Care at Home After a Hospital Discharge: What to Arrange and When

Hospital discharge is one of the most disorientating moments a family goes through. Your parent went in with a fall or an infection, and now they are coming home on Thursday. You have a bag of medication, a leaflet, and a strong sense that everyone else thinks this is fine.

The first couple of weeks at home matter a great deal. Going back into hospital is common, and a lot of it is avoidable with the right support in place from day one.

Before they leave the ward

Ask for the discharge plan in writing. You are entitled to know what support has been arranged, who is providing it and when it starts. "Someone will be in touch" is not a plan.

Ask about the medication. What has changed, what has stopped, what is new and what each new medicine is for. Medication changes during a hospital stay are one of the most common sources of problems afterwards.

Ask about reablement. Many areas provide short-term support at home after discharge to help people regain independence. In England this is free for up to six weeks. It is not always offered unless you ask.

Ask whether a care needs assessment is needed. If your parent's needs have changed, they should be assessed. Our guide to council funding for care at home explains how that works.

Ask about NHS Continuing Healthcare. If your parent has significant, ongoing health needs, ask for a Continuing Healthcare checklist. It is not means-tested and can fund care in full. Discharge is exactly when it should be raised, and it is often missed. Our guide to NHS Continuing Healthcare explains it.

Say so if the house is not ready. Stairs they cannot manage, a bed in the wrong place, no rails in the bathroom. Say it clearly before discharge, not after.

What free support covers, and what it does not

Reablement is valuable, but families often assume it covers more than it does.

It is short-term and focused on helping your parent do things for themselves again. Visits are often brief. It may not start on the day your parent gets home, and it ends after a set period. It does not usually cover company, help around the house, or someone noticing if things start to slip.

That is why many families arrange private care at home alongside reablement, or straight after it ends, rather than waiting for a gap to appear.

Arranging care at home

The help needed in the first fortnight is often more than the help needed a month later, and families frequently get this the wrong way round, arranging a small amount of support that stays the same.

It usually works better to put more support in at the start and reduce it as your parent recovers. In the first week or two, that typically means help with washing and dressing, making sure meals are eaten and drinks are taken, keeping on top of medication, and someone noticing early if something is wrong.

After a major operation or a bad fall, a short period of live-in care, perhaps two or three weeks, often does more good than months of visits and helps people get properly back on their feet. Our page on care after an operation explains the kinds of help available.

If your parent has a particular condition, such as dementia or a stroke, mention it when you arrange care, so the carer can be someone with the right experience.

If your parent has a discharge date, tell us now rather than on the day. Request a callback and we will be straight with you about what we can arrange and how quickly.

Getting the house ready

Usually a day or two of work.

Sort out where they will sleep. If stairs are a problem, a bed downstairs for a while is better than a struggle twice a day.

Clear the routes. Rugs, trailing cables, clutter on the stairs. Most falls at home happen on familiar ground.

Light the way to the bathroom. Night-time trips are when a lot of falls happen. Plug-in night lights cost very little.

Put essentials within reach. Phone, water, glasses, remote control.

Stock the kitchen. Food for the first few days that needs no effort to prepare.

Put the heating on before they arrive. Coming home to a cold house after a warm ward is genuinely risky for someone frail.

The first 48 hours

This is when problems start, usually quietly.

Check the medication. Compare what came home with what your parent was taking before. If anything looks contradictory, ring the GP surgery or a pharmacist. Do not assume someone else has checked.

Watch for new confusion. Confusion after a hospital stay is common and it is not automatically dementia. It can be caused by infection, dehydration or medication, and it needs a GP the same day. Our guide to sudden confusion in an older parent explains what to look for.

Make sure they are drinking. Dehydration is a common reason people end up back in hospital, and it creeps up unnoticed.

Expect them to be weaker. A week in a hospital bed costs a lot of muscle strength at eighty. Independence comes back gradually.

When to ring the GP, 111 or 999

GP the same day: new confusion, a wound that looks red or is weeping, not eating or drinking, a raised temperature, worsening pain, or sudden swelling in one leg.

999: chest pain, difficulty breathing, signs of a stroke, a fall with a suspected broken bone, or if your parent is hard to wake.

If you are unsure, 111 is there for exactly this.

Questions families often ask

Can we refuse a discharge if we do not think it is safe?

You cannot make a hospital keep someone, but you can and should raise concerns formally. Ask to speak to the discharge coordinator or ward manager, and put your concerns in writing. Hospitals must make sure a discharge is safe.

Who pays for care after my parent leaves hospital?

Reablement is free for up to six weeks. After that, the usual council financial assessment applies, unless your parent qualifies for NHS Continuing Healthcare. Many families pay privately for extra support alongside what is provided.

Can care start the day my parent comes home?

Sometimes, if it is arranged in advance. The earlier you tell a provider the discharge date, the better the chance of having the right person in place from the first day.

How long does recovery usually take?

Longer than most families expect, particularly after a fall or an operation. Think in weeks rather than days, and in months after a hip fracture. Reviewing the level of support every couple of weeks helps.

Getting support in place

We are often contacted while someone is still on the ward, and that is the right time to call. Our guide to emergency home care covers what happens when things are urgent, and our guide to arranging care after an operation covers planned stays.

Call 01225 63 77 19, request a callback, or read how Gladys works first.