Moving day — the logistics and the emotions

This article is for informational purposes only and does not constitute medical, legal, or financial advice. Please consult appropriate professionals for guidance specific to your situation.

Moving day comes quickly. You've done facility tours and signed paperwork, and suddenly there's a discharge date. Your parent is leaving the hospital or leaving home, and there's a bed waiting at a skilled nursing facility or rehabilitation center. The paperwork says what time to arrive. What to bring. What's provided. And you're trying to pack your parent's life into what will fit in a facility room while managing a logistics nightmare and an emotional avalanche.

This isn't like moving to a new house where you're excited about new beginnings. This is the moment you've been dreading. The moment that makes it real. Your parent is moving because their body failed them or their mind is slipping or their situation became unsafe. They're moving because you made a decision that felt impossible. Now you're executing it, and the emotions are overwhelming. You're sad. You're terrified. You're guilty. You're exhausted. And you also have to figure out whether your parent's medications came with them and whether the facility actually has a wheelchair accessible bathroom.

The transition from hospital to facility is actually medically critical, and it's also logistically chaotic. Getting it right requires attention to detail when you're emotionally unable to focus. Here's what matters.

Transition from Hospital

The hospital discharge team is responsible for coordinating the move, but "coordinating" is a generous term. They'll send your parent's medical records ahead, or they won't. They'll ensure medications are transferred to the facility, or there will be medication gaps. They'll communicate any special care instructions, or something important won't get mentioned. The system is supposed to work. Frequently it doesn't. Your job is to make sure it does.

Before your parent leaves the hospital, sit with the hospital discharge planner and ask specifically about the handoff. What medications is your parent on? Get a printed list with doses and frequencies. Don't trust that the facility has it. Bring a copy with you. Ask about any special precautions or monitoring. If your parent had a blood clot or an infection, the facility needs to know. Ask about pain management. How much pain is your parent in? What's the plan if they're in more pain at the facility? Ask about equipment. Does your parent need a special mattress to prevent pressure sores? Does your parent need a Foley catheter or other medical equipment? Make sure you understand what's being sent with your parent and what the facility is supposed to provide.

Medical records are legally required to be sent, but they sometimes get lost. Call the facility the day before your parent arrives and ask to confirm they have received the records. Ask specifically about the hospitalization summary, the discharge summary, and the medication list. If any are missing, push the hospital to send them. Don't wait until your parent is there and the facility can't provide proper care because they don't have critical information.

Also ask the hospital whether there are any follow-up appointments scheduled. Your parent might need to see the surgeon who did the hip repair. Your parent might need cardiology follow-up after a heart event. The hospital might have made these appointments, or they might not. Get the details. The facility will be responsible for getting your parent to appointments, but you need to know they're happening.

One of the critical handoffs that frequently gets botched is medication reconciliation. Your parent is on ten medications in the hospital. The hospital discharge paperwork lists them. But when your parent arrives at the facility, the facility might not have all of them immediately available. There's a waiting period while pharmacy processes the orders. During that waiting period, your parent isn't getting their blood pressure medication or their anxiety medication or their pain medication. This is dangerous and creates discomfort. When you arrive at the facility, make sure medication administration is your first conversation. Ask whether all medications have arrived. Ask when the first doses will be administered. Don't assume it's been handled correctly.

Your Role as Advocate

The days following admission are critical for establishing your role as an advocate without making staff feel like you're criticizing them or don't trust them. Staff at most facilities deal with families who are either completely absent or overly involved and combative. You want to be involved but collaborative. You want to ask questions without implying they're doing something wrong. This is a delicate balance, but getting it right pays dividends.

Start by being present. Spend time at the facility during the first week. Not all day every day, but enough that staff learn to recognize you and that you're there. You'll overhear conversations. You'll notice how the staff treats your parent. You'll see what the routine is. You'll get a sense of whether your parent is being rushed through therapy or supported through it. You'll understand whether the facility is chaotic or organized. You'll notice whether your parent seems okay or scared.

Ask questions about everything. What time is breakfast? What time is physical therapy? Are there morning and afternoon sessions? What should your parent expect? Does your parent have a primary nurse or multiple nurses? What's the best way to reach the team if you have questions? Ask about your parent's specific medical needs. Is the wound from surgery healing normally? Is pain being managed adequately? Is your parent sleeping, or are they anxious and awake all night? Ask about participation in activities. Is your parent invited to meals? To group activities? Is your parent choosing not to participate, or are they being isolated?

Also ask about your parent's emotional state. Is your parent crying? Withdrawn? Angry? Acting out? This is information you need because emotional struggles affect physical recovery. If your parent is depressed about being in the facility, they're less likely to participate in therapy. If your parent is confused or frightened, they're at higher risk for falls or accidents. If your parent is withdrawn, depression might be setting in, and the facility doctor needs to know.

Report anything concerning to the appropriate staff member. If your parent's wound looks infected, tell a nurse. If your parent isn't eating, tell the dietitian. If your parent fell, get the report from the staff member who was present. Ask how it happened. Ask what they're doing to prevent it from happening again. Don't approach these conversations as accusations. Approach them as problem-solving. "I noticed Mom didn't eat much at lunch. What was that about? How can we help her get enough nutrition?"

Building Trust with Staff

Staff at nursing facilities and rehab centers are mostly doing their best in an understaffed system that pays them poorly and asks them to work long hours with difficult populations. Most of them didn't go into nursing to get rich. Many of them are struggling financially themselves. They're exhausted. They're burnt out. But most of them genuinely care about the people they're caring for. Building a positive relationship with staff pays off enormously.

Be kind. Recognize their effort. Bring them coffee. Say thank you. When something goes well, acknowledge it. When staff does something thoughtful for your parent, notice and express appreciation. This isn't about being fake or overlooking problems. It's about recognizing that the people taking care of your parent are human beings who respond to kindness.

Also be aware that some staff-family conflict is normal and expected. A particular nurse might have a personality clash with your parent. That happens. A therapist might seem too aggressive to you, but might be exactly what your parent needs to push through recovery. A dietary aide might not explain something the way you'd explain it, but might be doing the job correctly. Not every personality conflict or difference of approach is a problem. Save your concerns for things that actually matter.

When there are real problems, escalate appropriately. If you have a concern about a nurse, talk to the charge nurse or nursing supervisor. Don't complain to other family members or on social media. Don't start with accusations. Say, "I've noticed my mother seems anxious during the afternoon shift. I'm wondering what's happening." Give staff a chance to explain. Maybe there's a reason. Maybe they can fix it. If a problem continues, then escalate further to the facility director.

The relationship with the primary physician is also important. Meet the doctor. Ask questions about the plan of care. Ask what goals you should have for recovery. Ask what you should monitor. A good doctor is accessible to families. A good doctor returns calls and involves families in decision-making. If your parent's doctor is difficult to reach or dismissive of your concerns, that's a legitimate problem.

Sometimes you and the staff will fundamentally disagree about what your parent needs. Your parent wants to go home. Staff says your parent isn't safe at home. You think the facility is pushing your parent into activities they're not ready for. Staff thinks your parent is capable of more than you believe. These disagreements are hard, and sometimes you're right and sometimes the facility is right. The goal is to have these conversations openly, to understand each perspective, and to figure out what your parent actually needs and wants. Not every disagreement can be resolved. But most can be, if everyone is willing to listen.

How To Help Your Elders provides educational content for family caregivers. This is not a substitute for professional medical, legal, or financial advice. Every family situation is different; what works for one may not work for another.