Count the Front Steps Before the Car Pulls In: Fit the Entry Route to the House You Have

Before the discharge time is set, somebody has to walk from the curb to the front door the way your parent will walk it. Not the way you walk it. Your parent will be slower, may be using a walker or a wheelchair, and will be carrying a bag of medicine and a discharge folder at the same time.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

Walk it with a tape and a notebook

Go to the house if you can. Stand where the car will stop and count every step from the walkway to the threshold. Write down the height of each step as well as the count, because a shallow step and a tall step are different problems. Measure the depth of the landing at the top. Note whether the railing runs on both sides, whether it feels solid enough to take weight, and where it ends.

Then measure the door. Check the clear opening with the door fully open, not the frame width from the outside. Note the threshold height. A walker or wheelchair needs room to turn on the landing, and a door that swings toward the person on the stoop takes that room away.

Ask the questions the hospital will not raise on its own

The discharge team checks whether the parent can get out of the building. They rarely check whether the parent can get into the house. Ask the case manager, in writing if you can, what route the discharge plan assumes. If the answer is the car, ask how far the car will park from the walk, whether the driver can help on the last step, and whether any transport the hospital arranges has a ramp or lift. Ask whether that transport is booked for the day you need it. Put the answers in your folder.

Ask the parent's therapist, if one has watched them walk, whether the steps are safe with the device they will use. Do not guess. If no one has watched them climb a step with that device, ask for that check before discharge day. The Start Here reading order shows which questions to settle first.

Decide who spots, and where

Write down who stands on which side for the first trip in. Two people is safer than one for a parent who has not done those steps since the hospital. Decide whether the parent will rest on the stoop, use a seat, or go straight in. Decide who carries the bag and who holds the door. The person who is carrying nothing is the spotter, so give that job to someone specific.

What to change before the car pulls in

If the railing is on one side only, check whether a second rail can go up before the day. If the threshold has a lip, check whether it can be made flush or ramped with a temporary product that a therapist or contractor approves. Clear the walkway of planters, hoses, and wet leaves. Check the porch light and replace the bulb if needed. Move mail, packages, and delivery boxes off the top step.

If the steps cannot be made safe for the device your parent needs, the question changes. Ask whether the first nights should be on the ground floor, whether a temporary arrangement can be made, or whether the entrance itself needs a different plan. Those choices belong to the doctor, the therapist, and the family together. The Local Help After a Discharge page lists where to start in St. Louis when the home needs changes on short notice.

On the day the car pulls in

The walk is the first job. Go slowly and let your parent set the pace. Stop on the landing if they need to. Do not hurry the last three steps because the front door is in sight. Once they are inside, check the route from the entry to the bathroom, because the same steps will be used again in the morning, and the trip back down will need the same spotters. If you want the general rules this desk relies on for stairs and entrances, the Sources page lists them.