Family Caregiver Checklist for Hospital Discharge in Rhode Island

You just became your parent's primary caregiver. Maybe it happened when the ER called at midnight. Maybe it crept up over months. Either way, the hospital is about to send your parent home, and the discharge plan assumes you know what you are doing.

You do not need to know everything. You need a structured sequence of actions, executed in the right order, at the right time. This checklist covers the 48 hours before discharge through the first week at home.

Before Discharge: The Hospital Phase

Designate yourself formally. Under Rhode Island's CARE Act, tell the hospital you are the designated family caregiver. This goes into your parent's electronic medical record and triggers the hospital's legal obligation to assess your capabilities and train you on after-care tasks before discharge.

Attend the care conference. This is not optional. The multidisciplinary team — physician, nurses, physical therapist, social worker — reviews the discharge plan in one meeting. If you cannot attend in person, request a phone-in option. Ask about:

• Diagnosis-specific recovery timeline
• Medications changed during the stay (and why)
• Activity restrictions (weight-bearing limits, driving restrictions, stair climbing)
• Warning signs that require immediate medical attention

Demand hands-on training. If the discharge plan includes wound care, insulin injections, catheter management, or any skilled nursing task, the hospital must train you in person. A printed instruction sheet is not training. Practice the task with a nurse watching you before your parent leaves.

Confirm equipment delivery. Every piece of durable medical equipment — hospital bed, walker, oxygen, shower chair — must be confirmed for delivery before the discharge date. If the supplier cannot deliver in time, push back on the discharge date.

Preparing the Home

The fall-proofing sweep (do this 24 hours before discharge):

• Remove all scatter rugs and loose floor coverings
• Secure or relocate electrical cords along walkways
• Install nightlights in the hallway, bathroom, and bedroom
• Clear pathways wide enough for a walker or wheelchair (at least 36 inches)
• Move frequently used items (phone, medications, water, remote control) within arm's reach of where your parent will sit or sleep

Bathroom modifications:

• Install grab bars next to the toilet and inside the shower or tub
• Place a shower chair or transfer bench in the tub
• Add a hand-held shower head (available at any hardware store for under $30)
• Put non-slip mats inside the tub and on the bathroom floor

Bedroom setup:

• If your parent cannot climb stairs, set up a sleeping area on the main floor
• Ensure the bed height allows your parent to sit on the edge with feet flat on the floor
• Place a bedside commode if the bathroom is more than a few steps away
• Set up a bell or baby monitor so your parent can call for help from bed

Discharge Day

Medication pickup:

• Fill all new prescriptions before leaving the hospital — do not wait until you get home
• Set up a daily pill organizer with the exact schedule from the discharge medication list
• Note which medications are new, which doses changed, and which pre-hospital medications were discontinued

Paperwork collection:

• Discharge summary with all diagnosis codes
• Complete medication list with dosing schedule
• Follow-up appointment dates and physician phone numbers
• Home health agency contact information and first visit date
• Written wound care or therapy instructions

Transportation:

• Bring non-slip shoes and a change of comfortable clothing
• If your parent needs a wheelchair to reach the car, arrange with the hospital in advance
• Plan the route home to minimize stairs at both the hospital exit and home entrance

The First Week at Home

Day 1-2: Clinical stability.

• Take and record vital signs (temperature, blood pressure, pulse) twice daily
• Administer all medications exactly as scheduled — set phone alarms for each dose
• Monitor the surgical site, wound, or catheter per the discharge instructions
• Confirm the home health nurse's first visit is scheduled (should be within 24-48 hours)

Day 3-5: Follow-up coordination.

• Call the primary care physician to schedule a follow-up within 7 days of discharge
• Confirm physical/occupational therapy start dates
• Contact The POINT (401-462-4444) if you need help with meal delivery, transportation, or additional personal care services

Day 5-7: Caregiver logistics.

• If siblings or other family members are sharing caregiving duties, set up a written rotation schedule
• Assign specific responsibilities: who manages medications, who handles transportation, who tracks bills and insurance claims
• Start a communication log — one shared document where everyone records what happened during their shift (vitals, medication given, mood changes, falls, physician calls)

When to Ask for More Help

You are not failing if you need more support than the discharge plan provided. Signs you need to escalate:

• You are unable to physically manage transfers (bed to wheelchair, wheelchair to toilet) without risking injury to yourself or your parent
• Your parent is refusing medications, meals, or therapy
• You are sleeping fewer than 5 hours per night for more than 3 consecutive days
• Your parent has fallen, even without injury
• The home health visits are not frequent enough to address your parent's clinical needs

Rhode Island's ADRC (The POINT) at 401-462-4444 can connect you with respite care, adult day programs, and personal care aide services — many on a sliding-scale cost-share basis under the state's Global Waiver.

The Rhode Island Hospital Discharge Toolkit includes all of these checklists in printable, fillable format — plus a medication reconciliation worksheet, caregiver shift log, and emergency contact card designed for the bedside.

See more Rhode Island guides →