|Leaving hospital can be a difficult time. For the person you care for there will be a mixture of emotions – relief at the thought of settling back into familiar surroundings mixed with some anxiety about the sort of care they may need.
For the family carer too it’s not easy. You may now be going to have to provide extra care for someone or far more nursing care may be needed.
The secret of a successful transfer from hospital to home lies in advance planning and good communication both with you, the family carer, and the patient. That is why the best hospitals are those with a proper discharge policy. It should involve everyone, have a written checklist and arrangements that are kept. As a carer, you can make your own checklists to help you keep in touch with the situation.
While the person is still in hospital
1. The hospital should provide a written discharge plan. This should include:
2. The name of a specific member of staff in charge of discharge procedure.
3. Information on who to talk to about any aids, adaptations, help or equipment that will be needed when the person returns home.
4. Information about who you should be in touch with once the person you care for returns home – for example, the GP, District Nurse, Social Worker, Care Manager.
The Following Should Also Be Available:
1. A visit from either the hospital social worker or someone from local social services, if the person you care for is going to need extra support when they come home, their needs should be assessed while they are in hospital.
2. Your needs as a family carer may also need to be assessed. Now is the time to ask for this and to talk about options.
What You Can Do
1. Contact local voluntary organisations or charities that may be able to offer help and support. For instance, in many parts of the country, Age Concern runs Hospital Discharge Schemes providing short-term (up to five days) volunteer support to older people following a hospital stay.
2. The aim is not to replace family support but to supplement existing care or provide support while other arrangements are put in place. Volunteers can help prepare a meal, collect medicines, do shopping and light housework, collect pension. Contact your local branch for information and to arrange for the Discharge Scheme Co-ordinator to visit the ward during the hospital stay.
3. Talk to hospital staff about the equipment that might be needed – commode or bedpan, a Health Visitor to give advice on day-to-day problems, visits from the District Nurse to change dressings.
4. Be aware of the health professionals who can help – physiotherapists, speech therapists, continence advisor, Macmillan or Marie Curie nurse.
5. If you have decided that you cannot cope or do not wish to cope with the caring, do not allow staff to put pressure on you. If the hospital insists that the patient comes home, you have the right to refuse or complain. Remember that even if the patient goes into residential or nursing accommodation, you are still a carer and may do the job better if less emotionally and physically drained.
1. On the day the person leaves hospital, there are a number of things hospital staff should do to make sure everything goes smoothly on the day.
2. The person in hospital should be given at least 24 hours notice before being discharged.
3. Transport home should have been arranged either by the hospital or yourself.
4. Check that any equipment aid and help requested are put into place.
5. Has the hospital given you, the family carer, a supply of medicines for the person to take until they see their doctor?
6. Have you been given sufficient information about the person’s condition? Do you know what to expect in the way of possible symptoms and where to get advice if it’s needed?
What You Can Do
1. There are some practical things you can do to make sure the return home is trouble-free. You should have at least 24 hours’ notice of the final discharge date.
2. Bring suitable outdoor clothes to the hospital.
3. Check on transport. The hospital can only provide free transport if its needed for medical reasons or if there is no other means of getting the patient home.
4. If the person is not coming to live with you, check on their house. Is it clean and tidy? Warm enough? Safe – with good lighting, non-slip rugs or mats? Is there enough basic food in the cupboard?
5. If the patient is not living with you, they should not be left on their own immediately. If you work, you may need to organise for someone to be with them, at least for a few hours but ideally for a few days.