Discharge from hospital after treatment should be planned and carers or family should receive advance notice. Discharge preparations should begin as soon as the person goes into hospital. A Social Worker can advise on the suitability of residential or nursing care, or on ways of helping when the person returns home. An Occupational Therapist can assess the home environment to advise on any aids to help support the person living at home.
The hospital discharge process should include;
- an assessment of the person's needs, living environment and support network
- a written care plan that records these needs
- confirmation that any required services are in place in time for the discharge
- a system for monitoring and, if necessary, adjusting the care plan to meet any change in needs
- an assessment to see if the person qualifies for NHS Continuing Health Care, this will ascertain w the balance of health and care needs and whether there is responsibility under legislation for the NHS to provide or fund an individual’s care provisions.
- John’s CampaignJanuary 15 2018John’s Campaign is about making carers of people with dementia welcome on hospital wards and reflects a positive attitude towards the importance of carers and sensitivity to their needs.
- Cracks in the pathwayOctober 30 2014This report presents the findings of a Care Quality Commission review of the care people living with dementia receive as they moved between care homes and acute hospitals.
- The £20 Billion Question – An inquiry into improving lives through cost-effective dementia servicesJuly 4 2011This report published by the All-Party Parliamentary Group on Dementia (APPG) explores the the evidence for cost effective models of dementia care. It makes recommendations to focus on early intervention and prevention to reduce early entry to residential care and reduce unnecessary hospital admissions.
- Find me good careOctober 23 2012This website developed by the Social Care Institute for Excellence (SCIE) is designed to help people find the right care and support to suit their needs and lifestyle, whether at a time of crisis or as they plan for the future.
- The Triangle of Care – carers included: A guide to best practice for dementia careSeptember 4 2013The Triangle of Care is a model for dementia care that supports a partnership approach between the person with dementia, the staff member and carer. It is designed to ensure that carers are appropriately included and involved in the care of people with dementia, particularly in hospital settings.
- Hospital 2 Home resource packOctober 26 2012This resource is designed to make it easier for health and social care professionals involved in hospital discharge to support older patients in returning home safely after a hospital stay and reduce the risk of readmission to hospital.
- National Audit of Dementia – third reportJuly 13 2017The National Audit of Dementia (NAD) (care in general hospitals) measures the performance of general hospitals against criteria relating to care delivery which are known to impact upon people with dementia while in hospital. The third audit collected data between April and November 2016.
- Preparing for a Social Services Care Needs AssessmentMarch 28 2019Tips for people with Dementia on preparing for a social services care needs assessment can be found on the Alzheimers UK website, link below. http://www.alzheimers.org.uk/get-support/legal-financial/dementia-care-needs-assessment
- Social Services Support for DementiaEven if you feel you don't need support now, it's a good idea to know what's available and plan ahead. The adult social services department of your local council can help with your personal care and day-to-day activities. The first step is to arrange a needs assessment.
- Dementia Action Plan for Wales 2018 – 2022November 20 2019The Welsh government have adopted the Dementia Action Plan for Wales 2018 - 2022, with Vaughan Gething, Cabinet Secretary for Health and Social Services, stating that, "Our vision is for Wales to be a dementia friendly nation that recognises the rights of people with dementia to feel valued and to live as independently as possible in their communities."
- NHS Continuing Healthcare and NHS-funded Nursing CareMarch 28 2019NHS Continuing Healthcare If you have complex health and care needs, the NHS may cover the cost of all your care at home or in a care home, including the services you receive from the local council. This is called continuing healthcare and is funded ...
- Independent Living Equipment in GwentNovember 1 2019Cefndy-Medequip work with local authorities and the NHS to provide the community equipment service in Gwent. They specialise in aids and equipment for the home, mobility, bathrooms, bedrooms, kitchen and dining, living room and outdoors. Their catalogue has a section called "Dementia Friendly Collection".
- Independent Living by MelinMelin's Independent Living team manages over 850 properties across Blaenau Gwent, Torfaen, Newport, South Powys and Monmouthshire. These are designed for single people and couples aged 55 and over, for those with continuing health care needs, or residents who need some additional support. They also have three extra care schemes designed to meet residents' changing care support needs.
- Cwm Taf University Health BoardCwm Taf University Health Board is responsible for providing healthcare services to the population of Merthyr Tydfil and Rhondda Cynon Taf, estimated to be around 289,400 people.Ynysmeurig House, Navigation Park, Abercynon, Rhondda Cynon Taff, CF45 4SN01443 744800https://www.cwmtafuhb.wales.nhs.uk
- Hywel Dda University Health BoardHywel Dda University Health Board provides healthcare services to a total population of around 372,320 throughout Carmarthenshire, Ceredigion and Pembrokeshire. Corporate Offices, Ystwyth Building, Hafan Derwen, St Davids Park, Jobswell Road, Carmarthen, SA31 3BB01267 235151 https://www.hywelddalhb.wales.nhs.uk
- Aneurin Bevan University Health BoardAneurin Bevan University Health Board covers the areas of Blaenau Gwent, Caerphilly, Monmouthshire, Newport, Torfaen and South Powys. It serves an estimated population of over 639,000, approximately 21% of the total Welsh population.St Cadoc's Hospital, Lodge Road, Caerleon, Newport, Wales, NP18 3XQ01873 firstname.lastname@example.org://www.aneurinbevanhb.wales.nhs.uk/
- Betsi Cadwaladr University Health BoardThe Betsi Cadwaladr University Health Board serves a population of 678,000 people across the six counties of North Wales: Anglesey, Gwynedd, Conwy, Denbighshire, Flintshire and Wrexham.Ysbyty Gwynedd, Penrhosgarnedd, Bangor, Gwynedd, LL57 2PW01248 384 384https://www.bcu.wales.nhs.uk
- Abertawe Bro Morgannwg University Health BoardAbertawe Bro Morgannwg University Health Board sereves a population of approximately 500,000 people in the areas of Swansea, Neath Port Talbot and Bridgend. 1 Talbot Gateway, Baglan Energy Park, Baglan, Port Talbot, SA12 7BR01639 683344https://www.abm.wales.nhs.uk
- Cardiff and Vale University Health BoardCardiff and Vale University Health Board provides health services to a population of around 472,400 people living in Cardiff and the Vale of Glamorgan. Cardigan House, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW029 2074 7747https://www.cardiffandvaleuhb.wales.nhs.uk
- Powys Teaching Health BoardPowys Teaching Health Board is responsible for meeting the health and wellbeing needs of around 133,000 people living in Powys, mid Wales. Mansion House, Bronllys, Brecon, Powys, LD3 0LS01874 711661https://www.powysthb.wales.nhs.uk/