Medication reconciliation during transition from hospital to home-based palliative care is often treated as a discharge task even though medication meaning, ownership, feasibility, and appropriateness continue to change at home. This conceptual article presents a transitional medication-safety framework integrating discrepancies, continuity, information transfer, patient and caregiver work, nursing surveillance, pharmacist and prescriber interfaces, and implementation conditions. Reliable reconciliation requires an interpretable medication state that is communicated, received, understood, supplied, enacted, reassessed, and corrected. The framework separates verification, responsibility transfer, early-home comparison, discrepancy interpretation, authorized resolution, and feedback. Nurses often detect mismatch after responsibility is distributed across services, while pharmacists, prescribers, patients, and caregivers contribute different knowledge and authority. Reconciliation is therefore a longitudinal function supported by both clinical accuracy and an operable system of responsibility.
