Preparing a home for a parent after a hospital stay

Quick answer

Start with the hospital team. Before the discharge date, ask what help, equipment and medicines the person will need at home, who pays, and who to call with problems [1] [2]. Then get the home ready for the first weeks. Set up a clear, lit path from the bed to the bathroom, the bathroom equipment the team suggests, and everyday things within easy reach [3] [4] [5]. The two printable checklists below cover both steps.

What to do, and when

Before discharge: questions to ask

From simpleaging.com. This checklist is general information, not medical advice.

Bring this list to the hospital and write down the answers. Most of the questions come from Medicare’s discharge planning checklist and Ontario Health’s guide for people leaving the hospital [1] [2].

The plan

• When is the person likely to go home? What is the earliest day we should plan for?
• Who is planning the discharge, and how do we reach them?
• Can we have the written discharge plan, in words we can understand?
• Will the person need a ride home, or help getting to the car?

Help at home

• Will they need home care, like visits from a nurse or therapist, or help with bathing, dressing or cooking? How soon, how often, and who pays?
• Which everyday tasks will they need help with: bathing, dressing, using the bathroom, stairs, cooking or shopping?
• Can an occupational therapist or physiotherapist check the home, or tell us how to set it up [15] [4]?
• If stairs will be hard for a while, should we set up a bed on the main floor?

Equipment

• Will they need equipment, such as a walker, shower chair, raised toilet seat or hospital bed?
• How do we get it, who pays, and who delivers it?
• Can someone show us how to use it before discharge?

Medicines

• Which medicines were added, stopped or changed, and why?
• Can we go over the full list together, including over-the-counter drugs, vitamins and herbal supplements? Which ones should they keep taking?
• Will there be enough medicine to last until we can get to a pharmacy?

Follow-up and who to call

• Which follow-up visits are booked, and which do we need to book? By when?
• What problems should we watch for, and what do we do about them?
• Who do we call with questions once we’re home?
• How will we know whether to call the doctor or go to the emergency department?

For you, the caregiver

• What will I need to do at home? Can you show me how, and let me practice, before discharge?
• Who else can help if I can’t be there every day, or if I need a break?

Where to buy equipment for the first weeks

Before you buy anything, ask the hospital team what the person needs. Some items can be borrowed, rented or covered (see Borrow, rent or buy equipment and Costs and funding below).

Pharmacies, home health and medical supply stores, and hardware stores sell these items in Canada and the US. You can also shop online. The table lists items from the checklists whose makers publish their specs. The figures come from the makers’ pages, linked in the sources. We haven’t tested the products ourselves.

A few terms: a commode is a toilet seat on a frame, with a bucket. A tub transfer bench is a long seat that sits across the tub wall. A toilet safety frame adds two arms around the toilet. A reacher is a grabber tool for picking things up.

More options at Amazon: motion-sensor night lights (opens in a new tab), reachers (opens in a new tab), 3-in-1 commodes (opens in a new tab), shower chairs (opens in a new tab), tub transfer benches (opens in a new tab), raised toilet seats (opens in a new tab) and toilet safety frames (opens in a new tab).

Getting the home ready: room by room

From simpleaging.com. This checklist is general information, not medical advice.

Walk through the home with this list a few days before discharge. The items come from the CDC, the National Institute on Aging and the Public Health Agency of Canada [3] [4] [5]. Our home safety checklist covers the rest of the home.

Entrance and steps

• Outside steps are in good repair, not broken or uneven.
• The steps have firm handrails on both sides.
• The entrance light works, and walkways are clear of leaves, snow and ice.
• There’s a seat by the door for putting on and taking off shoes and boots.

From the bed to the bathroom

• The path is clear. Furniture is moved so no one has to walk around it.
• Throw rugs are gone, or held down with double-sided tape or a non-slip backing.
• Cords are coiled or taped next to the wall.
• Nothing is left on the floor.
• Night lights light the way. Some turn on by themselves in the dark, or when they sense movement, like the GE 12201 (opens in a new tab).

Bedroom

• A lamp or light switch is within easy reach of the bed.
• A phone is near the bed: a landline or a charged cell phone.
• A flashlight is by the bed, in case the power goes out.
• The bed isn’t too high or too low, so it’s easy to get in and out of.
• If stairs are hard for now, there’s a bed on the main floor [2]. A toilet or a commode is close by, like the Carex 3-in-1 commode (opens in a new tab). Our 3-in-1 commode guide covers setting one up beside the bed or over the toilet.

Bathroom

• Grab bars are installed next to and inside the tub, and next to the toilet, like the Moen 8724 (opens in a new tab). Our grab bar height guide shows where they go, and our guide to grab bars on fiberglass tubs covers one-piece tub-showers.
• A non-slip rubber mat or self-stick strips are on the floor of the tub or shower.
• A night light, or a light left on, lights the bathroom at night.
• Equipment the hospital team suggested is set up, like a shower chair (opens in a new tab) or transfer bench (opens in a new tab), and a raised toilet seat (opens in a new tab) or toilet safety frame (opens in a new tab) [2].
• Everyone knows not to lean on towel racks or soap dishes.

