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

What to do now

1. Raise urgent symptoms immediately.
   Tell the nurse at once about new or severe symptoms, distress, or immediate danger. If your relative is already at home and enrolled in hospice, use the hospice contact route for symptoms. Call 911 immediately for an emergency.

2. Ask for the discharge-planning conversation now.
   Ask the nurse to contact the staff member coordinating discharge and the treating clinician. Ask for palliative care if it is available. Say: “There is no safe care plan at home. Please discuss the discharge plan with us before the handoff.”

3. State the home limits plainly.
   Say who is actually available at home and what they cannot safely do. Mention overnight gaps, lifting, toileting, medication administration, stairs, access problems, distance from help, and whether the person would be alone. Ask the team to record these limits and plan around them.

4. Ask for specific names, start times, and contact routes.
   Ask:

   • What does the team expect your relative to need immediately after discharge?
   • Which services have been ordered, and when will each one start?
   • Which agency or clinician is responsible for each part of the plan?
   • Who should you call if a service does not arrive?
   • What number should you use after hours if symptoms worsen?

5. Ask how medications, equipment, and transport will work.
   Ask which medications must be available before your relative arrives home, who will prescribe them, and where they can be obtained. Ask when any ordered equipment, such as a bed, commode, or oxygen, will arrive. Ask whether the transport plan and access to the home are workable.

6. Ask for an urgent hospice evaluation if that fits your relative’s goals.
   Say: “Could hospice evaluate whether it can help and explain what level of care may be available?” Ask when the evaluation can happen, when services could start, and what support is realistically available in the area. Hospice options depend on assessed needs and local availability.

7. Ask for the details in writing.
   Request written discharge instructions and a written list of confirmed arrangements. Ask for medication instructions, ordered services, equipment arrangements, start times, agency contacts, the after-hours contact route, and the follow-up plan. Ask the team to explain anything unclear.

8. Use the Medicare fast-appeal route promptly if it applies.
   If your relative is a Medicare hospital inpatient and you believe discharge is too soon, ask for the Important Message from Medicare and follow its appeal instructions by the deadline on the notice. A Detailed Notice of Discharge is provided after an appeal is requested. If your relative has a Medicare Advantage plan, ask whether plan-specific steps also apply.

9. Escalate inside the hospital if the concern is not being addressed.
   Ask for the charge nurse, nurse manager, or patient relations service if available. Repeat the practical point: “There is no feasible care plan at home, and we need the discharge safety concern addressed.”