The Family Voice in Hospital Discharge Planning 

My immediate and extended family are both experiencing significant health issues these days. Having a family member in hospital right now for an acute injury, it struck me that the concept of discharge planning is completely unfamiliar to my relatives. As a nurse, of course, I am very aware of the standards and expectations for discharge planning. But for those who don’t ordinarily interact with the health care system, this process is entirely new.

A good discharge plan is essential, both for the optimal recovery of the patient, and also for the ability of family to manage at home. If the plan is not initiated by the hospital, the patient and family may have no idea how to do this. And so as I urged my in-laws to request a family meeting, I looked for a simple checklist they could take with them. Not so easy to find!

This checklist from the Mood Disorders Association is the best thing I was able to find Hospital Discharge Checklist. It would be useful for persons hospitalized for any mental health concern, and for their families.

My mission now: to find or develop a guide that patients and families can use, regardless of the reason for the hospitalization, and especially one that includes attention to the needs of the family. This one is good, but lengthy, and is from the USA so not all parts apply here in Canada Hospital Discharge Guide for Families and Caregivers. Also, not all involved family members can properly be called “caregivers”.

In the meantime, here is my advice:

  1. Find out who the discharge planner is for your family member. This is usually a primary nurse or social worker.
  2. Request a family meeting as soon as possible to begin planning. It may take some time to get services in place, so the earlier the better. More than one meeting may be needed.
  3. Any involved family members should attend, and especially the patient if they are able. If the patient cannot attend, you can ask them to let the health care team know it’s ok to talk with the family. Remember in Manitoba, close family members do have the right to information about the patient’s current health condition (unless the patient specifically objects). If the family will be providing care after discharge, then they must be given information that will enable them to do so safely. See the Personal Health Information Act.
  4. Bring a list of questions to have answered at the meeting. (See the links above for ideas)
  5. Bring pertinent information you need the health care team to know e.g. Are there stairs at home, are you unable to lift the patient, etc.
  6. Be very clear about what you can or cannot do after discharge and any concerns you have for the safety of the patient or yourself.  Do participate in problem solving ways to address potential concerns.

The hospital team does want to work with you! Person-and-family-centred care is increasingly being practiced and seen as a standard of care. So don’t be afraid to speak up and ask to be involved in decisions that impact your family! It’s safer for everyone if we all partner together.

More tools for families from the  Manitoba Patient Safety Institute

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