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We hope you are well and that none of you have to go through the experience we just had.

My brother, who had a recent stroke, had to go back to the hospital recently with an infection. They kept him a few days and sent him home. When I spoke with his doctor, the plan was to put him on preventive antibiotics so he wouldn’t have another infection.  That sounded reasonable.  
There was discussion about when he would be discharged.  First, his treating doctor discussed it with the nursing case manager and the physical therapist.  It was decided that the physical therapist should check him out to be sure he was strong enough to return to his apartment at assisted living.  If so, he would be cleared to leave.

The physical therapist didn’t get around to seeing my brother that day until after 4pm. After an assessment, the physical therapist cleared him to go home.  The person who arranges transport of a patient to home at this hospital is the case manager.  She was also supposed to see that everything was ready for the patient to leave the hospital, that all the necessary medications were available and that his personal belongings were with him on discharge. 
My brother has aphasia since the stroke.  It is hard for him to say what he wants some of the time. Another brother, who is the only family in his area, was told that discharge would probably happen that day. The case manager said she would call back when a time was firm for the transfer.  But the discharge process didn’t get completed until after 5:00 pm. That was when things fell apart. The doctor was out of town that afternoon and the next day.  I got a call from my hospitalized brother:  “When am I supposed to go home?” he asked.  Some of his words weren’t clear but I got what he wanted to know. We all wanted to know. “I’m not sure”, I said . “Maybe they’re going to keep you there until tomorrow.”
There was no communication from anyone at the hospital with any family member about time of discharge or whether he was cleared to go.  Nonetheless my brother was hustled into the ambulance and driven the short distance back to his apartment.

After he got there, he called  and with the unclear words, I figured out that he was home. I was shocked. I knew he was supposed to be on antibiotics to prevent another infection. “Did they give you your new medicine?”, I asked.  No. And the people at the front desk said no medication was sent home with and there was no doctor’s prescription to get it. It was a mess. 
I spent the better part of the next day making multiple calls to figure out what prescriptions he should be taking.  Of course, the case manager was off duty, no one could reach the doctor and everyone passed the buck.  After 10 different phone calls, I got the home health RN to chase down the doctor and get the prescription filled and the antibiotics delivered that day. What a mess! 

The scenario I am describing is unfortunately not a rare occurrence.  The hospital discharge process is supposed to follow rules and procedures. The hospital is required by law to provide for a “safe discharge”. Sending a vulnerable  person home without his needed medication is dangerous and could have deadly consequences. Human error in the chain of people who were in charge of my brother was repeated by several of them.   These things happen often enough that you should never totally trust that they won’t happen to your family member.   Things do not go smoothly sometimes.  No matter how good a hospital is, there are risks and mistakes everywhere.
What Can Family Do To Help?
If you have a loved one who must be hospitalized for any reason, family members need to be on alert. Do not trust that every person involved in discharging your loved one will do as their jobs require.  No one followed through to get the hospital pharmacy to give my brother a supply of his antibiotics to get through the next day or two until he could get a pharmacy to give him the required amount of his pills.

Worse yet, my other brother had to go to the hospital itself to find out about the medication the next day. He was looking for our brother’s cell phone charger at the same time. It seems it somehow got “lost” in the shuffle.  No one was able to find it.  My brother can’t just sashay down to the store and buy a replacement. He has difficulty communicating.
I was worse than annoyed with all of this. I reported it and will continue to escalate the complaint until I am sure that someone in authority is paying attention to how this all happened. I was thinking of what others do who have a loved one at a distance. It’s scary what can go on if no one in the family is staying on top of every step of release from a hospital. I hope sharing this story saves someone from a similar problem. 

The takeaways

1.  If your loved one is going to be released from any hospital large or small, be there if you can.
2.  If the doctor has ordered anything new, ask about whether your loved one got what he or she was supposed to get.  Too often someone drops the ball. Discharge errors are common, especially nights and weekends.  Missing medication can be a life or death matter.
3.  Keep a checklist of personal belongings and valuables he or she brings in and be sure it is checked off when your loved one leaves.
Taking some extra time yourself after a hospitalization to be sure things are completed, followed up on and delivered will ensure the best outcome for your loved one.
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Until next time,
Carolyn Rosenblatt,

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