Discharge Planning

Question 1

Discharge planning

Answer 1

• Is a shared responsibility
• Ideally discharge planning starts as soon as the person is admitted to the service
• The multidisciplinary team works together with the patient and their family

Question 2

Effective discharge planning

Answer 2

• Ensures continuity and a smooth transition to their next destination
• Improves coordination if services after discharge from the hospital by considering the patient’s needs
• Prevents unnecessary readmission
• promotes increased satisfaction and confidence with patients and their families

Question 3

Nurses have a very important role

Answer 3

Nurses are the front line in delivering care. Concerns by patient and family may be communicated to the nurse

Clear communication with patient and multidisciplinary team to ensure effective car wand discharge planning eg handover noted to the team including info about the level of care

Question 4

Role of a social worker

Answer 4

The social worker profession facilitates social change and development, social cohesion and the empowerment and liberation of people.
Principles and of social justice, human rights, collective responsibility and respect for diversities are central to social work

Question 5

4 key social work values

Answer 5

Client self-determination
Empowerment
Social justice
Advocacy

Question 6

A psychosocial approach

Answer 6

Systems theory
Increasing complex and chronic presentation for care
Presenting issues may not be the underlying cause
Each patient is different and has their own unique story

Question 7

My aged care

Answer 7

Myagedcare is the entry point to access aged care services and information about
Different types of age care services
Eligibility for service
Referral to service provider
The financial contribution to the cost of aged care

Question 8

Myaged care will ask

Answer 8

A person a series of questions that will determine if they would be suited for a follow up by regional assessment team or aged care assessment team

Question 9

Regional assessment service

Answer 9

Home supprt assessments are provided by a local accessor from ras. They can assess and provide approval form entry level services under the commonwealth home support programsto help a person remain independent home and actively participate in the community

Question 10

Acat age care assessment team

Answer 10

Acat can conduct a comprehensive assessment to determine if a person if a person is eligible for

Question 11

Services acat

Answer 11

Home care package 
Residential care in an aged care home
Residential respite care
Transition care
Other services that a person may need

Question 12

Home care packages

Answer 12

A coordinated package of care and services to help an older person live independently in their own home for as long as they can

There are 4 levels of packages to meet different levels of care needs

Everyone accessing a home cafe package pays a contribution towards their care

Question 13

Alternative options

Answer 13

Existing support network
Department of veteran affair
Private service 
Day centre respite , in-home respite and emergency respite
Transitional care packages