstrate the safe and proper treatment of your wounds, if any, and the use and handling of catheters, intravenous ports, and medical equipment. The planner may also have a nurse or technician instruct you on safe ways of getting in and out of bed and chair, and bathing. The planner should also have a nurse go over with you the medications you will be taking at home, and their potential side effects and interactions with other drugs.