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Coming home from the hospital or other care setting after an illness or surgery can be worrisome for both patients and the friends and family members who care for them. Planning ahead can make the process much easier. The Centers for Medicare & Medicaid Services (CMS) has advice that is useful to the millions of Americans who are actively involved in caregiving. Through its caregiver initiative, Ask Medicare, CMS recommends the following steps to prepare for a transition:

• Plan ahead: You can - and should - start thinking about the discharge process well in advance, even as early as at the time of admission. CMS has a helpful checklist of key points in its "Planning for Your Discharge" guide, available at the "Medicare Basics" link on the home page of the Ask Medicare website at www.medicare.gov/caregivers. This checklist will help you prepare for the next steps in care.
• Get ready for new responsibilities: Talk to hospital staff about what you will need to do at home, who will show you how to properly carry out any new tasks you will be taking on, such as administering medication, using medical equipment, changing bandages or giving shots.
• Make needed changes to your home: You might need to rearrange your home to have room for items such as a hospital bed, walker or a wheelchair. You might need to consider installing a ramp in place of stairs - be sure to ask the hospital staff what will be needed. You should also remove area rugs and other items that may cause falls and group electrical cords together with ties or clips to keep them clear of high-traffic areas.
• Prepare for extra costs: The person you are caring for may need new medical services or medicines after coming home. Medicare may cover some of these costs, but not all. You can learn about services and care that are covered by Medicare at the "Help With Billing" and "Is It Covered?" links at the Ask Medicare home page.
• Keep a list of key contacts: Put contact information for doctors, pharmacists, home care agency staff and others involved in the care process where you can easily find them.
• Don't be afraid to ask for help: If you're overwhelmed, don't hesitate to ask a friend or family member to lend a hand. If paid home health services are needed, you can learn more about home health services in the "Medicare and Home Health Care" booklet, which is also accessible at the Ask Medicare home page.

It's also important to keep a file of resources on hand and to bookmark useful web sites, including Ask Medicare, the United Hospital Fund's "Next Step in Care" initiative at www.nextstepincare.org and AARP's caregiving site at www.aarp.org/caregivers. More information can be accessed through www.healthcare.gov, a new web portal offered by the Department of Health and Human Services.

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