Managing Hospital Discharge for the Elderly

 

As we get older, the chances are we will find ourselves caring for an elderly relative, or maybe friend and neighbour, who has to spend time in hospital. Hospital visits to ensure they have all they need are one thing, but what about when treatment has been completed? Hospital discharge can be a worrying time. Trying to ensure everything they require is in place before they arrive home.

Prior to Discharge:

Before the big day arrives, talk to the patient. Are they happy with everything? Do they have any concerns about treatment, dressings, or aches and pains they haven’t mentioned to hospital staff? With the pressure NHS Trusts are under, and the fact patients tend to recover quicker in their own surroundings, means hospitals like to discharge patients as soon as possible after treatment.However, before this happens, things need to be put in place ensuring they or their carer, has everything needed to ensure their continued recovery at home. This can include six weeks of intermediate aftercare on the NHS.

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Patient Discharge Obligations:

Each hospital has to have a patient hospital discharge policy. Their responsibilities don’t just end with the treatment. They also have to ensure:• The patient is medically fit for discharge.

• That they assess the support required on discharge.

• A written care plan made available to patient or carer.

• The required support is in place before discharging the patient.

This hospital discharge plan is not just written out on a sheet of paper and handed out to all and sundry. While the patient is in hospital, they will be visited by different members of the after-care team. This team will be made up of health-care professionals and a social worker, coordinating all patient requirements for their release.

The discharge plan assessment includes such things as the patient’s mobility. Are they fully fit, partially disabled, totally disabled, or have any mental disabilities. Whether they are fully capable of looking after themselves, or do they need to be admitted to a nursing home.

If you are acting as a carer; go through the plan with the patient. Sometimes the elderly can be forgetful, if you have any reservations about anything laid down, or not laid down, ask to speak to one of the team. They are there to help.

Discharge and After-care:

Prior to hospital discharge, as your elderly relative’s carer be sure you’re completely satisfied they are ready for discharge. It’s not unknown for patient’s to omit mentioning a problem to hospital staff because they want to be discharged. If you feel there is anything not quite right, ask to have a word with the ward sister in her/his office. They can then follow it up without upsetting your relative.
Once you are totally satisfied with your relatives medical condition, discharge conditions need considering. For instance:

• Will you be collecting them from hospital?

• Will they be in your care 24/7?

• Will you be visiting them daily?

• If not are they fully mobile around the home?

• Can you administer any change of dressing if required?

• Are they able to cook and clean themselves?

• What additional NHS help is required, and is it in place?

Things are much easier if your elderly relative lives as part of your household, or you can visit daily. However, if this isn’t possible due to other commitments, arrangements need to be made through the hospital discharge plan. Health workers can call in to change dressings.

Care workers can be arranged to help with meals and day to day problems, and social workers can visit to ensure everything is being done to provide for your relatives wellbeing. It is paramount you work with the hospital after-care team. After all, who can blame them for not turning up if they didn’t know they were supposed to?

As the country’s population continues to live to a greater age, an increasing number of resources are being put in place to ensure they get the most from their twilight years, and why not, they’ve worked all their lives for it.

Aftercare:

Aftercare also includes such professionals as occupational therapists, physiotherapists, speech therapists, dieticians, and mental health nurses. If needed, arrangements for all these professionals to call can be arranged, or transport arranged to get your elderly relative to hospital and back, after follow up treatment. Any that are required, should be included within the hospital discharge policy.

Once this discharge policy is drawn up, it is not set in stone. Should your elderly relative’s circumstances change, then contacting their healthcare or social worker, can have additional back-up put in place.

Not only is help available for different medical conditions, but for providing as much home support as possible to make day to day living a little easier. Such things as wheelchairs, special beds, stair-lifts, and various adaptations to the home are available through various council and healthcare grants.

Should your relative’s condition be such that they fall outside the NHS requirements for various help at home. There are some excellent private companies which specialise in private homecare.

Let’s go Home:

Prior to collecting the patient from hospital, ensure heating is on in their home if it’s cold. They have food and drink in the home and everything is ready for their arrival, such as clean sheets or bed freshly made. Their GP should be informed they are arriving home.

When collecting your elderly relative ensure they have adequate clothing for the weather conditions. You have a care plan copy to keep abreast of assistance. If they have any aids to use like inhalers, or medication to take – ensure they know how to use them, and when to take their medication.

Finally, if you are unable to collect them, be sure the hospital knows when to transport them home, so someone is available to help them settle in on their first night back in their own surroundings.

 

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