Hospital Discharge Resource 2024 | FAQ

When the person you care for is first admitted into hospital, you may feel overwhelmed with the initial information, so our carers have put together some tips of things that you should consider.

Ask for a ‘getting to know me’ form:

The ‘getting to know me’ form is an opportunity to let hospital staff know of any accommodations that can be made for the person you care for, if they are struggling to communicate for themselves. This can be anything from how they take their tea to what calms them down when upset. The form can be requested from a member of staff on the ward and left visible at the bedside once filled out.

Parking at the different hospitals:

Each hospital has their own parking management system and we advise that you familiarise yourself with any time limits.

• Trafford General - 3 hours of free parking, concessions available if staff notified
• Wythenshawe – 30 minutes of free parking, concessions available for frequent visits or all-day parking
• MRI – 30 minutes free parking, concessions available for frequent visits or all-day parking
• Salford Royal – 30 minutes free parking, concessions available for carers

Please speak to staff at the hospital (usually a front desk representative) for up to date information and guidance.

Travel to your hospital visits:

If you do not drive, live in an area with poor infrastructure or something else is preventing you from being able to travel easily, getting to the person you care for in hospital can be a worry. The resources below can help if you are facing issues with travel:

• TfGM Travel Vouchers - Travel vouchers can be used to pay for taxis or Ring and Ride.
• Ring and Ride - accessible minibus service for disabled people and older people.
• Local Link - bookable shared minibus service for people in areas where public transport is limited.

To find out if you are qualify/to register for the above services call 0161 244 1000 or visit https://tfgm.com/

Good Neighbour Trafford (Royal Voluntary Service) - Community Transport Service offers lifts to people with limited mobility or health conditions. To enquire please call 0161 871 2011.

Best Interest Meetings are arranged when a patient lacks mental capacity to make important decisions about their care or treatment. During these meetings, a multidisciplinary team comes together to make a decision for the patient's best interest. As a carer, you should be included in this meeting to represent your loved one and make known any limitations or needs when caring for the person who is being discussed. If you have lasting power of attorney, final decisions will be yours to make.

Lasting Power of Attorney (LPA):

Lasting power of attorney is a legal document that can appoint someone as your ‘attorney’ to make decisions on your behalf if you lack the mental capacity. In order to determine if a person lacks mental capacity, a capacity test can be carried out, this can be requested in the hospital. Power of attorney may be a temporary measure during a hospital stay or long-term if a person is diagnosed with dementia, for example.

In order to request Lasting Power of Attorney, you must contact the Office of Public Guardian or you can request one on GOV.UK. Requesting one does not require a solicitor but it can prevent problems later down the line, if it is a complex case. Please follow this link for more information: https://www.gov.uk/power-of-attorney

Each hospital has its own discharge policy – this can be requested from the ward manager or Patient Advice and Liaison Service. The discharge planning should begin as soon as the person you care for is admitted.

A hospital discharge plan should include:

• the name of the member of staff at the hospital who’s responsible for checking you’re discharged properly
• arrangements for an assessment of your care needs, if necessary
• details of any support, help, equipment or adaptations which are to be set up at your home before discharge, and information about who is responsible for providing these (with an idea of timescales)
• details of any contacts to be made to the community health services, such as GP, district nurse or social worker

A patient can ask for a copy of the discharge plan, and so can a carer or representative with the patient’s permission.

As a carer in the hospital setting, it is important that you are included in any decision making along the way. You can begin this by making staff at the hospital aware of your caring role. As a carer, you may find asserting yourself and getting your ideas across difficult in the hospital setting. This could be because you are used to putting others before yourself or maybe you feel you are too busy to ask for something. Below, please find some information on your rights as a carer in hospital.

Input in the care plan, care package and discharge planning:

As the carer, it is your right to have your needs taken into consideration when hospital staff create a care plan, care package and discharge plan.

This is important as caring can be a demanding and stressful role, and it is crucial that caregivers receive the necessary support and assistance. Hospital staff should take the time to listen to the caregiver's concerns and needs, and work with them to create a plan that takes into account their well-being, as well as that of the patient.

There are many things to keep in mind when preparing for the discharge of the person you care for. Below, please find items to consider and discuss with staff involved in the discharge of the person you care for to feel confident about a ensuring a safe discharge.

Transport home

• Will the person you care for need support with being transported home? Do Patient Transport Services need to be contacted?

Medical equipment

• Will the person you care for be using new medical equipment in the home? How will the equipment be made available to you? Will you need any training or a demonstration from Occupational Health on how to use it?

Medication

• Do you need to ask a doctor or nurse about the dosage and when the medication needs to be taken? Can you access repeat prescriptions and/or delivery to the home?

Follow up appointments

• When and how often will they take place? Will they take place in person or can they be done over the phone or via a home visit?

Ongoing care needs

• Is it applicable? What options are there? Will it cost you?

Informal support services

• Which services will be helpful to you pre and post discharge?

NHS contact / Social Care crisis contact

• Who is your contact in the community once discharge has gone through?

Reablement:

As part of a short-term care package, ‘reablement’ may be used to support discharge from hospital, prevent readmission or enable an individual to remain living at home. Reablement can include: agency carers coming to the home to help assist you in caring; adaptations in the home; and/or new equipment, such as a hospital bed or wheelchair etc.

