My parent is coming home from the hospital alone. What do I need to have ready?

Updated September 3, 2026. Published by Parents Home Care.

Before she leaves, get three things in writing from the discharge planner: the new medication list, the follow-up appointments, and the number to call if something goes wrong. Then cover the first 48 hours at home with a person, not a plan. Someone sleeps there, or checks in morning and night.

If you think the discharge is too soon, say so before she leaves. Medicare patients in the US can ask for a fast appeal and stay while it is reviewed.

Before she leaves the hospital

Find the discharge planner, get a direct number, and ask these questions. Write the answers down.

What was treated, and what should we watch for at home? Which signs mean “call the doctor,” and which mean “call 911”?
What medicines is she going home on? Which are new, which have changed, and which have stopped?
When is her follow-up appointment, and who books it? If it is “call your doctor,” ask them to book it before she leaves.
Who do we call at night or on a weekend if something goes wrong?
Will someone come to the house to assess it? Does she qualify for home health visits, physical therapy, or equipment, and who arranges that?
Can she bathe, dress, get to the toilet, and make a meal on her own right now? If not, who is doing those things tomorrow morning?
Is there a written copy of all of this that I can take home?

If the answer to question six is “she will manage,” ask what staff observed today. Name the task she could not do, and ask how it will happen at home.

If the discharge feels too soon

Say so before she leaves. An unsafe discharge is a release from the hospital to a place where the person cannot get the care she needs, before that care has been arranged. It is not a legal term in most places.

In the United States, a Medicare patient has a formal way to push back. Within two days of admission, and again before discharge, the hospital must give her a notice called An Important Message from Medicare about Your Rights. If you did not get it, ask for it. It explains that she can appeal to a Quality Improvement Organization, an outside reviewer authorized by Medicare to give a second opinion about her readiness to leave.

	What it means for you
When to ask	Follow the directions on the notice no later than the day she is scheduled to be discharged.
What happens	The reviewer looks at her records and decides, usually within one day of getting the information.
While you wait	She can stay in the hospital, and she will not pay for those days except normal coinsurance or deductibles.
Who to call	1-800-MEDICARE (1-800-633-4227), 24 hours a day, for help reaching the reviewer for her state.

Put your concerns in writing to the discharge planner. The Family Caregiver Alliance says the appeal is free and generally resolved in two to three days, and the hospital cannot discharge her while it is under way.

In Canada there is no equivalent fast appeal. The route is the discharge planner first, then the unit’s charge nurse, then the hospital’s patient relations office. The message is the same: “She lives alone, nobody will be there, and this is what I saw today.” Be specific about what she cannot do. A vague worry gets a reassurance. A fact about the bathroom trip gets a plan.

Key facts

About one in six Medicare patients aged 65 and older went back to the hospital within 30 days in 2016, at 16.0 per 100 admissions.
Medicare patients have the right to a fast appeal if they think they are being discharged too soon, and the reviewer decides within a day.
Only a physician can authorize a release, but a discharge planner, social worker or nurse usually runs the planning.
Falling once doubles the chance of falling again, and more than one in four people 65 and older falls each year.
People 65 and older take more medicines than any other age group, so a changed list after a hospital stay needs a careful check.

Not sure where she stands overall? The five-minute assessment asks about what you've actually seen, then shows its reasoning. Free, no sign-up.

The first 48 hours at home

Someone is with her, or checking in morning and night, for the first two days. What goes wrong after a discharge goes wrong quietly: a missed dose, a dizzy spell on the stairs, a fever nobody notices.

The ride home. Bring the written plan, the new medicines, and any equipment. Sit with her for the first evening and watch how she moves from the chair to the bathroom. What you see is the true discharge assessment.
The first night. If she is unsteady on that trip to the bathroom, someone sleeps over. Light the path from bed to bathroom. The National Institute on Aging says to keep a well-charged phone with you and arrange daily contact with a family member or friend, so put a charged phone within reach of the bed.
The first morning. Lay out the day's medicines from the new list, not from the old bottles. Put the old bottles in a bag and out of reach until the pharmacist has compared the two.
Day one. Eat, drink, and walk a little, if the plan allows. Check the warning signs on your list once in the afternoon and once at bedtime. If one shows up, call the number you were given, even if it feels small.
Day two. Confirm the follow-up appointment exists and that someone can drive her. Set a time for a daily check-in call that will continue after you leave. See how to check on a parent every day.
After that. The person in the house leaves, and the check-in takes over. The first week is when the readmission risk is highest, so the check-in call should ask about the specific warning signs, not just “how are you.”

Call 911 if she cannot breathe, cannot be woken, or has fallen and cannot get up.

The medicine check at home

Put the old bottles and the new list on the table together, and go through them one by one with a pharmacist, so that nothing is doubled, dropped, or clashing. Hospitals call this medication reconciliation. It is supposed to happen before discharge. Do it again at home, because the old bottles are still in the cupboard.

The National Institute on Aging's rules for taking medicines safely are the ones to follow this week:

Keep one up-to-date list of every medicine, over-the-counter drug, and supplement, and give a copy to everyone who helps her.
Use one pharmacy, so the pharmacist's records can catch a clash between a new drug and an old one.
Ask the pharmacist for larger type on the labels and bottles she can open.
Never take more than the doctor prescribed, and do not stop a medicine because she feels better without asking.
Call the doctor right away about any problem with a medicine, including dizziness or confusion that was not there before.

If she was already missing doses before the hospital, this is the week it will show. See what to do when a parent misses or doubles a dose.

