Coming home from hospital: the first two weeks
Discharge is not recovery. What to put in place before the ambulance arrives, and what to watch for afterwards.
—6 min read
Hospital discharge often moves faster than families expect. A bed is needed, someone is medically fit, and a date appears with very little notice.
Being medically fit for discharge is not the same as being safe at home, and the gap between the two is where most problems happen.
Before the discharge
Ask for the discharge plan in writing. You are entitled to know what support has been arranged, by whom, and when it starts.
Ask specifically about a reablement package. Many areas provide up to six weeks of free short-term support after a hospital stay. It is not automatic — it has to be arranged, and it is easy to miss.
Check the equipment. If a frame, a commode, a raised toilet seat, a bed rail or a stair rail has been recommended, find out whether it will be delivered before the person is home or three weeks later.
Ask about the medication changes. Doses are very often altered in hospital. Ask what has changed, what has stopped, and what is new — and make sure the GP surgery has the discharge letter.
Be realistic about the house. If they were struggling with the stairs before the admission, they will struggle more now.
The first forty-eight hours
The risks in the first two days are practical ones: a fall in the night, not drinking enough, missing medication, and the exhaustion that follows a hospital stay.
- Somewhere comfortable to sit downstairs, with a phone within reach
- Food that requires no effort at all
- Drinks left where they can be reached without standing up
- A working night light, and a clear path to the bathroom
- Someone who can actually get there quickly if called
What to watch for in the fortnight
Not drinking enough. Dehydration is the commonest cause of readmission and of sudden confusion. It goes unnoticed easily.
Sudden confusion. New or worsening confusion in an older person is a medical symptom, not just part of getting older. It frequently indicates infection. Ring the GP the same day.
Not eating. Appetite often disappears after a hospital stay. Small, regular, familiar food does more for recovery than supplements.
Not moving. Fear of falling leads to sitting still, which leads to weakness, which leads to falling. Gentle, regular movement matters, and the physiotherapist's exercises are not optional extras.
The wound or the surgical site. Redness spreading, increasing pain, discharge or fever needs medical attention promptly.
Mood. A hospital stay shakes confidence badly. Withdrawal and low mood are common and worth mentioning to the GP.
Who to call
- The GP for anything new: confusion, fever, worsening pain, a wound that looks wrong
- NHS 111 out of hours, when it is not an emergency but will not wait
- 999 for chest pain, breathing difficulty, signs of stroke, or a fall with a suspected fracture
- Adult social services for a needs assessment, which is free and which you are entitled to request
Where live-in care fits
The first two to six weeks after a discharge are exactly the period short-term live-in care is designed for: someone in the house day and night, keeping medication straight, cooking properly, walking with them until the stairs stop being frightening, and getting them to the follow-up appointment.
Many of these arrangements end because they are no longer needed. That is the intended outcome, and a good provider will tell you honestly when they think it can safely stop.