The first 48 hours after the hospital

1. Before you leave the hospital

• The discharge instructions, in writing, and someone who has gone through them with youAsk the nurse to explain them back to you in plain words. You can ask for the discharge planner or case manager.
• The full medicine list: what is new, what changed, what to stopAsk: "Which of the medicines at home should we stop, and which continue?" Ask where the new prescriptions are being sent.
• Who to call with questions, and the number, day or night
• The follow-up appointment: with whom, when, and whether tests are still pending
• What they can and cannot do: walking, stairs, driving, eating, bathing, lifting
• Whether home health, therapy or equipment is being arrangedIf they might need home health, ask the discharge planner about the options and compare agencies at Medicare.gov/care-compare. If they are on Medicare and you think the discharge is too early, the hospital should have given you the "Important Message from Medicare", which explains how to ask for a fast appeal. Medicare's own discharge checklist (PDF).

2. Tonight

• Put the new medicine list next to the bottles at home and match them one by oneSet aside anything the hospital said to stop. If two bottles look like the same medicine, ask the pharmacist before giving either.
• Get the new prescriptions filled today, not tomorrow
• Clear the path from the bed to the bathroom: lights on, rugs up, cords away, a chair to sit onFalls are most common in the first days home. The fall-risk check takes two minutes.
• Someone is in the home tonight, or within earshot
• Food and fluids they are allowed are in the house
• A written list by the phone: doctor, pharmacy, hospital unit, and you

3. The next two days

• Expect a call from the doctor's office and answer itMedicare's transitional care service requires contact within two business days of discharge and a visit within 7 or 14 days. Ask the office whether they offer it.
• The follow-up visit is booked, and you know how they are getting there
• Any tests that were pending have an owner: who will call with the result?
• Take a daily note: medicines given, eating, drinking, sleep, pain, confusion, and anything newBring it to the follow-up visit.
• Someone else knows the plan, so it is not all on youA short message to a sibling or friend: what you need this week. Practise asking for help.

Call the doctor the same day for

• Fever, or new chills.
• A wound or incision that is red, swollen, leaking or opening.
• Pain that is getting worse, or that the medicine no longer controls.
• Vomiting, or not able to keep fluids down for a day.
• New confusion, unusual sleepiness, or a big change from how they were in the hospital.
• Swelling in one leg, or a sudden gain in weight or swelling.
• A dose missed or doubled, or a medicine you cannot get.
• A fall, even if they seem fine.

If you cannot reach the doctor and are worried, call the hospital unit that discharged them or the after-hours line. If it may be an emergency, call 911.