How do I get Mum out of Hospital?

Every winter poses an increased level of challenge for the NHS.

With the colder months comes the increased prevalence of respiratory illnesses such as colds, flu(s) & pneumonia. This coupled with the threat that COVID-19 still poses to our clinically vulnerable, it will doubtless be a testing time for our already stretched health service.

Meaning it is imperative that you’re fully armed with all the information you need regarding how to get your loved one discharged from hospital to a safe environment.

FAQ’s regarding Hospital Discharge:

1. Who should I speak to at the Hospital regarding discharge?

In short, the Ward Sister or Hospital Discharge Coordinator.

All hospital patients will be cared for by a multidisciplinary team of healthcare professionals e.g. Consultants, Nurse, Occupational therapists etc. Once the team of healthcare professionals deem that a patient is ready for discharge they will likely inform the Ward Sister or Discharge Coordinator.

2. Why is my Mum deemed ‘not fit for discharge’?

The barrier to many elderly people being discharged from the hospital is that although they have got over their acute healthcare needs which led to hospital admission they now have ongoing care needs which require ongoing support.

Many elderly people live alone or have an ageing spouse who despite their best intentions would not be able to safely meet their partner’s care needs.

The team of people responsible for your Mum’s care wish to minimise the chances of readmission to the hospital by ensuring she is discharged to an appropriate setting. This can lead to a delay in hospital discharge whilst appropriate arrangements are made.

3. It is no longer safe for my Mum to return to living in her own home, what should I do?

Regardless of whether your Mum is entitled to local authority-funded care or is deemed a self-funder, she will be eligible for state-funded intermediary care. Find out more information regarding funding long-term care.

Intermediary care comes in two forms:

• Discharge to Assess bed: For people who no longer require acute care in a hospital setting but need further care before deciding whether they are safe to return home or require ongoing care in a community setting.
• Reablement Care: A package of home care, no more than 6 weeks, designed to support individuals to regain independence whilst they recover from any ongoing care needs post-hospital admission.

4. My Mum is in a Discharge to Assess bed, what happens next?

Once your Mum has been discharged to a ‘discharge to assess’ otherwise known as a ‘step-down’ bed, you can expect her to stay to last between 2 to 6 weeks. Let me reiterate that this care is fully funded by the NHS regardless of your Mum’s financial circumstances.

Where possible, most people wish to return to living in their own homes. The additional care provided to the individual during their stay may mean they are recovered enough to return to living independently. Some people may require adaptations to their home & a package of home care to be put in place in order to make returning home a viable option.

Some people’s care needs may be too great to be met with a package of home or live-in care. In this instance, care within a residential or nursing home will be sought. It’s worth noting that many ‘step-down’ beds are within care/nursing homes. If you are happy with the care provided in this setting you may wish to make enquiries about whether they have any availability for your Mum to transition into a permanent bed at the home.

5. My Mum requires a package of home care in order to return home, how do I arrange this?

Again, regardless of financial circumstances, everyone is eligible for home adaptations/equipment up to the value of £1,000 in order to make their return home possible. An Occupational Therapist (OT) will need to assess what equipment is needed and get this in place which can take a number of weeks. Contact the social services department at your local council to find out more.

If your Mum is local-authority funded she will likely be assigned a Social Worker who will look to organise a package of home care on her behalf. Whereas if your Mum is required to privately fund her care, it will likely come down to immediate family members to help source appropriate care.

6. My Mum requires residential/nursing care, what should I do?

Again, if your Mum is local-authority funded she will be assigned a Social Worker who will aim to find an available bed in an appropriate care setting for your Mother. As a family, it is important to be aware that social services are required to offer you a choice of at least 2 services. Furthermore, there is nothing to stop you from conducting your own search for a suitable care home & advising social services of your choice.

When speaking to care/nursing homes be sure to ask them whether they accept individuals who are funded by the local authority. All homes should accept local authority-funded individuals but there may be a third party ‘top-up’ required in order to meet their weekly costs.

If your Mum is required to privately fund her care then again it will likely come down to family members to shortlist services. We would always advise visiting shortlisted services to help inform your decision-making. Once more, do not be afraid to ask about the weekly cost of care as it is important to understand whether it is affordable. In the instance that your Mum’s home needs to be sold in order to fund care then some councils offer a deferred payment scheme which you may wish to enquire about.

7. My Mum’s reablement care has come to an end, what should I do now?

If your Mum was discharged from the hospital with a package of reablement care this will come to an end after 6 weeks. Reablement care is normally funded by the local authority, sometimes in conjunction with the NHS. As with ‘step-down’/discharge to assess, reablement care is fully funded regardless of your Mum’s personal financial situation.

At the point of discharge, we would recommend getting in touch with your local council to organise a care needs assessment. This can take up to 10 weeks in some parts of the country so it's best to start soon! As part of the care needs assessment a financial assessment will be done which will confirm whether your Mum is required to privately fund her care or is eligible for local authority-funded care. The care needs assessment will also determine your Mum’s ongoing care needs and what level of support needs to be arranged.

If you know your Mum is required to privately fund her care you may wish to skip the care needs assessment with the local authority & start contacting home care providers directly to find out their availability to support. Providing the home care company has the capacity to support they will complete their own assessment of Mum’s care needs and advise on how many visits per day/week they would recommend. Normally all home care companies offer a free initial assessment which comes with no obligation to take out their services.