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For families & caregivers

The days after discharge shouldn't be a mystery.

Here's what actually happens when your person is sent home with care — who's coming, when the first visit lands, and how the decisions that matter get documented.

After the discharge order

What you can expect, step by step.

A real plan, not a promise

When your person is sent home, their referral becomes an accepted placement with a committed first-visit window — a specific clinician, a specific time.

A quiet window in

If your person shares access with you, you see the same status their care team sees: who accepted, when the first visit lands, read-only, no phone tag.

Nothing shared without consent

Access is granted by the patient, scoped to exactly what they choose, and every view is logged. No surprise exposure of their health information.

Advance care planning, in plain language

Decisions, documented — before the hard day.

Advance care planning is a set of conversations and documents that record what your person wants — who speaks for them, what care they'd choose, and what they'd decline. CaraLoom helps families and care teams track these decisions; it never makes them for you.

Signed isn't the same as in effect
  • Signing is what makes a document valid — most states require witnesses, a notary, or both, and the rules differ by state and by document.
  • Taking effect is different: a living will or healthcare proxy usually only guides care when your person can't speak for themselves — while POLST/MOLST forms are medical orders that clinicians follow as soon as a clinician signs them.
  • A signed document sitting in a drawer helps no one — the last step is always getting it on file with the care team.
Reference content only — CaraLoom does not provide medical or legal advice. Requirements vary by state; always verify with your state's official forms and, where needed, a qualified professional.

Check your state

Common directive documents and how signing works where you live — all 50 states + DC.

Commonly recognized documents
Healthcare proxy / medical power of attorneyLiving willPOLST or MOLST (portable medical orders)Do-not-resuscitate (DNR) order
Signing

Most states require adult witnesses, a notary, or both for a living will or healthcare proxy to be validly signed — and the rules differ by state and by document. POLST/MOLST forms are completed WITH a clinician and require a clinician's signature.

When it takes effect

A living will or healthcare proxy generally guides care only when the person can no longer speak for themselves. POLST/MOLST forms are medical orders and are followed by clinicians as soon as they are signed by a clinician — signing and taking effect are not the same moment for every document.

Always use your state's current official forms — most state health department or attorney general websites publish them for free.
Reference content only — CaraLoom does not provide medical or legal advice. Requirements change; verify with your state's official forms.
Common questions

Advance-directive basics, answered.

What is an advance directive?

An umbrella term for legal documents — like a living will and a healthcare proxy (medical power of attorney) — that record who can speak for a person and what care they would or wouldn’t want if they can no longer speak for themselves.

What’s the difference between a living will and a healthcare proxy?

A living will records treatment preferences in writing; a healthcare proxy names a person (an agent) to make medical decisions. Many states combine both into a single advance-directive form.

When does an advance directive take effect?

Signing makes a document valid, but a living will or healthcare proxy generally only guides care once the person can no longer make or communicate decisions. POLST/MOLST-style forms are different — they are medical orders that clinicians follow as soon as a clinician signs them.

Do we need a lawyer to complete an advance directive?

Generally no. Every state publishes free statutory forms through its health department or attorney general. Most states require adult witnesses, a notary, or both — the form’s instructions spell out exactly what your state expects.

What is a POLST or MOLST form?

A portable medical order for people with serious illness or frailty, completed with a clinician and signed by one. Its name varies by state (POLST, MOLST, POST, MOST), and unlike a living will it is an active medical order the moment it is signed.

What should we do with the documents once they’re signed?

Get copies on file with the care team, the hospital, and the named healthcare agent — a signed document sitting in a drawer helps no one. CaraLoom’s care teams track which documents are on file and when to revisit them.

Reference content only — CaraLoom does not provide medical or legal advice.

Be in the loop, the calm way.

Your person grants access; you see the status. That's the whole deal.

CaraLoom

Care, woven into one continuous thread. From discharge to accepted placement to first visit — one record, one promise.

care@caraloom.com

Chantilly, VA 20151 · Serving providers nationwide

HIPAA-ready End-to-end encrypted Background-checked

CaraLoom is a care-coordination software platform, not a direct care provider. Hospitals and receiving providers use CaraLoom to coordinate discharge; clinical decisions and staffing remain with the licensed organizations and clinicians who use the platform. See our Trust page for what we verify.

A software platform, not a care provider

CaraLoom is a care-coordination software platform used by hospitals and receiving post-acute providers — not a healthcare provider, staffing agency, or employer of clinicians. Clinical decisions, staffing, and treatment remain the responsibility of the licensed organizations and clinicians who use the platform.

Coverage checks & orders

Eligibility and authorization checks surface information from third-party sources to help planners and providers coordinate discharge. They do not create coverage, guarantee payment, or replace payer determinations. Orders and consents signed in the platform carry a full audit trail; during pilot, e-signature runs in a non-binding test mode until vendor agreements are complete.

Profiles & verification

Provider organization profiles and clinician credentials are furnished by the organizations themselves and verified at onboarding, with license status monitored on an ongoing basis. No verification is ever exhaustive — hospitals remain responsible for their own due diligence when selecting receiving providers. See what we check on our Trust page.

AI guidance

AI features on the platform are informational tools that assist licensed users; they are not a substitute for professional medical advice, diagnosis, or treatment, and every consequential action is reviewed by a human user before it takes effect.

Emergencies

If you are experiencing a medical emergency, call 911.

Promotions & marks

Pilot pricing and program terms are subject to the written agreement between CaraLoom and the participating organization. CaraLoom℠ and “Care, woven into one continuous thread.” are service marks of CaraLoom, Inc. © 2026 CaraLoom, Inc. Your use of this site is subject to our Terms of Service and Privacy Policy.

© 2026 CaraLoom, Inc. All rights reserved. Care, woven into one continuous thread.

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