The Questions to Ask Before Your Parent Is Discharged From Hospital

When my mum was discharged after sepsis and a pulmonary embolism, I'd braced myself for her to come home weak. What I hadn't braced myself for was how rushed and disjointed the leaving would be, and I'm an occupational therapist. I know this system from the inside, and I still felt the ground move under me.

So if you're reading this in a hospital corridor, on your phone, trying to work out whether what's being arranged is actually safe, this is the article I wish someone had handed me.

It won't tell you what to decide. Every person and situation is different, and the people who know your parent's clinical picture are the ward team in front of you. But it will tell you what to ask, so that whatever happens next happens with you informed and in the room, rather than to you.

A quick note before we start: this is written for England, where discharge follows NHS processes and the Care Act 2014. Scotland, Wales and Northern Ireland use different systems and different terms (in Scotland, for instance, it's PASS rather than PALS, and the assessment framework differs). The principles below still help, but check your nation's specifics.

First, understand the two words that change everything

Hospitals don't wait for someone to be "better" before discharging. They discharge when a clinician decides the person is medically stable or medically optimised, meaning they no longer need an acute hospital bed, not that they're well. This is the single biggest gap between what families expect and what actually happens. Someone can be medically stable and still be a long way from coping at home. Once you understand that this is how discharge works, rather than a sign something has gone wrong, you can stop fighting the wrong battle and focus on the one that matters: what support is in place to cover the gap between "stable enough to leave" and "able to cope at home"?

The questions

1. "What pathway is my parent being discharged on?"

In England, discharge follows one of four pathways (0 to 3). Pathway 0 is home with no new support. Pathway 1 is home with additional health or social care support. Pathway 2 is a short stay in a bedded setting for further recovery and rehabilitation. Pathway 3 is for people who need ongoing 24-hour bedded care, which can mean a care home placement. Knowing the pathway tells you immediately what level of need the team has identified, and gives you a reference point if their plan doesn't seem to match what you're seeing.

2. "Is this 'discharge to assess'? When and where will the full assessment happen?"

Many discharges now happen under "discharge to assess," where the person leaves first and their longer-term needs are assessed afterwards, at home or in the community, rather than on the ward. This isn't inherently bad; assessing someone in their own kitchen is often more accurate than on a ward. But it means the support arranged at discharge is temporary and provisional. Ask who will carry out the assessment, when, and how you'll be involved, so you're not blindsided when the initial package changes.

3. "What is the reablement or intermediate care plan, and how long does it last?"

Short-term reablement and intermediate care are usually free for up to six weeks, are not means-tested, and are genuinely valuable in helping someone regain independence. But two things catch families out. First, six weeks is the maximum, not a guarantee, and it can end sooner once you've met your recovery goals. Second, and this happened to us, if the person is readmitted to hospital, that package can stop entirely and isn't automatically reinstated. Ask what happens to the package if your parent goes back in.

4. "Has a needs assessment and a carer's assessment been arranged?"

This is the one almost nobody tells you about. Under the Care Act 2014, the person being cared for has a right to a needs assessment (Section 9), and you, as the family carer, have a separate right to a carer's assessment (Section 10) in your own right. Both are free. Both are statutory rights regardless of income or savings. Yet most carers have never had one. Even if you think you're coping, ask for one, because it creates a documented record of the caring role and its impact, which strengthens every later request for support. Note that the acute hospital itself usually doesn't carry these out; they happen via the local authority, often after discharge. Ask who is making the referral and get a contact name.

5. "Could my parent be eligible for NHS Continuing Healthcare?"

NHS Continuing Healthcare (CHC) is fully NHS-funded care for people whose needs are primarily health needs rather than social care needs. If your parent qualifies, the NHS pays for all of it, including in a care home. It's complex, the assessment is involved, and not everyone is eligible, but the screening should happen at the right time and shouldn't be skipped simply because someone's needs are still settling. If your parent has significant or complex health needs, ask whether a CHC checklist screening has been considered. This matters enormously if you're otherwise facing self-funding.

6. "What equipment will be in place before they come home, and who is providing it?"

Grab rails, a raised toilet seat, a perching stool, a commode, a bed lever, a hospital bed: whatever's needed should be arranged before discharge, not promised for later. Sometimes an occupational therapist will visit the home first to assess for equipment or adaptations. Ask specifically what's being provided, when it'll be installed, and what you're expected to source yourselves. (I'll cover the equipment that genuinely earns its place in a separate guide.)

7. "What medication is changing, and do we understand it?"

People often leave hospital on different medication than they arrived on. Ask for the discharge summary, check what's new or stopped, confirm you understand the doses and timings, and make sure there's a plan for the GP to take over prescribing. Don't leave the ward until this is clear, because confusion here is a common cause of readmission.

8. "What happens if something goes wrong, and who do we call?"

Ask for the names and numbers of the people who'll be involved after discharge: the community team, the social worker, the reablement provider, the GP. Ask if there's a crisis or rapid-response service you can contact out of hours. Having a number to ring at 9pm on a Sunday is the difference between managing a wobble at home and another 999 call.

9. "I want to be part of these decisions, so how do we make sure that happens?"

You're entitled to be involved, and the guidance is explicit that families and carers should be part of discharge discussions from the outset, with the patient's consent. That last part matters: if your parent has mental capacity, the team can only share information and involve you with their agreement, so have that conversation with your parent early. Tell the ward you're a carer, ask to be kept informed, and don't be afraid to speak up if decisions seem to be happening without you.

What if you don't think it's safe?

This is the part families don't realise they're allowed to do.

You can raise concerns and ask for a discharge to be delayed or reviewed if you believe it's unsafe. Start with the discharge coordinator or ward manager, and ask for a multidisciplinary discharge meeting if needed. If you can't resolve it that way, contact PALS (the Patient Advice and Liaison Service). Every hospital has one, it's free and confidential, and they can act quickly while someone is still on the ward. If there's a genuine risk of harm, you can also ask the local authority about a safeguarding concern.

One important nuance, because it's widely misunderstood: as a family member, you can decline to personally provide care you're not able to give, and you should never be press-ganged into being the care package. But a patient can't simply refuse to leave hospital if their needs can safely be met in the community. The aim isn't to dig in and refuse; it's to make sure the right support is actually in place before they go. "I'm not able to provide that level of care at home" is a clearer, stronger thing to say than "we don't want them discharged."

If, looking back, a discharge was handled badly, you can raise it through the hospital's complaints process or PALS, and an NHS complaints advocate can support you for free. That won't undo it, but it can be part of how the system gets better.

You're allowed to ask all of this

Here's what I most want you to take from this: asking these questions isn't being difficult. It's being a good advocate, and the system is designed to involve you even when it's too rushed to feel that way. Every question above is one a discharge team should be able to answer. If they can't, that itself tells you something useful.

I didn't ask all of these when my mum came home. I know them now, and I'd rather you have them before your version of that phone call than after.

*My family's story is shared with their knowledge and consent. No information about patients or clients from my clinical practice is ever shared on this site.