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You're Discharged… Now What? 

  • Luciana Lo
  • Mar 28
  • 3 min read

The Housing Gap No One Prepares You For 


Discharge day can feel like a finish line. You've made it through the hardest part: the surgeries, the assessments, the exhausting in-patient routines. But for many people leaving rehabilitation or acute care, discharge is less of an ending and more of a starting pistol for a race no one trained them for. 


And one of the biggest gaps that gets overlooked? Housing. 


What "Safe Housing" Actually Means 

Before you go home (or anywhere), it's worth pausing to ask: is this space actually ready for the person I am now? 

Safe housing post-discharge isn't just about having a roof over your head. For someone returning with new mobility needs, a brain injury, or a spinal cord injury, it means making important considerations: 

  • Stairs: Are there steps to enter the building? Steps between floors or to get to the bathroom? 

  • Bathroom access: Is there a roll-in shower, a tub transfer bench, or grab bars where you need them? 

  • Space for equipment: Will a wheelchair, walker, or hospital bed fit and move around your space? 

  • Emergency planning: Can you get out safely if there's an emergency? Does someone nearby know your situation? 


We often overlook these everyday encounters that occupational therapists (OTs) look at during home visits. If a home visit hasn't been arranged before your discharge, ask for one. It can make a real difference in preventing a fall, a readmission, or a really stressful first week home. 


You Might Not Know: Transitional Care Units 

Not everyone goes straight from hospital to home, and honestly, that's okay. Transitional care units (TCUs) are short-stay facilities that sit in- between: you're no longer in acute care, but you're not quite ready to be fully home either. They offer continued therapy, nursing support, and some breathing room to get housing, equipment, and home care properly sorted out. 


In Ontario, this option often goes underused simply because people don't know to ask. If your home isn't ready, your caregiver needs more time to prepare, or your equipment hasn't arrived yet, a TCU might be worth asking about. Bring it up with your care team or social worker before your discharge date, not after. 


Questions to Ask Before You Leave 

Before you walk out those doors, try to get clear answers on these five things: 

  1. Equipment: What do I need at home, and has it been ordered? When will it actually arrive? 

  2. Home care: Has a referral been made? Who do I contact if something changes? 

  3. Follow-up appointments: When and where are they? Will I need accessible transportation to get there? 

  4. Medications: Do I have what I need? Does the person helping me at home know my schedule? 

  5. Emergency contact: Who is my first call if something goes wrong, and do they know what to expect? 


If you don't have answers to these before leaving, ask your OT, social worker, or discharge planner. No question is too small, and nobody should leave the hospital guessing. 


Talking to Landlords or Roommates 


If you rent or live with others, a short heads-up conversation before you come home can save a lot of friction later. You don't owe anyone your full medical history, but sharing what you need helps everyone get on the same page. Something like: 


"I'm coming home with some new mobility equipment and I'll need the bathroom kept clear. I may also have home care workers coming by during the week." 


Try to document any agreements in writing. Even a quick email recap counts. If you're going to need modifications like grab bars or a ramp, know that under Ontario's Human Rights Code, landlords are generally required to accommodate disability-related needs to the point of undue hardship. You have more ground to stand on than you might think. 


If You Have No Accessible Options Right Now 


This is a harder reality, but it's one a lot of people are facing. Some places to start: 

  • Your hospital social worker: They can connect you to community housing resources, interim funding, and advocacy organizations. 

  • Home and Community Care Support Services (Ontario): They can help arrange home care and assess what you need. 

  • Local independent living centres: Great for peer support and help navigating housing options. 

  • PP+ Community Resources page: possibilitiesprojectplus.ca/community-resources 


You don't have to figure this out alone. 


Screenshot This: 5 Questions to Bring to Your Discharge Appointment 

  1. Has a home assessment or home visit been arranged before I leave? 

  2. Is a Transitional Care Unit an option if my home isn't ready? 

  3. What equipment do I need, and when will it be delivered? 

  4. Has a home care referral already been made? 

  5. Who do I call in an emergency, and does my building or landlord know my situation? 



This post is for informational purposes only. Everyone's situation is different, so connect with your care team for guidance that fits your needs. 

 

 

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