Falls are more likely this week

She is weaker, on new medicines, and often dizzy when she stands. Three things for this week:

Stand up slowly, every time. Sit on the edge of the bed for a minute before standing.
Shoes with grip, not slippers with smooth soles, and nothing on the stairs.
A phone or pendant she will actually carry, and one person who will notice if she does not answer.

If she does fall, or already has, read what to do after a fall. It covers why a long time on the floor is the harm to plan against.

After the first week

The question changes from getting through the discharge to whether living alone still works. Review the pattern of the past year, not only the past two days.

The Parents Home Care assessment gives one of three results. Living alone looks workable right now means nothing you told us pointed to a problem today. Living alone can work with more support means one or more areas need attention, and the result names the kind of support each area calls for. It is time to look at more support than home alone can give means either one event the assessment treats as serious on its own, or difficulty in four or more areas at once, and the first step is a conversation with your parent's doctor. The result is never a number and never a guarantee. The rules behind it are published in full on the how the assessment decides page.

The assessment asks about what a hospital stay can reveal: personal care, meals, bills, falls, changes in awareness, and available help. Read how the assessment decides and the signs a parent may need more support.

The National Institute on Aging links social isolation with longer hospital stays and more readmissions. If family cannot be there, the Eldercare Locator connects US families to local aging services. In Canada, use 211 for community services and the provincial health line for clinical questions.

Questions families ask

Who do I call if something goes wrong at night?

The number the discharge planner gave you, which is why you ask for it before she leaves. If you did not get one, call the hospital's main line and ask for the unit she was on. In most Canadian provinces, 811 reaches a nurse at any hour. If she cannot breathe, cannot be woken, or has fallen and cannot get up, call 911 in either country.

Can a hospital discharge someone who lives alone?

Yes. Living alone is not by itself a reason a hospital must keep someone. What the hospital must do is plan for the care she needs afterward, and in the US a Medicare patient can appeal if she believes the discharge is too soon. The strongest thing you can do is describe, in writing, what she could not do today and who will not be there tomorrow.

Who runs the discharge plan?

A discharge planner, social worker, or nurse usually organizes it, and only a physician can authorize the release, according to the Family Caregiver Alliance. Discharge planning is the work of identifying the care she needs after the hospital. Get that person's name and a direct number before she leaves.

How long does the Medicare fast appeal take?

The outside reviewer decides within about one day of getting the information it needs from the hospital, and the Family Caregiver Alliance says appeals are generally resolved in two to three days. If you ask by the scheduled discharge day, she stays in the hospital while it is reviewed and does not pay for those days beyond normal coinsurance or deductibles.

Why is a fall more likely right after a hospital stay?

Because a hospital stay adds to the everyday odds. More than one in four older people falls each year, and less than half tell their doctor. The National Institute on Aging lists the causes of falls that a hospital stay makes worse: lost muscle, balance problems, blood pressure that drops when you get up, and medicines that cause dizziness or confusion. The more medicines she takes, the more likely a fall.

What if she refuses help once she is home?

Start with what she will accept. Many parents refuse “help” but accept a daily phone call, a meal delivery, or a grandchild who happens to visit. Ask the discharge planner to say the words “you need someone for two nights” in front of her, because it lands differently from a doctor than from a child. Then choose the one thing that matters most this week and let the rest wait.

Can a stroke patient live alone?

Some people do, and the answer depends on what the stroke changed: walking, using one hand, swallowing, speech, memory, or judgment. The rehabilitation team's assessment before discharge is the honest answer for your parent, so ask them directly and ask what would have to be true at home. The Parents Home Care assessment can help you think it through after she is home, but it cannot see what the team saw.

Where this leaves you

Tonight was one event. If you're wondering about the pattern, the assessment is the place to think it through. It can say living alone looks workable right now, and it will show you why.

Start the free assessment

Source: Centers for Disease Control and Prevention. Use of this material does not imply endorsement by CDC, ATSDR, HHS or the United States Government.

Published by Parents Home Care. Clinically reviewed by Sarah Fleischman, CCC-SLP on September 3, 2026. Updated September 3, 2026. Sources: 11 linked below.

Sources

Hospital Discharge Planning: A Guide for Families and Caregivers, Family Caregiver Alliance fact for the definition of discharge planning, who does it, and the appeal notes.
Fast appeals, Medicare.gov fact for the Important Message, the deadline, and what happens while the reviewer decides.
An Important Message from Medicare about Your Rights, form CMS-R-193 fact for the right to a second opinion and the Medicare phone number.
Characteristics of 30-Day All-Cause Hospital Readmissions, 2010-2016, AHRQ HCUP Statistical Brief 248 fact; the figure is for 2016 and is the most recent in that brief. "About one in six" is our rounding of 16.0 per 100.
Taking Medicines Safely as You Age, National Institute on Aging fact; content reviewed September 22, 2022.
Falls and Fractures in Older Adults, National Institute on Aging fact; content reviewed September 12, 2022. That a hospital stay makes these causes worse is our inference from the causes listed.
Older Adult Falls Data, CDC fact.
Loneliness and Social Isolation, National Institute on Aging fact; content reviewed July 11, 2024.
Eldercare Locator fact for the number and what it connects to.
211 Canada fact.
Medical services by phone, Heart and Stroke Foundation of Canada fact for which provinces use 811; dated November 10, 2022. That there is no Canadian equivalent of the Medicare fast appeal is our inference; no such mechanism was found.

The definition of an unsafe discharge above is ours (opinion), written for families; it is not a legal definition.