Coming Home from the Hospital: What Families Need to Know About the First 72 Hours

The discharge paperwork says your mother is ready to go home. The nurse has gone over the instructions. You've nodded along, tried to absorb as much as you can, and now you're in the car — and the weight of what comes next is fully on you.

Hospital discharge is one of the most vulnerable moments in an older adult's care journey. Readmission rates within 30 days are high, and most complications happen in the first week — often because the transition home wasn't adequately supported.

Before you leave the hospital

Ask for a written medication list and have someone go over every change with you. New prescriptions, discontinued medications, changed dosages — all of it. Medication errors at discharge are common, and they're preventable.

Ask who to call if something changes at home. Get a name and a direct number, not just a general hospital line. Know the specific symptoms that should send you back to the emergency room versus symptoms you should monitor and report to the primary care doctor.

Ask whether home health has been ordered. If your loved one qualifies for skilled nursing visits or therapy at home, those should be arranged before discharge — not after.

Setting up the home before arrival

If you have any lead time, do a quick safety sweep. Clear pathways of rugs and obstacles. Make sure the bedroom and bathroom are accessible. A raised toilet seat, grab bars, and a shower chair are inexpensive and make a significant difference.

Have a plan for the first meal and the first night. Fatigue after hospitalization is real and often underestimated. The first few days should be as low-effort and low-stimulation as possible.

What to watch for in the first 72 hours

Changes in mental status — confusion, disorientation, unusual agitation — can be a sign of infection, medication interaction, or dehydration and should be taken seriously. Many older adults become temporarily more confused after a hospital stay, but significant changes warrant a call to the care team.

Watch for signs that pain is not being managed adequately. People who are in pain don't move, don't eat, and don't recover well. Don't wait for them to complain — ask directly.

Track whether they're eating and drinking. Hydration in particular tends to drop after discharge and contributes to a cascade of other problems.

When to bring in extra help

The first week home is exactly when professional support makes the biggest difference. Even a few hours a day of assistance with meals, medications, mobility, and personal care can be the difference between a smooth recovery and a return trip to the hospital.

If your family member was discharged from a San Diego hospital and you're not sure what level of support is appropriate, Comfort Keepers San Diego offers free consultations and can usually arrange care within 24 hours.