With the stress and worry of having a loved one in the hospital—and then helping with the transition home afterward—it’s easy to lose track of prescriptions and how they are supposed to be used.

Yet medication management is among the most important tasks for caregivers. Medication errors can easily cause additional health problems, sometimes very serious ones.

But there are a few things you can do to stay on top of your loved one’s medication regimen, even during moves between hospital, home, and a rehabilitation or skilled nursing facility.

Make a medication list

First and foremost, take a close look at what your loved one is taking and make a complete medication list. Make sure that list goes with your loved one and is updated regularly. (Check out post about tips on creating medication lists.)

Many patients have had health problems that could have been avoided—if they’d had a current medication list to share with their medical providers and pharmacists.

For example, Jenny* went home after a hospital stay with a prescription for Coumadin (warfarin) to prevent blood clots from forming and causing a stroke, heart attack or organ damage. After recuperating for a while at home, she joined her daughter’s family for a vacation, but had a urinary tract infection while she was away. Jenny hadn’t added Coumadin to her medication list, so the health care provider at the local clinic didn’t realize she was taking it. An antibiotic that intensifies the effect of the blood thinner was prescribed, and the local pharmacist didn’t have the records that would've raised a red flag.

Jenny had nosebleeds at first and soon progressed to having internal bleeding. The bleeding was so extensive that she needed to be admitted to the hospital and received multiple transfusions.

Somewhere along the way, the information about her current medication use was lost. Luckily, she was able to make a full recovery and get back on track quickly.

Get the information you need

When your loved one is returning home after a stay at the hospital, rehab, or skilled nursing facility, make sure to:

• Ask to speak with a discharge pharmacist to go over the medications, including their dosages and their purposes.
• Request that the hospital staff call the prescriptions in to your pharmacy, so you’ll have less of a wait when you go to pick them up. If there's a retail pharmacy located in the hospital, ask if the prescriptions can be filled there before discharge.
• Find out if there are specific instructions, especially for inhalers and injectable medications.
• Ask whether prescriptions previously issued by other prescribers should still be taken. If any of the medications that will no longer be used are on automatic refill, notify the pharmacy, so you won’t be charged for medications that aren't needed.
• Ask your loved one’s primary care provider or the hospital’s discharge pharmacist for help, so you understand what each prescription (old and new) is for. Names for generic and branded medications are different, so it’s important to be familiar with both. For example, someone could be prescribed the brand name version of a medication they're already taking and not realize they're the same thing. This could lead to them mistakenly taking a double dose, which could have negative consequences. 

Watch for issues with these 3 drugs

Three types of drugs that are frequently prescribed by hospitals are also the most likely to cause side effects that could send your loved one back to the hospital. They are:

• Opioids
  This class of medications includes pain reducers such as oxycodone, oxycodone/acetaminophen, hydrocodone, and morphine. Because they are highly addictive and can have potentially serious side effects (such as accidental overdose), opioids need to be prescribed carefully and monitored closely. Opioids should be used at the lowest effective dose for the shortest amount of time possible. And they should be kept in a safe place away from children, pets, and anyone who has an addiction to opioids.
  
  A notable and common side effect of opioid use is constipation. If untreated, it can result in an intestinal blockage. Ask the provider if a laxative is needed, and if the answer is yes, make sure your loved one takes it. 
 
• Diabetes medications
  If your loved one is diagnosed with diabetes and begins taking insulin or another medication to lower blood sugar, you should know the signs of hypoglycemia (low blood sugar). Low blood sugar can cause fatigue, weakness, paleness, shakiness, anxiety, sweating, hunger, irritability, and fast heartbeat. People with severe hypoglycemia can seem intoxicated—and in severe cases they can lose consciousness. Talk with your loved one’s provider about how best to address any signs of hypoglycemia.
 
• Anticoagulants
  Blood thinners such as Eliquis (apixaban), Xarelto (rivaroxaban), Lovenox (enoxaparin), and the less commonly prescribed warfarin are used in various situations. If your loved one has excess bruising, gum bleeding, or blood in the urine, contact his or her provider. If your loved one develops unexplained fatigue that doesn't go away, talk to their health care provider.

These drugs interact with other medications—including ibuprofen, antibiotics, and many more—as well as several foods, including green tea, leafy green vegetables, cranberries, grapefruit, and others. Be sure to tell the prescriber if your loved one has had any changes in medication or diet.

Communicate with both doctor and pharmacist

Some of these recommendations may seem like common sense, but it’s not unusual for some of them to slip through the cracks. A simple misunderstanding between any of the parties can have far-reaching effects.

For years, Marco* has taken insulin once a day to control his diabetes. But while he was hospitalized for another issue, he was given insulin 3 times daily. When Marco was being discharged, his physician told him to continue to take his insulin 3 times a day when he got home.

That’s exactly what Marco did—but he used his existing supply of insulin that was a long-acting formula meant to be taken only once a day. Taking it 3 times in a day lowered his blood sugar so much that he got dizzy when he stood up, lost his balance, and broke his hip when he fell. His recovery was long, slow, and painful.

Marco is not alone in experiencing serious consequences due to drug errors. Often mistakes can be avoided with better communication and a current medication list. Helping your loved one with medication management can make all the difference.

* Names have been changed to protect patient anonymity.

Originally published: August 2018
Last updated: January 2026

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