The first 48 hours after your parent is admitted: an admin checklist

Hour one: the seven facts to write down

You will be given a great deal of information in the first hour and you will remember almost none of it. Before anything else, open a note on your phone and get seven things down in writing.

The unit or ward name. The room number. The direct phone number for the nurses' station, not the hospital switchboard. The name of the attending physician or hospitalist, spelled out. The name of the case manager or social worker assigned to your parent. The medical record number from the wristband or the admission paperwork. The date and time of admission.

Those seven lines are what every later call needs. At nine in the evening the switchboard will not connect you to a ward you cannot name, and the record number is what turns a five-minute hold into a thirty-second one.

While you are at the desk, ask two more things: what the visiting hours are, and which entrance is open after hours. Write the answers on the same note. Then photograph the note and send it to yourself by email so it exists somewhere other than a phone that may run out of battery in a waiting room.

• Unit or ward name
• Room number
• Direct phone number for the nurses' station
• Attending physician or hospitalist name
• Case manager or social worker name
• Medical record number (MRN)
• Admission date and time
• Visiting hours and the after-hours entrance

What to bring from the house, and what to leave there

The second trip is the one you can plan. Make a list before you drive back, because standing in your parent's bedroom at midnight is not when good decisions get made.

Bring: glasses and the case, hearing aids and spare batteries, dentures and a container, any breathing or mobility equipment already in daily use, phone and a charging cable longer than you think you need, insurance cards and photo ID, a small amount of cash, non-slip socks, a cardigan, lip balm, a comb, a pen and a notebook, and a printed list of family phone numbers in case the phone dies.

Leave at home: jewelry, the wallet with the cards in it, large amounts of cash, the house keys beyond one set you keep with you, and anything with sentimental value.

Write your parent's name on everything in permanent marker, including the hearing aid case and the glasses case. Hospitals lose hearing aids and dentures constantly, and neither is cheap to replace. If your parent arrives wearing rings or a watch, ask the nurse for a valuables envelope and get a receipt for it.

• Glasses, hearing aids and spare batteries, dentures and container
• Phone plus a long charging cable
• Insurance cards, photo ID, a little cash
• Non-slip socks, cardigan, lip balm, comb
• Pen, notebook, printed family phone list
• Name written on every single item
• Leave behind: jewelry, cards, keys, valuables

The medication list: copy it, do not summarize it

Someone will ask for your parent's medication list within the first few hours, and it will be asked for again by a different person the next day. Get it right once.

Photograph every bottle, box, tube and blister pack in the house, including the ones in the bathroom cabinet and the one by the bed. Then transcribe exactly what is printed on the label: the name as written, the strength as written, how often the label says to take it, the prescribing doctor, the pharmacy, and the date on the label. Include over-the-counter items, vitamins, supplements, eye drops, creams, inhalers, patches and anything taken only when needed.

Copy. Do not edit, do not round, do not tidy it up into what you think it means. Transcription is your job here; interpretation is the pharmacist's and the doctor's.

Add known allergies exactly as your family has always reported them, and note the date and time of the last dose if you actually know it. If you do not know, write not known rather than guessing.

Bring the bottles in a labeled bag if you can. Many units want to see the containers. Ask the nurse whether they keep them or send them home, and write down which.

One update, one channel

The thing that exhausts people in the first 48 hours is not the hospital. It is the eleventh phone call from a relative asking the same question.

Set the rule on the first evening. One person is the point of contact for the hospital, and the ward is given that one number. One group message goes out at a fixed time each day, and it contains facts only: where your parent is, what is scheduled, what has been arranged, and what is actually needed from anyone. Speculation stays out of it, because speculation multiplies.

Tell your family the update time in advance. People call less when they know when the news is coming.

Ask the nurse or the unit clerk what the hospital requires before staff are permitted to share information with a family member, and whether a form needs to be signed. Every hospital has its own process, and the person at the desk knows it. Get the form done early rather than at the point when you urgently need an answer.

Write the answer, the form name and the date in your notebook. If a different relative is on the ward on day three, they will need to know what was already arranged.

• One named point of contact for the hospital
• One daily group message at a fixed time
• Facts only: location, schedule, arrangements, needs
• Ask the unit what form is needed before staff can share information
• Write down the form name and the date it was signed

Day two: the questions, and who answers which

Different people answer different questions, and asking the wrong person costs you a day. Keep one running page of questions and write the right initials next to each.

The bedside nurse knows today: what is scheduled, when tests are happening, who has been in the room, and when the next shift starts.

The attending physician or hospitalist does rounds at a set time. Ask the nurse what that time is and be there for it. A question asked in person during rounds gets answered; the same question left as a message often does not.

The case manager or discharge planner owns what happens next: what has to be arranged, what forms are required, and roughly how long things take.

The hospital pharmacy takes medication questions. Patient accounts or billing takes insurance, authorization and paperwork questions.

Write the answer on the same line as the question, with the date and the name of the person who gave it. Ask for a reference number where there is one. Two days later, when someone says the opposite, you will have a name and a time rather than a feeling.

Open the discharge file on day one

Discharge is usually decided faster than anyone expects, and often on a Friday. Start the file while you still have time to read things.

Buy a plain folder in the hospital gift shop. Everything you are handed goes into it, and you photograph every page before it does, because paper gets lost in car doors and hospital bags.

What usually ends up in that folder: the discharge or after-visit summary, the discharge medication list, follow-up appointment details, referral slips, orders for equipment, contact details for any agency involved, and forms the hospital needs signed.

Ask the case manager on day one, not day four: what has to be in place at home before your parent can leave, who arranges each of those things, how much notice you will get, whether transport is arranged by the hospital or by you, and what number to call at the weekend if you have a question after discharge.

Write the answers down. Then, while you are still at the house collecting things, measure the front step, the internal door widths and the stairs, and photograph the bathroom. If anyone asks about equipment later, you will have the numbers instead of a guess.

• A plain folder, started on day one
• Photograph every page before filing it
• Ask: what must be in place at home, and who arranges it
• Ask: how much notice, and who arranges transport
• Ask: what number to call at the weekend after discharge
• Measure doorways, steps and stairs while you are at the house

Questions