Ask A Nurse - Discharge from Hospital

How do I best prepare for the discharge of my 78 year old mother who has had a lengthy stay in hospital and has been denied going to a rehabilitation facility prior to coming home? My dad (80) will be home with her, but it will be too much for him to be responsible to look after her. Please advise us.

Barbara

Dear Barbara:

It is very important to connect with the social worker on your mother’s ward as early as possible as they are your in-hospital advocates.

When discharge is being discussed or seems eminent, it is vital that you request a team conference / discharge planning meeting to discuss the services that are available from the Community Care Access Centre (CCAC) in Ontario. Ask for a meeting with the hospital’s CCAC discharge planner. If you are having trouble finding this person ask to speak to a social worker.

The discharge planner will answer your questions about what government home care services will be provided. Afterwards, you will be able to make an informed decision as to what additional private services you may require, to ensure the discharge is successful and that your mom does not have to return to hospital.

Many families request that one of our qualified Registered Nurse Case Managers attend the discharge planning meeting, as well, to help you to understand what should be available and what is being offered.

Pivate services that you may want/need to consider are:

- additional personal care by a Personal Support Worker (PSW)

- at home physiotherapy

- at home occupational therapy

- at home nutritionist

- at home massage therapy

All of these private services are available through Qualicare without the delays currently associated with CCAC services.

Please let us know if you need more information or is we can help.

Andrea

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