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What is Transitional Care?
Transitional care is a multidisciplinary transitional service which aims to help patients following an acute episode requiring hospital admission to receive low intensive therapy and continuing nursing care to help improve their independence and confidence and hopefully return to their own home safety.
The “package” which also includes the ability to return home with an assessed care plan and continuing support from health professionals.
Transition care can be provided for a period of up to 12 weeks, with the possibility to extend to 18 weeks if you are assessed as needing an extra period of therapeutic care.
To be eligible for transitional care, yo9u must be an older person and an in-patient of a hospital.
You must have completed your acute stage.
A flexible care program will be designed for the client to meet individual needs. The team will include:
• The clients own GP
• Relevant nursing personnel
• Relevant allied health personnel
• Case manage
• Personal care assistants
How do you access the program?
• By being an existing patient in an acute hospital
• No longer requiring hospital care
• Medically stable.
• Have an Aged Care Assessment Team Assessment for flexible care.
• Have potential to achieve a lower level of dependency.
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- to achieve optimal quality of life for our residents.
- To prevent loneliness, boredom and isolation
- To “pursue” Best Practice in the care we provide.
- To include the family in the care.
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