Next Step in Care: Family Caregivers & Health Care Professionals Working Together

Discharge Planning

What You Need to Know

Planning for discharge from the hospital (or subacute rehabilitation) can be confusing and rushed.

Discharge planning is ideally a process - a conversation over time between:

  • the person needing care (when possible),
  • the family caregiver(s),
  • decision makers such as a power-of-attorney (if the patient has one), and
  • the patient's health care team.


A good discharge planning process requires everyone involved to have a thorough understanding of the person's diagnoses (the medical problems, even if they aren't related to why the person is in the hospital) and prognosis (the likely course of the person's future health and care needs). Once everyone has the same understanding of the situation, then everyone can work together to decide the next steps, including what kind of care the person needs and where that care is best provided.

These Next Step in Care guides and checklists can help you, your family member, and the care team talk the issues through, and give you a good idea of what the options might be. The guides discuss safety issues, HIPAA and confidentiality, appealing discharge, payment, and much more. The checklists help you stay organized and be sure you have the information that you need in order to support your family member through this discharge.

About decisions:

Leaving the Hospital and Going Where?

Hospital-to-Home Discharge Guide

What Do I Need as a Family Caregiver?

Home Care: A Family Caregiver's Guide

Short-Term Rehab Services in an Inpatient Setting

Information you need:

HIPAA: Questions and Answers for Family Caregivers

Care Coordination

Getting a Post-Discharge Appointment in 7 Days

LGBT Caregiving

Durable Medical Equipment

Helpful checklists:

Going Home: What You Need to Know

A Family Caregiver's Planner for Care at Home


As you think about the next steps, guides in these other categories may also help:

The Hospital           Rehabilitation and Subacute Care

Care at Home          Outpatient Care


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