Hospital discharge process Hospital and whatever comes next On the ward It is normal for Carers to start having concerns while their family member or friend is in a vulnerable situation on the ward. Typical issues can include: Nobody is
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Presentation Transcript
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Hospital discharge process Hospital and whatever comes next<br>
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On the ward It is normal for Carers to start having concerns while their family member or friend is in a vulnerable situation on the ward. Typical issues can include:
Nobody is keeping me informed.
They are confused – is someone doing something about this?
Fear of patient being sent home while Carer feels they can't cope with them in this state.
Desperation to have them home because the patient is unhappy / deteriorating / approaching End of Life.<br>
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Expectations There may be the expectation that when someone is in hospital that their medical/surgical treatment and care should be everything they could hope for. In many cases this is accomplished. However, the hospitals are facing many challenges, Doctors strikes, shortage of staff, the pressure of bed shortages, and having to respond to availability of Care Packages and Placements either at short notice or with weeks of delay.
For the Carer hearing some of these reasons may just feel like excuses. It is natural for them to want the very best of for their loved one.<br>
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Helpful guidance If there is a particular issue that is concerning the Carer suggest that they speak directly to the ward staff. (They can't address the issue if they don't know about it).
The Carer should speak calmly and clearly about their wishes. This will encourage a good working relationship with the ward staff, helping the Carer achieve their rights in involvement during the hospital admittance and with the discharge process.
Understand the hospital process of Medical treatment and discharge, Physio and OT process and Discharge Co-Ordinator role.<br>
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Hospital Discharge This is where much of the Hospital Service support is requested. We have continually encouraged earlier referrals and involvement with the carer journey however it is at the Discharge stage that most assistance is requested, both by the Carers and by the hospital. It is at this stage when the challenges become a reality and the best possible outcome is examined.
It is important that the Carers rights to be involved in the process are recognised as it is they who will be providing an ongoing caring role. Once again, this should be done in a constructive manner.<br>
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Common Discharge outcomes Patient discharged home without Package of Care – Where it is decided that the patient is 'independent', e.g., can get to bathroom on their own.
Patient discharged home with UCR (Urgent Community Response). A PoC arranged to send a patient home with, lasts up to 10 days during which time the carers will assess what ongoing care the patient requires, and this is passed to Social Services who will arrange the continuing PoC.
Privately funded PoC. If the patient is identified whilst in hospital as self-funding the provision of care on discharge will be paid for by the patient/family. If it has not been established who will be funding the UCR process will be followed, and the funding of care clarified at the Financial Assessment held by Social Services when the patient<br>
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Common discharge outcomes continued Re-enablement. Up to 6 weeks of visits from the Community Teams to continue required improvement at home. This may be visits from the Community Nurse or Physiotherapist, or both. If required a further referral can be made for specific ongoing support.
Placement, short term. All placements start by being described as Short Term. The patient may be being transferred to a Care Home because they do not require a bed in an Acute Hospital but are not ready to return home. For some it will be on the advice of the professionals as they feel the person would not be safe being cared for in their own environment. This may then become long term placement.<br>
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Common Discharge outcomes continued End of Life. End of Life can be a matter of hours, months or even years. Most patients facing EoL would prefer to do so at home. Discharge for those who are approaching end of life depends on the availability and suitability of care at home, or availability at a hospice. Many who would choose otherwise are dying in hospital.
It is important for the Carer to understand the Discharge Procedure and be a part of the planning for future care of the patient. The role of the Hospital Service is to provide the appropriate information to the Carer and where necessary act as an advocate in this process.<br>
