The answer to this question varies. For example, if an elderly person has been hospitalized with a broken hip, a hospital discharge planner - usually a nurse or social worker - is supposed to help the patient and caregiver order the proper equipment and supplies. If home care has been arranged through a certified agency, the nurse or supervisor is supposed to arrange delivery of necessary equipment and disposable supplies. If a patient has been in a rehabilitation facility or a rehabilitation unit in a nursing home, a physical therapist is supposed to evaluate the need for home equipment and coordinate the ordering. Sometimes a doctor will prescribe medical supplies such as nutrition supplements or needles for insulin injections, which can be obtained from a pharmacy. However, nothing should be taken for granted and the responsible person - whether the patient or the caregiver - must follow up to make sure the proper equipment is ordered and delivered on time.
Due to the current brevity of most inpatient hospital stays, the discharge plan may not be discussed until the last minute, leaving little time to plan for and obtain needed equipment and supplies. Furthermore, equipment used in the hospital may differ from that available for home use, so instructions provided in the hospital may not be applicable to the home setting. Some well-intentioned discharge planners may order equipment and supplies of the wrong kind because they are not adequately informed about a patient's specific needs and the home environment. Therefore, caregivers should offer as much information as possible and also should ask questions about equipment and supplies to ensure that the products will be provided. For example, ask if the hospital bed will have electric rather than hand-operated controls and be equipped with an air mattress to prevent pressure sores.
Based on prior conversation with the patient's insurer, the discharge planner may only present the equipment option for which the insurer will pay. Therefore, you should ask the discharge planner to inform you of all options, not just the one the insurance company approves. Some negotiation then may be necessary in order for other, more suitable equipment to be delivered and its additional cost covered by the insurance company or, if need be, paid out-of-pocket. It's up to the caregiver to be diligent in determining and obtaining what is best for the care recipient, even if doing so requires an appeal of the insurer's decision.
A discharge plan is just that - a plan to release the patient from the hospital safely. If other needs become apparent once the patient is home, the caregiver and the home care nurse (if one is involved in the case) should identify and obtain the necessary equipment or supplies.