Your Parent Is Being Discharged From Hospital — And They Live Alone. Here's Your Checklist.
You have 24–48 hours to get everything in place. This guide walks you through exactly what to do before discharge, during the critical first 72 hours, and for the dangerous month that follows.
Last updated: March 2026 | Sources: AIHW, Australian Commission on Safety and Quality in Health Care
Before You Leave the Hospital
Do not let your parent be discharged until you have completed these steps. Hospital staff are busy — you need to advocate.
Ask for a written discharge summary
This should list diagnoses, procedures, medications changed, and follow-up instructions. Do not leave without it.
Confirm all medication changes with the hospital pharmacy
New medications, changed doses, and stopped medications. Ask the pharmacist to write a plain-English medication list with times.
Ask about follow-up appointments
GP review (usually within 7 days), specialist follow-ups, wound checks, blood tests. Get dates and referral letters before leaving.
Request a home risk assessment from the Occupational Therapist
The hospital OT can assess whether your parent can safely manage at home. This is free and can be done before discharge.
Ask about the Transition Care Program (TCP)
Up to 12 weeks of funded support including nursing, personal care, and allied health. Available immediately post-discharge. Ask the social worker.
Get the ward's direct phone number
If something goes wrong in the first few days, calling the ward directly is faster than going through ED. Save this number in your phone.
Ask if they qualify for Hospital in the Home (HITH)
Some patients can receive hospital-level care at home with daily nurse visits. This is fully funded and avoids premature discharge.
Do not accept a Friday afternoon discharge if you can avoid it. GP clinics and pharmacies have limited weekend hours, and community services are unavailable until Monday. If Friday discharge is unavoidable, ensure you have enough medication and supplies for the weekend.
The First 72 Hours
The highest-risk period. Most preventable readmissions happen within the first three days.
- Collect all medications
Ensure they understand what each one is for, the correct dose, and the time to take it. Write a large-print schedule and stick it on the fridge.
- Stock the fridge with easy meals
Pre-made soups, sandwiches, fruit, yoghurt. They may not have energy to cook for several days. Consider Meals on Wheels if ongoing.
- Set up medication reminders
Phone alarm, pill organiser (Webster pack from pharmacy), or a daily check-in call service that prompts about medications.
- Ensure they can reach a phone from bed and bathroom
Most falls happen at night and in the bathroom. A cordless phone or mobile on the bedside table is essential.
- Do a quick safety walk-through
Remove loose rugs, clear pathways, check lighting (especially hallway and bathroom at night), ensure handrails are secure. Full fall prevention checklist.
- Check wound care and bandages
If applicable, ensure dressings are clean and dry. Check for redness, swelling, or discharge. The discharge summary should specify wound care instructions.
- Confirm GP follow-up is booked
Within 7 days of discharge. Book a longer appointment (double booking) and bring the discharge summary. Many GPs offer home visits for post-hospital patients.
- Set up a daily check-in system
Family call roster, Red Cross Telecross, or a service like Kindly Call. Someone needs to make contact every single day for at least the first month.
- Watch for delirium
New confusion, agitation, hallucinations, or dramatic personality changes in the days after hospital discharge are not normal aging. Post-operative delirium affects 15–25% of elderly patients and requires medical attention.
- Assess if they are managing independently
Can they get in and out of bed? Shower safely? Prepare basic meals? If struggling with any daily task, contact the hospital social worker or My Aged Care.
- Check medication compliance
Are they taking the right medications at the right times? Count remaining pills against what they should have taken. Medication errors are the leading cause of preventable readmission.
- Review food and fluid intake
Check the fridge. Are they eating and drinking enough? Dehydration and malnutrition accelerate rapidly in elderly patients after hospitalisation.
- Contact My Aged Care if ongoing support is needed
Call 1800 200 422. You can call on your parent's behalf with their consent. Assessment and support can be arranged while Transition Care is still running.
