Hospital Discharge for Seniors

As a caregiver, you need to understand the prognosis, medications the senior takes, hospital discharge instructions, and symptoms to watch for.

Studies have found that 40 percent of patients over 65 had medication errors after leaving the hospital. Eighteen percent of Medicare patients discharged from a hospital are readmitted within 30 days.

Such occurrences could be prevented if an older patient is well prepared for hospital discharge.

When a senior is released from the hospital it means they are well enough without hospital care, but it doesn’t mean they’re fully recovered, according to Daily Caring. They’ll still need extra care.

You should receive the information, services, and resources needed to help your senior before he or she leaves the hospital. But “hospital discharge nurses are often overloaded and may not spend enough time helping patients and family understand everything they need to know.”

That makes it important to advocate for a senior and make sure they and their other caregivers have all the necessary information before leaving the hospital.

It helps to become educated about your senior’s illness before they leave the hospital, knowing facts such as their detailed diagnosis, whether the problem is new or a flare up of a chronic problem, what’s the treatment plan at the hospital and once they go home, how they should be monitored and how often, and what you should expect in the coming weeks, writes Rebecca S. Boxer, MD.

You should review all of a senior’s prescriptions with the medical staff, including what was taken before hospitalization. That means knowing what medication has been changed or stopped, what are the new medications, what are possible side effects, and whether any blood work is needed to monitor the medications.

A senior should leave the hospital with the caregiver knowing what the warning signs are for their condition and who should be contacted if symptoms worsen.

“I encourage patients to advocate for themselves and ask doctors simple, straightforward questions,” says Eileen Brinker, transitional care manager at the University of California San Francisco Medical Center. “Why am I here, what are you doing for me in the hospital, how can I take better care for myself.”

Patients should also know their prognosis, no matter how much trepidation that involves. This is important after exploratory surgery, for example, and a patient needs to know what their diagnosis was and whether that’s changed since they’ve been in the hospital.

For professional caregivers, other important information to know includes whether the senior lives alone, are they at risk for polypharmacy issues, will they be able to maintain a healthy diet, and does the senior have access to transportation.

“The way this transition is handled — whether the discharge is to home, a rehabilitation ("rehab") facility, or a nursing home — is critical to the health and well-being of your loved one,” according to the Family Caregiver Alliance (FCA). “Studies have found that improvements in hospital discharge planning can dramatically improve the outcome for patients as they move to the next level of care.”

Patients, family caregivers, and healthcare providers all play roles in maintaining a patient's health after discharge. Although it's a significant part of the overall care plan, there is a surprising lack of consistency in both the process and quality of discharge planning across the healthcare system, the FCA adds.

Medicare says discharge planning, which should begin the day the patient is admitted to the hospital, is "a process used to decide what a patient needs for a smooth move from one level of care to another."

Only a doctor can authorize a patient's release from the hospital, “but the actual process of discharge planning can be completed by a social worker, nurse, case manager or other person. Ideally, and especially for the most complicated medical conditions, discharge planning is done with a team approach,” the FCA writes.

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