The first week at home after a hospital stay is a period of adjustment, and it is also when problems most commonly appear — a medicine mix-up, a patient not drinking enough, or a slow return of the original illness. Knowing what to watch for helps families act early.
In hospital, a patient is observed by nurses and doctors throughout the day. At home, that responsibility is shared with family members who may not know exactly what to watch for. Patients are often weaker than before their illness, may be taking new medicines, and may still be recovering from the underlying condition.
Most people recover steadily after discharge. But when problems do occur — such as dehydration, a medicine error, a new infection or the original illness returning — they often appear in the first days. Recognising them early allows simpler treatment and can prevent readmission.
The discharge summary is the most important document you will receive. It usually explains the diagnosis, the treatment given, the medicines to continue, any medicines stopped or changed, planned follow-up and tests, and warning signs to watch for. Read it on the first day, while any questions are fresh, and keep it in a place where all caregivers can find it.
If anything in the summary is unclear — handwriting, abbreviations, doses or instructions — ask the hospital team or your doctor early. Our guide on medicines after hospital discharge explains how to check the medicine list.
Watch whether the symptoms that led to admission are gradually improving, staying the same or returning. For example, after pneumonia, breathlessness and cough should slowly improve; after a heart failure admission, increasing leg swelling or breathlessness when lying flat may be important. Ask the ward team which specific signs are relevant to the patient's condition.
Check that each medicine is being given as listed on the discharge summary — the right medicine, dose and time — and that old medicines that were stopped are not being taken by mistake. Watch for possible side effects such as dizziness, drowsiness, rash, stomach upset or unusual bleeding.
Appetite is often reduced after illness. Small, frequent meals and regular drinks help. Tell the doctor if the patient is eating very little for several days, has difficulty swallowing, or is not drinking enough — see preventing dehydration.
Note whether the patient is passing urine normally. Reduced urine output can be a sign of dehydration or kidney problems. Constipation is common after a hospital stay, particularly with reduced mobility and some pain medicines, and can cause discomfort and confusion in older people.
Many patients are unsteady at first. Supervise walking, especially at night and on stairs, and use any walking aids provided. Falls are a common problem in the first weeks; our guide on preventing falls offers practical steps.
Some older patients may have ongoing confusion after a hospital stay, particularly if they experienced delirium during the illness. It should not simply be assumed to be a normal consequence of hospitalisation. Persistent, new or worsening confusion, unusual drowsiness or agitation should be medically reviewed promptly.
If the patient has a surgical wound, a urinary catheter, a cannula site or another device, check it daily as instructed. See our guides on wound care and urinary catheter care.
A notebook with a few lines each day is often enough. Useful entries include:
Note the dates of clinic appointments, repeat blood tests and any other planned reviews. These are often arranged to check that a problem has settled, or that new medicines are safe. Missing them can mean that a problem is detected late. If attending a clinic is difficult, ask whether a review or repeat blood tests can be arranged at home.
If the patient's original symptoms return, or new symptoms appear, do not wait for the next scheduled appointment. Our guide on when to contact a doctor after discharge explains how to judge the urgency, and when home care is not enough lists emergency warning signs.
The first week can be tiring for families. Sharing tasks, writing down responsibilities and asking for help early reduces the risk of mistakes caused by exhaustion. If caring at home is becoming difficult, tell the doctor; additional support, such as nursing visits, may be possible.
Published by: Sineth Hospitals
Medically reviewed by: Dr. Seneth Gajasinghe, MBBS (Colombo), MD (Colombo), Medical Director, Sineth Hospitals
Last reviewed:
Follow the discharge summary and the instructions of the hospital team. This guide is general information and does not replace them.
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