Kitchen

• Things used every day are within easy reach, about waist high.
• A reacher is handy for things that are too high or too low, like the Drive 28 in (opens in a new tab) or RMS 32 in (opens in a new tab) reacher. No one stands on a chair to reach.
• There’s a place to sit while making food.
• The fridge and cupboards are stocked for the first days, including food for any special diet [1].

Phone and help

• A list of emergency numbers, in large print, is near each phone, and the numbers are saved as favorites on the cell phone.
• The names and numbers of people to call with questions are written down [1].
• Prescriptions are filled before discharge day [1].
• If the person will be alone at times, there’s a way to call for help. Our medical alert guide explains the types. If the family is thinking about a camera, our guide to cameras in a parent’s home starts with consent.

How discharge planning works

Discharge planning means getting ready for the move from the hospital to home. Medicare’s checklist says the doctor and staff will work with the person to plan the discharge. It calls the person and their caregiver, a family member or friend, “important members of the planning team” [1].

In Ontario, the province’s quality standard says one clinician should be named to plan the move home. Before the person leaves, the hospital team should give them a written plan, sometimes called a patient-oriented discharge summary, or PODS [2].

A few things help:

• Tell the team you’re the caregiver. Say what you can do and what you can’t. Ontario Health’s guide says it’s important to be honest with yourself about how much you can do [2].
• Take notes. Write down what the team says, or ask someone to take notes for you [2].
• Bring up the home early. If the bedroom is upstairs, or the home needs changes, tell the team [2].
• In the US, you can appeal. If you think the person is being sent home too soon, people with Medicare can ask for a fast appeal. In the hospital, staff should give them a notice called the “Important Message from Medicare,” which explains how [1].

Where to start at home

Plan for the first few weeks. Start with the rooms the person will use most: the bedroom, the bathroom and the path between them. The CDC suggests a night light on the path from the bed to the bathroom, and notes that some night lights go on by themselves after dark [3]. The National Institute on Aging suggests motion-activated lights that plug into outlets and turn on when you walk by [4].

An occupational therapist or physiotherapist can help you set up the home. In British Columbia, for example, community rehabilitation is given by a physical therapist or occupational therapist. One of its goals is to make sure a client’s home is set up for their needs and safety [15]. After a fall, the National Institute on Aging says, a doctor might suggest a home visit by an occupational therapist, physical therapist or nurse. They can check the home’s safety and suggest changes [4]. Ask the hospital team whether a visit like this is possible.

Bathroom equipment has to fit both the person and the room. Our guides explain what to measure: shower chairs, tub transfer benches and raised toilet seats and safety frames. If stairs will stay hard, our stair lift guide covers costs and funding in Canada. For a shorter need, our guide to renting or buying a reconditioned stair lift compares the options.

Borrow, rent or buy equipment

Ask the hospital team first. Medicare’s checklist suggests asking whether the person will need medical equipment, whether it’s covered, and who will arrange its delivery [1].

Canada

The Canadian Red Cross Health Equipment Loan Program lends health equipment to people recovering from illness or injury. It runs in British Columbia, Alberta, New Brunswick, Prince Edward Island, Nova Scotia, Newfoundland and Labrador, and Yukon. Its basic short-term loans are generally for three months or less. Health care professionals refer people to the program, “like a prescription,” the Red Cross says [20].

In Ontario, Ontario Health’s guide points to thehealthline.ca to find local services for the move home, such as medical equipment [2]. Elsewhere, ask the hospital team about loan programs near you.

United States

Medicare Part B covers medically necessary equipment for use at home, like walkers, commode chairs and hospital beds, when a doctor or other health care provider orders it. Depending on the item, you may need to rent it, you may need to buy it, or you may be able to choose. Medicare pays only if the supplier is enrolled in Medicare [21]. Some bathroom items aren’t covered (see Costs and funding).

Help at home after the hospital

Canada

Here is how three provinces describe getting home care after a hospital stay:

• Ontario. Ontario Health atHome says that when a parent leaves the hospital, their care team decides whether help at home or in the community is needed. The team may include an Ontario Health atHome care coordinator. The help may include nursing, personal support, help with medicines and rehabilitation. Its toll-free number is 1-833-515-1234 [17].
• British Columbia. If the person will need help at home, you can ask the hospital doctor, nurse or social worker to contact the local health authority’s home and community care office [16]. Community nursing and rehabilitation are generally short-term. They help families feel confident taking over care at home [15].
• Alberta. Alberta Health Services says that in the hospital, a transition coordinator or discharge planner will help connect the person with the support they need to go home. You can also contact continuing care on a parent’s behalf [18]. Anyone can call Health Link at 811 to arrange an assessment for a loved one who can’t call, and no referral is needed [19].

