MY CARE DIARY
Care team members :_______________________________________________________________________________
RESOURCES
Medications or procedures :_________________________________________________________________________
Questions or notes :________________________________________________________________________________
_______________________________________________________________________________________________
DISCHARGE INSTRUCTIONS
Your care team will review the information below with you . For care partners , it is extremely important that you make plans to be at the bedside when discharge instructions are discussed , so you can learn how to help your loved one . You will need time to learn about and practice any special care needs such as changing dressings , turning and skin care , feeding tubes , or giving shots .
• My expected discharge date is :_____________________________________________________________________
_______________________________________________________________________________________________
• I was admitted to the hospital for :___________________________________________________________________
_______________________________________________________________________________________________
• When I am discharged from the hospital , I will go :______________________________________________________
_______________________________________________________________________________________________
• My discharge instructions are :______________________________________________________________________
_______________________________________________________________________________________________
• If I have any restrictions , they are :___________________________________________________________________
_______________________________________________________________________________________________
• If I have questions , I should call :____________________________________________________________________
_______________________________________________________________________________________________
• I should always call if I experience :__________________________________________________________________
_______________________________________________________________________________________________
• If my appointments are not on my discharge papers , what follow-up appointments should I have and with whom ?
_______________________________________________________________________________________________
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