What to do if…
a hospital is discharging a dying relative and you have no care plan at home

What to do now

1. Say the safety problem plainly and ask for it to be recorded.
   Ask the nurse in charge to tell the ward doctor, discharge coordinator or discharge team, and specialist palliative care team. Say: “There is no safe care plan at home, and we cannot provide the care required.” Ask them to write this in the notes.

2. Ask for a same-day discharge planning conversation.
   Ask for a short meeting or phone call with the discharge lead and, if involved, social work or adult social care liaison. Ask:

   • “What exact date and time is being proposed?”
   • “What must be in place before discharge?”
   • “Who is the named coordinator I can call today?”
   • “Who is responsible for arranging care visits, equipment, medicines, and community nursing?”

3. Check the first 24 hours at home, not the whole future.
   Ask the team to describe the first day hour by hour where needed:

   • what time your relative would arrive home
   • what medicines they will have with them
   • what equipment will already be there
   • who will visit first, and when
   • who to call overnight if symptoms worsen or care breaks down
   • what to do if the planned carer or nurse does not arrive

4. Ask what can happen if home is unsafe today.
   If your relative no longer needs an acute hospital bed but home is not ready, ask what short-term local options can be arranged before discharge. These may include urgent home-care visits, community nursing, rapid response input, equipment delivery, hospice support, or a temporary assessment bed, depending on local services and clinical need.

5. If your relative is nearing the end of life, ask about urgent palliative and funding routes.
   Ask the palliative care team or ward doctor: “Is there an urgent end-of-life discharge route, hospice-at-home route, or rapid community palliative care route here?” In England, also ask: “Should NHS Continuing Healthcare Fast Track be considered, and can an appropriate clinician complete the tool today?” Fast Track is for people with a rapidly deteriorating condition who may be entering a terminal phase; support is intended to be arranged quickly, often within 48 hours, but ask what will happen locally and by when.

6. Get a written plan before discharge happens.
   Ask for a written discharge plan, even if it is a draft. It should say:

   • medicines, including symptom-control medicines and how to get urgent medicines out of hours
   • equipment, such as a hospital bed, commode, pressure-relief mattress, hoist, or oxygen if needed
   • clinical support, including community or district nursing and palliative care contact routes
   • personal care visits, including start date, times, and whether any night support is arranged
   • transport and handover, including who books it and who will be at home when your relative arrives

7. Escalate the same day if discharge is still being pushed with gaps.
   Ask for the ward manager, matron, senior nurse, or duty manager. In England, contact PALS and say: “We are raising an urgent discharge safety concern because no safe plan exists at home.” In Scotland, Wales, or Northern Ireland, ask the hospital switchboard or ward for the patient advice, liaison, concerns, or complaints route.

8. Ask how decisions are being made if your relative cannot clearly decide.
   Ask: “Has capacity for this discharge decision been assessed today?” If your relative cannot make or communicate the decision, ask how the decision-making process is being documented and how family, carers, attorneys, guardians, or representatives are being involved where appropriate.

9. Give the team a short home reality note.
   Write one page with who is at home, what you can and cannot do, whether anyone can cover nights, stairs or access problems, lifting or toileting issues, pets, distance from the hospital, and any immediate risks. Ask for it to be added to the notes and used in the discharge plan.