As part of the reablement assessment and planning, as a carer, you should be asked what care you provide, whether you are happy to continue, and to what extent. Carers in paid work have statutory rights to help balance paid work and caring responsibilities.

NHS Continuing Care:

Involving carers and family members in this evaluation and assessment process is essential. If eligible, the assessment will determine the required assistance, the intensity and complexity of the needs, and the health risks if proper care is not timely provided.

In cases of rapid deterioration or end-of-life care, a fast-track application for NHS Continuing Care can be submitted. If you believe the person you are caring for meets the criteria, you can request NHS Continuing Care through your healthcare provider, doctor, or social worker. Please find out more information by following this link: https://www.nhs.uk/conditions/social-care-and-support-guide/money-work-and-benefits/nhs-continuing-healthcare/

Social services may become involved in the discharge of the person you are caring for when care needs to be continued after the hospital stay. If the person you look after is likely to have long-term health or care needs, social services will arrange a care needs assessment.

A care needs assessment will help towards a plan for your support, whether this is agency carers coming into the home or adaptations in the home etc. A financial assessment will also determine the amount you will need to pay towards any long-term care needs. The discharge team should contact the local social services team to request a social worker for your case or you may contact them directly if you feel it is needed (0161 912 5199).

It is most likely that the assessment will take place after hospital discharge, unless there is a special circumstance. This is due to the Discharge to Assess (D2A) policy. Please find more information at: https://traffordlco.org/services/adult-community-services/discharge-to-assess-service/

Every hospital has their own discharge policy and you can request this from a member of staff or from PALS. Hospitals must meet basic discharge needs for a safe discharge, including clothing, transport, short-term financial support, incontinence supplies if needed, equipment training, and informing the patient's GP. If you believe discharge needs aren't met, you can raise concerns with the Patient Advice and Liaison Service (PALS) to arrange a meeting with the multidisciplinary team.

If you unfortunately feel you need to make a complaint regarding the person you care for’s stay in hospital and need support doing so, you can access an advocate by making a referral to Advocacy Focus (0300 323 0965). Their trained advocates can offer independent and confidential advice on understanding the outcome you are hoping for, writing complaint letters, and understanding responses. You can find out more by scanning the QR code.

Carer burnout is very common but rarely discussed. But what exactly does ‘carer burnout’ mean? ‘Carer burnout’, ‘carer fatigue’ or ‘carer breakdown’ is when an unpaid carer reaches the end of their energy reserves. This can happen because, as a carer, you are on the go every day, making sure the needs of the person you caring for are all being met, without stopping to think about your own wellbeing.

Some signs to look out for include:

• Feeling depressed or emotionally numb
• Overreacting emotionally
• Mood swings
• Difficulty concentrating, slow and confused
• No longer finding enjoyment in things you normally would
• Engaging more in unhealthy coping mechanisms, such as smoking and drinking alcohol
• Feeling physically exhausted
• Self-neglect and/or neglect for the person you care for
• Feeling physically ill or run down
• Poor appetite
• Social isolation
• In a state of hypervigilance
• Post-trauma, the stressful feelings catch up with you when you stop for a break or your caring role comes to an end

Not having the person you care for at home may seem like a break to others, but as carers, we know this is not the case. Carers can become at risk of carer burnout due to the build-up of responsibilities and stress throughout a hospital stay.

To help reduce the risk of burnout our carers recommend:

• Book a GP appointment.
• Reach out for support from family and friends.
• Speak to ward staff about how you are feeling.
• Call Trafford Carers Centre’s Carers Line.
• Contact other local organisations in the community.

Professional support with your mental health:

If you are concerned about your mental wellbeing and would like to seek professional help around this, it may be worth filling out a PHQ-9 and/or GAD-7 questionnaire. These questionnaires are able to indicate symptoms and the severity of symptoms for depression and anxiety. You can then use your answers from the questionnaire to show to your GP or the mental health practitioner at your practice, when accessing professional mental health support.

PHQ-9 - https://patient.info/doctor/patient-health-questionnaire-phq-9

GAD-7 - https://patient.info/doctor/generalised-anxiety-disorder-assessment-gad-7

Qwell:

Qwell is a free online mental wellbeing service for adults. With no waiting list or referral required, you can anonymously access proffessional support via online chat until 10pm every night. The website also offers a variety of personal development tools and community support on a monitored peer to peer forum. Follow this link to find out more and/or sign up: https://www.qwell.io/

Here at Trafford Carers Centre, we accept referrals from ages 5 and upwards. We help to support carers looking after someone in the Trafford area. This support could be information and advice, carers assessment and support plan, emotional support, signposting and referrals to relevant services or referrals to internal services such as counselling, benefits advice, respite opportunities and more.

Please do not hesitate to reach out to us if you care for someone in Trafford and would like to receive some information on how we can help you. You can refer yourself or make a referral on behalf of someone else on our website or by sending a physical copy of a referral form to us in the post.

Please follow the link to fill out an online referral form: https://www.traffordcarerscentre.org.uk/our-support/make-a-referral/