Week 2 to Month 1: The Dangerous Gap
The first week gets attention. The second, third, and fourth weeks are where things quietly go wrong.
elderly patients are readmitted to hospital within 30 days of discharge
Source: AIHW, Australian Hospital Statistics 2024–25
of readmissions are preventable with proper post-discharge monitoring
Source: Australian Commission on Safety and Quality in Health Care
After the initial flurry of activity, family attention naturally fades. Your parent may insist they're “fine” because they don't want to worry you. But the first month post-discharge is when deconditioning, medication errors, and falls are at their highest risk. The hospital safety net is gone, and community services may not yet be in place.
| Risk Factor | What to Watch For | Severity |
|---|---|---|
| Delirium / new confusion | Sudden personality change, agitation, not recognising familiar people or places. Common in over-75s post-surgery. | High |
| Medication errors | Taking old medications alongside new ones, wrong doses, forgetting doses entirely. | High |
| Falls | Unsteady on feet, dizziness from new medications, trip hazards at home, getting up at night. | High |
| Dehydration / poor nutrition | Not drinking enough, skipping meals, unable to prepare food, loss of appetite. | Medium |
| Wound infection | Redness, swelling, warmth, discharge, or increasing pain around surgical site or IV sites. | Medium |
| Depression / withdrawal | Loss of interest, not answering phone, sleeping all day, expressing hopelessness. | Medium |
| Blood clots (DVT) | Swollen, red, or painful calf. Shortness of breath. Risk increases with immobility post-surgery. | High |
This is why daily contact — whether from family, a volunteer service, or a check-in call service — is critical for the full first month after discharge.
Government Support You Can Activate NOW
These programs exist specifically to support elderly Australians after hospital discharge. Most can be initiated from the hospital before your parent leaves.
| Program | What It Covers | How to Access | Timeframe |
|---|---|---|---|
| Transition Care Program (TCP) | Nursing, personal care, allied health, home help. Bridges the gap between hospital and home. | Ask the hospital social worker before discharge. Referral is made by the hospital. | Starts immediately, up to 12 weeks |
| Commonwealth Home Support Programme (CHSP) | Meal delivery, transport, social support, home modifications, nursing. | Call My Aged Care: 1800 200 422. Can apply from hospital. | 2-6 weeks for assessment |
| Support at Home (from Nov 2025) | Ongoing in-home support across 8 levels. Replaces Home Care Packages. | My Aged Care assessment required. Call 1800 200 422. | 4-12 weeks (start ASAP) |
| Hospital Social Worker | Free coordination of all the above. Knows what your parent qualifies for. Advocacy and referrals. | Ask the nursing staff to arrange a visit. Available in every public hospital. | Same day (before discharge) |
The single most important step: Ask to speak with the hospital social worker before discharge. They coordinate all of the above and can fast-track applications. This service is free in every Australian public hospital. Full guide to aged care funding.
Red Flags: When to Call the Hospital Back
Call the ward directly or present to ED if your parent experiences any of the following after discharge:
This is NOT a normal part of aging or “just being tired.” Post-hospital delirium is a medical emergency that can be reversed with treatment.
May indicate infection — urinary tract, wound site, or respiratory. In elderly patients, even a low-grade fever can signal serious infection.
Signs of surgical site infection. Some redness is normal initially, but spreading redness, pus, or increasing pain is not.
Dehydration develops rapidly in elderly patients and can cause falls, confusion, and kidney failure.
A fall in the first week post-discharge needs medical assessment. They may have a head injury, fracture, or blood thinner complication they are not aware of.
Dizziness, nausea, rash, excessive drowsiness, or breathing changes after starting new medications.
Call the ward directly (faster than ED) or Nurse-on-Call: 1300 60 60 24 (24/7, free, available Australia-wide)
Setting Up Daily Monitoring
The first month after hospital discharge requires daily contact of some kind. Here are your options.
Family Call Roster
Divide daily calls among family members. Works well short-term, but often breaks down after 1–2 weeks as life gets busy.
Cost: Free | Reliability: Variable
Red Cross Telecross
Volunteer-run daily phone calls. Excellent service but limited availability, waitlists in some areas, and calls may be brief.
Cost: Free | Availability: Limited
Daily Check-In Call Service
Services like Kindly Call make daily calls at a set time, check on wellbeing, remind about medications, and alert family to concerns. Available immediately.
Cost: From $1/week | Reliability: Daily, consistent
The method matters less than the consistency. What matters is that someone makes contact every single day for at least the first four weeks. If your parent says “I'm fine” but sounds confused, flat, or different — that's a signal, not a reassurance. Compare all daily check-in options.
Related Reading
Fall Prevention for Seniors Living Alone
Home safety checklist and risk reduction strategies.
Caring for Elderly Parents from a Distance
Practical guide for families who live far away.
Aged Care Funding for Daily Calls
Government programs that can cover monitoring costs.
Dementia and Daily Phone Calls
How daily calls support people with cognitive decline.
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