The hospital florist has a lock on business — and tacky arrangements. What else can I send to a friend in the hospital?

There are good reasons to forgo flowers in a hospital. Flowers can harbor germs and bacteria and therefore are often not allowed in ICUs, cancer wards, and pediatric units (where balloons, a choking hazard, are also generally forbidden).

Susan Halpern, the author of The Etiquette of Illness (Bloomsbury, $12.50, www.amazon.com), suggests sending a card with a nice picture on it or, if a loved one isn’t going to be in the hospital for long, sending flowers to her home afterward. Stick with a bouquet in a vase. Even someone who normally likes to arrange flowers may not have the energy for that when she’s sick, and a live plant might be too much of a chore to look after. If a friend or a relative will be in the hospital for a while, consider these flower alternatives:

Gift certificates to a nearby coffee shop or restaurant (to pick up or order in).

Travel-size versions of Scrabble, checkers, or other games.

A stash of magazines or books.

CDs, DVDs, audiobooks, or videos (if the room has the necessary equipment for using them).

Bright, fresh fruit (for the patient and visitors).