United States

• Medicare home health care. Medicare covers part-time or intermittent skilled nursing, physical therapy, occupational therapy and some home health aide care for people who are “homebound” and need skilled care. A doctor or other provider must see the person in person and order the care, and a Medicare-certified home health agency must provide it. Medicare doesn’t pay for 24-hour care at home, meal delivery, or help with daily tasks like bathing and dressing when that’s the only care needed [22].
• Eldercare Locator. This public service of the Administration for Community Living connects older adults and their families with local services. Call or text 1-800-677-1116 [23]. The National Institute on Aging suggests it for finding local home modification programs [4].
• Veterans. The VA Caregiver Support Program offers skills training, coaching, peer support and referrals to caregivers of veterans enrolled in VA health care. Every VA facility has a Caregiver Support team. The Caregiver Support Line is 1-855-260-3274, Monday to Friday, 8 a.m. to 8 p.m. Eastern [24]. For VA grants that help pay for changes to the home, see our guide to home modification grants in the US.

Costs and funding for equipment and home care

What you pay depends on what the person needs and where you live. Prices vary by product, store and region, so we don’t list them. Ask the hospital team and the supplier who pays before you buy.

Canada

Medical expense tax credit

The Canada Revenue Agency lists these as eligible medical expenses. Each needs a prescription: “bathroom aids to help a person get in or out of a bathtub or shower or to get on or off a toilet,” hospital beds, and walking aids for a person with a mobility impairment [25]. Keep the prescription and the receipts. Our medical expense tax credit guide covers the devices and renovations that count. Our medical expense tax credit calculator adds up your medical costs, takes off up to 3% of net income, and estimates the federal credit [25]. For permanent changes to the home, see our Home Accessibility Tax Credit guide and tax credit calculator.

Ontario Assistive Devices Program

Ontario’s program helps people with long-term physical disabilities pay for equipment, like wheelchairs. To qualify, a person generally needs the equipment for 6 months or longer. The program doesn’t cover bath and shower aids such as benches and chairs, commodes, grab bars, hospital beds or raised toilet seats [26]. See Funding in Canada for other programs.

United States

Medicare: medical equipment

Part B covers medically necessary equipment that a doctor or other health care provider orders for use at home. After the Part B deductible, you pay 20% of the Medicare-approved amount, if the supplier accepts assignment [21]. Medicare’s equipment list doesn’t cover bath seats, raised toilet seats or grab bars. It covers commodes if the person is confined to bed or to one room, or to one floor of the home with no bathroom on that floor [27].

Medicare: home health care

If the person qualifies, you pay nothing for covered home health services [22]. Our guide to home modification grants and programs in the US covers other help that may apply.

IRS medical expense deduction

If you itemize, the IRS lets you deduct medical costs above 7.5% of your adjusted gross income. Changes to the home made for a disability, like grab bars and handrails, can count as medical costs [29]. Our IRS medical expense deduction calculator estimates what you might deduct and whether it would lower your tax.

Questions to ask

A pharmacist

Ontario Health’s guide says that once the person is home, a clinician such as their community pharmacist should talk with them about their medicines [2].

• Can you go over the new medicine list with us, and compare it with what’s at home?
• Which medicines are new, changed or stopped? What side effects should we watch for?
• Would a pill organizer or blister packs make the medicines easier to manage?

An equipment supplier or loan program

• What is the maker’s weight limit? Will it fit our bathroom and our doorways?
• Do you deliver and set it up? Can you show us how to use it?
• Can we rent or borrow it instead of buying it? Can we return it if it doesn’t fit? Some sellers don’t take back toilet products. Carex, for one, says on its site that it doesn’t accept returns on toilet products, including commodes and raised toilet seats [6].
• In the US: are you enrolled in Medicare, and do you accept assignment [21]?

A home care program

• Who will come, how often, and starting when?
• Who do we call if a visit is missed, or if the person’s needs change?
• Is there a cost for any of the services?

Safety notes and when to talk to a professional

Follow the maker’s instructions. Set up each item as its maker says. Its weight limit should be above the person’s weight.

Hold grab bars, not towel bars. Grab bars must be firmly anchored. The Public Health Agency of Canada says towel racks and soap dishes “should never be used for support” [5]. Follow the maker’s installation instructions, or have a qualified installer put grab bars in.

Bed rails and hospital beds. If the hospital team suggests a hospital bed or a bed rail, ask them how to set it up. The US Food and Drug Administration has received reports of deaths and injuries with adult portable bed rails. Most were from entrapment (getting trapped by the rail, for example between the rail and the mattress), suffocation and falls. The FDA says these rails “are not for everyone, nor every situation.” They can be a hazard even when they’re well designed, fit the bed and are used correctly. This is especially true for people with physical limitations or confusion, such as dementia or delirium [28]. Ask the hospital team before you add one, and follow the maker’s instructions. Our guide to bed rails, bed canes and assist handles explains how they differ and the safety standard to look for.

Don’t climb to reach. Never stand on a chair or table to reach something. The National Institute on Aging suggests a reach stick, another name for a reacher, or asking for help [4].

Know who to call. Keep the hospital’s numbers by the phone. Ask the team how to tell whether a problem needs the doctor or the emergency department [2]. In an emergency, call 911.

When to talk to a professional. If someone has fallen, feels unsteady or worries about falling, talk to a doctor. A doctor can look for causes and may suggest seeing a physiotherapist or occupational therapist. An occupational therapist can also look at the home and suggest changes that fit the person’s needs. After a hospital stay, the hospital team or the home care program is a good first call.