27/09/2015
Leaving the familiar environment of a hospital after an illness or injury can be a daunting prospect. Many individuals wonder, "When should I be sent home from hospital?" The answer is not always straightforward and often hinges on a comprehensive assessment of your needs and your potential for recovery. A key consideration in this process is the provision of intermediate care and reablement services, designed to empower you to regain independence and confidence before returning home or making long-term care decisions.
It's vital to understand that hospital discharge isn't simply about vacating a bed; it's about ensuring you are safe, well-supported, and have a clear plan for your continued health and well-being. If there's a possibility that your hospital stay might lead to a permanent move to a care home, the hospital staff have a responsibility to thoroughly assess your needs. This assessment should explore whether you would benefit from intermediate care or reablement services. These services act as a bridge, offering short-term support to help you make as full a recovery as possible and rebuild your confidence before any decisions about your long-term living arrangements are made.
What Exactly is Intermediate Care?
Intermediate care is a specialised form of short-term support with a singular, crucial aim: to help you become as independent as possible. This support isn't confined to a hospital setting; it can be delivered in various locations, including community hospitals, care homes, or even in the comfort of your own home. Before you are discharged from the hospital, the healthcare team will carefully consider if you stand to gain from these intermediate care services. If they determine that you would benefit, they will work collaboratively with you to set achievable goals. You will then receive tailored support to help you reach these objectives.
This support often involves a multidisciplinary team. You might work with health professionals such as physiotherapists, who can help you regain strength and mobility, or occupational therapists, who can assist you in adapting your home environment or learning new ways to perform daily tasks. Social care staff also play a significant role, providing assistance and guidance. The focus is on helping you to relearn skills that may have diminished while you were unwell, ensuring you have the necessary tools to manage your daily life effectively.
Understanding Reablement: Empowering Your Daily Living
Reablement is a specific and highly effective form of intermediate care that places a strong emphasis on helping you learn or re-learn the essential skills required for daily living. Unlike traditional care where tasks might be done for you, reablement services involve social care staff supporting you in your own home by observing and guiding you through tasks. This could include anything from washing and dressing yourself to preparing a simple snack. The underlying principle is to empower you to do things for yourself, fostering a sense of accomplishment and self-reliance.
The ultimate aim of reablement is to help rebuild your skills, improve your mobility, and crucially, restore your confidence. By successfully completing these daily tasks with support, you gain a renewed sense of capability, which is fundamental to a successful transition back into your community. It’s about building capacity, not just providing assistance.
Duration and Funding of Support
If you are deemed eligible for these services, you can receive up to six weeks of reablement care free of charge following your hospital discharge. Intermediate care, including reablement services, typically has a duration of no longer than six weeks. However, this timeframe is flexible; if you achieve your set goals sooner, your period of support could be as short as one or two weeks. This personalised approach ensures you receive the support you need for the duration that is beneficial to your recovery.
Towards the conclusion of your intermediate care or reablement period, the professionals involved will conduct a review. They will assess your progress and determine if you are likely to benefit from further support. If your care needs extend beyond the initial six weeks, you may be required to contribute towards the cost of your care. This is a common aspect of social care funding, and it’s important to have a clear understanding of potential costs.
What Happens if You Don't Benefit from Further Reablement?
If the assessment indicates that you are unlikely to benefit from further reablement support, a comprehensive care needs assessment will be carried out. This assessment is crucial for determining your long-term support requirements. It will explore whether you need ongoing social care services, provided by local authorities, or NHS continuing healthcare, which is fully funded by the NHS for individuals with complex, ongoing health needs. This assessment ensures that your future care plan is tailored to your specific and ongoing needs, providing a safety net for your continued well-being.
Key Questions to Ask Your Healthcare Team
When you are nearing discharge, it’s essential to be proactive and informed. Here are some important questions you might want to ask your healthcare team:
- What is the planned date for my discharge?
- Will I be offered intermediate care or reablement services?
- What are the specific goals we will be working towards during this period?
- Who will be involved in providing my support (e.g., physiotherapist, social worker)?
- How long will these services typically last?
- What happens if I need care for longer than six weeks?
- Will I have to pay for any of these services, and if so, how much?
- What is the process for a care needs assessment if I require long-term support?
- What support is available if I am unable to return to my own home?
- Who can I contact if I have concerns about my discharge plan or the support I receive?
Comparing Support Options
To help clarify the different types of support available, here’s a simple comparison:
| Service Type | Primary Aim | Duration | Typical Providers | Funding |
|---|---|---|---|---|
| Intermediate Care | Regain independence and functional ability | Up to 6 weeks | Community hospitals, care homes, home care teams | Generally free for up to 6 weeks |
| Reablement | Learn/re-learn daily living skills | Up to 6 weeks | Home care teams, social care staff | Generally free for up to 6 weeks |
| Long-Term Social Care | Ongoing support for daily living needs | Indefinite (based on assessment) | Local authority care services, private care agencies | Often means-tested, may require contribution |
| NHS Continuing Healthcare | Complex, ongoing health needs | Indefinite (based on assessment) | NHS healthcare teams | Fully funded by the NHS |
Common Concerns and FAQs
Q1: I feel I'm not ready to go home yet. What should I do?
A1: It’s important to voice your concerns to the nursing staff or your named nurse. They can escalate your worries to the discharge planning team or social worker, who can re-evaluate your readiness and explore further support options if necessary.
Q2: What if my home isn't suitable for me to return to?
A2: If your home environment presents significant challenges to your independence, the occupational therapist will assess this. They may recommend adaptations to your home, or suggest that intermediate care in a different setting might be more beneficial initially.
Q3: Who decides if I need reablement?
A3: The decision is usually made by the multidisciplinary team involved in your care, often in consultation with you. They will consider your current abilities and your potential to improve with targeted support.
Q4: What if I disagree with the assessment of my needs?
A4: You have the right to ask for a review of the assessment. Discuss your concerns with the social worker or discharge coordinator. They can explain the process for challenging a decision or requesting a reassessment.
Discharge from hospital is a critical phase in your healthcare journey. By understanding the role of intermediate care and reablement services, and by actively engaging with your healthcare team, you can ensure a smoother transition and a more successful recovery, empowering you to live as independently as possible.
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