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Arranging care before you leave hospital

Arranging Care Before Leaving Hospital Panel

Recovering at home after a hospital stay is an important step in regaining your strength and independence. However, for some individuals, a return home might necessitate additional support. This can be particularly true for older adults or those with ongoing health conditions.

If you or someone you know goes into hospital, help and support should be arranged before you go home (are discharged).

This means:

  • any extra help is arranged, such as visits from a district nurse or paid home help
  • any equipment is fitted, such as a raised toilet seat
  • any home adaptations are made, like grab rails in the bathroom

What happens while you're in hospital

Hospital staff should contact social services to arrange a discharge assessment. This is so they can find out what help you need when you go home.

It doesn't matter if your hospital stay was planned or an emergency.

The assessment can happen in a hospital, or they might visit your home. It helps to have a key safe at home, or to leave keys with family or friends.

Speak to the staff in charge of your discharge to make sure you have everything you need. This includes a date, a care plan, and equipment.

You'll be involved in the assessment and agree on a care plan together.

This should include things like:

  • treatment and care when you get home
  • who's in charge of your care and how to contact them
  • when and how often you need care

Identifying your care needs

The first step is to assess the level of support you might require at home. Consider your ability to perform daily living activities (DLAs), such as:

  • Personal care: Bathing, dressing, and toileting
  • Mobility: Getting around the house safely, transferring in and out of bed
  • Meal preparation: Shopping, cooking, and eating
  • Medication management: Remembering to take medications as prescribed

Be honest with yourself about your current limitations. If you anticipate difficulties with any of these activities, it's crucial to communicate this to your healthcare team during your hospital stay.

Preparing to leave hospital

Hospital staff should make sure:

  • you can get home
  • you have your care plan and your care home has a copy, if you live in one
  • you have any medicine you need and know how to take it
  • you can use new equipment, such as crutches
  • your GP knows you have been discharged
  • you know how to get help from a district nurse if you need it, or when to expect a visit

When you get home from hospital

Preparing your home for your return

While still in the hospital, take steps to ensure your home is safe and comfortable for recovery:

  • Remove trip hazards: Secure loose rugs, arrange furniture for easy navigation, and ensure proper lighting throughout the home.
  • Bathroom safety: Install grab bars in the shower and near the toilet. Consider a raised toilet seat if needed.
  • Assistive devices: If recommended, have any necessary equipment, like walkers or shower chairs, delivered to your home before discharge.
  • Stock up on essentials: Ensure you have enough groceries, toiletries, and medications to last for a few days after returning home.

Gathering information and contact details

Before leaving the hospital, gather crucial documentation and contact details:

  • Discharge summary: This document outlines your diagnosis, treatment plan, and any ongoing care needs.
  • Medication instructions: Ensure you understand dosage schedules and the potential side effects of new medications.
  • Contact information: Collect contact details for your GP, any specialists you'll be following up with, and your designated care provider (if applicable).

Temporary care

If you have had a short illness or an operation, you might only need care for a short time to get back to normal. This is called intermediate care, reablement or aftercare.

The aim of this type of short-term care is to help you:

  • look after yourself rather than having someone care for you
  • stay as independent as possible
  • avoid unnecessary hospital stays

Ongoing care

Soon after you leave the hospital, social services will check if your care plan is right.

If you're likely to need care for longer than 6 weeks, they'll work with you to put a care plan in place. This care isn't free.

Care plans are checked once a year, but if at any time you feel your care isn't right, contact social services and ask for a review.

Care options in Plymouth 

  • Home care: Trained carers can visit your home to assist with personal care, meal preparation, medication reminders, and light housekeeping.
  • Equipment loan and purchase: Mobility aids like walkers, wheelchairs, or shower chairs can significantly improve independence. The NHS or social services might offer loan schemes, or you can purchase equipment privately.
  • Reablement services: These short-term programmes focus on helping you regain independence with daily tasks through physiotherapy, occupational therapy, or speech and language therapy.
  • Day care services: Day care centres offer social interaction, meals, and activities while providing respite for carers.
  • Residential care: For those requiring more extensive support, care homes offer a supervised living environment with 24/7 care.

What to do if you're unhappy with your hospital discharge

You can complain if you're unhappy with your hospital discharge, or the discharge of someone you know.

For example, if:

  • the hospital plans to discharge you before you think it's safe
  • you don't think your discharge assessment was done correctly

Speak to the hospital staff who arranged your discharge.

It might help to get advice from the Patient Advice and Liaison Service (PALS).

Read more about the NHS complaints process.



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