Going home from the hospital after a spinal cord injury requires careful planning to ensure your home is accessible and safe, getting the necessary medical equipment, supplies, and home care services, and arranging follow-up appointments with your healthcare team.
In this article, we will guide you through the process of leaving inpatient rehab after a spinal cord injury (SCI) and returning home. We'll explain the discharge planning process, necessary home modifications and equipment, and what you and your family can expect during the transition.
Your medical and rehab team will start discharge planning as soon as you are admitted for rehabilitation. Nurses, therapists, social workers and case managers work together with you and your family to build a plan for your homecoming. This plan covers your medical needs, home situation, equipment and caregiver support.
For example, a physical or occupational therapist meets with the patient and talks with the medical team and nurse care coordinator to form a discharge plan. These meetings may include your family or other caregivers. Together you'll set goals (like independence with transfers or self-care) and decide what level of home support and equipment you need.
Typical steps include:
Researchers stress that successful discharge from rehabilitation for patients with spinal cord injury relies on a smooth transition home. Assessing your readiness to leave can reduce complications and improve satisfaction. In other words, the more prepared you feel (and the more support is arranged), the better you will cope at home. Working closely with your rehab team and case manager ensures your discharge plan covers everything from equipment to follow-up care.
Making your home safe and accessible is a top priority. Think about changes that let you move around independently. For example, you may need a ramp or platform lift at your entrance, a hospital-style bed, and grab bars or a roll-in shower in the bathroom. Your team will help identify these needs. As a VA guide advises, "When planning your return home, consider modifications and equipment. Think about changes to your home such as ramps and other things that will make spaces in your home easier to move around in."
Common modifications include:
Your insurance or local disability programs may cover many of these changes. Veterans should ask their SCI/D team about housing adaptation grants and ramps or grab bars. Even if you have to fund some upgrades, think of it as an investment in safety and independence.
Going home after rehab often involves family members or caregivers helping with transfers, transportation, and daily routines. You're not alone in this process. The first day or two at home can be challenging: new routines, schedules for meds or catheter changes, and lots to remember. It's normal for you and your family to feel both excited and anxious. Expect that caregiving tasks will shift more to your household. A spouse, parent, or hired aide may help with bathing, dressing, meal prep, driving to appointments, and other tasks.
You may feel tired at first. Your body has been working hard in rehab, and it will keep adjusting at home. You might need more rest breaks and may not feel fully confident until you've practiced routines a few times in the familiar surroundings. That's okay. Plan for some "learning curve" time. Speak openly with your therapists about what you can do independently and what tasks you still need assistance with. By discharge, most teams set you up with home health nurses or therapists who come visit to check that you're managing well.
A helpful tip is to set up a home health schedule immediately: arrange for at least a nurse visit after a few days home (to review wound care, catheters, etc.), and start outpatient therapy (PT/OT) as recommended. If you can, have the first home visit on a day with family available so everyone gets questions answered.
Going home after an SCI is not just a physical change but an emotional one too. It's common to feel overwhelmed, frustrated, or even grieving the loss of your previous independence. Recognize those feelings are normal, and know that support is available. In fact, studies show about one-third of people with SCI experience depression at some point.
You don't have to cope alone. Talking with a counselor, psychologist, or peer mentor can help you process emotions and stay motivated. Your rehab center can often connect you to a counselor, or you may find support in group therapy or online SCI communities (see resources below).
Logistically, plan ahead to avoid stress. Make checklists for:
Emotionally, keep communication open with your family. They too may be adjusting to new roles. Consider setting up a family meeting (with your rehab social worker) to discuss expectations and concerns. You might also benefit from peer mentors or support groups.
Talking with others who've "been there" can be very reassuring. SpinalCord.com's Recovery Advocates are trained peers who offer practical tips and encouragement by phone or email. Our Spinal Cord Injury Support Group Map can help your family find local or virtual support groups for additional guidance.
Remember, even after you leave the hospital, you still have a care team. If you ever feel unprepared or need advice, call your discharge coordinator or therapy team. They expect that the transition is an adjustment and can help fine-tune your home plan. If insurance or distance is an issue, many teams offer phone follow-ups.
SpinalCord.com also offers ongoing support. Besides our Recovery Advocates, our website has infographics that explain self-care (skin checks, catheter routines, etc.) and community guides. We maintain a National SCI Resource Center with links to nonprofit organizations, legal assistance, and more. Don't hesitate to reach out. We're here to help you through the tough early months and beyond.
SpinalCord.com is a dedicated community for SCI survivors and caregivers. We provide trusted guidance, helpful tools, and a caring network to support you every step of the way.
Sources: Authoritative resources such as university and hospital publications and VA health guides were used to ensure accuracy. For example, rehab specialists note that forming a discharge plan with the care team is vital, and VA guides highlight the importance of home ramps, adaptive beds and getting help from peer counselors. We strive to provide information consistent with current best practices in SCI care.
References
Traumatic Brain Injury Patient and Caregiver Education - UH Hospitals
Spinal Cord Injury (SCI): Your Transition Home - Veterans Affairs
Spinal Cord Injury or Disorder: Home Modifications - Veterans Affairs
Depression and Spinal Cord Injuries and Disorders - Veterans Affairs