Leaving Hospital

After a person with a life-limiting illness recovers from an acute period of their illness,  they are often discharged home from hospital. It can be helpful for family members and/or carers to seek advice from HSE staff as to how they can care for their family member at home, particularly as the persons health may have deteriorated since their hospital admission.

From a practical perspective it is important to become familiar with the medications that the person is on, frequency of dosage, and possible side effects. The attending doctors / medical team in the hospital will be of assistance in this regard, as will your local GP and Public Health Nurse.

It maybe helpful to consider whether additional equipment in the home would be of assistance in the provision of care. Often items such as electronic bed, commodes, hoists or wheelchairs can assist in the day to day care. Such needs should be discussed with the occupational therapist (OT) in the hospital prior to discharge, and the community based OT may also provide advice with regard to more long term structural adaptations to the home. Assist Ireland  provides comprehensive details of equipment that could be of benefit.  The HSE published a Code of Practice in Discharge Planning which sets out the standards and procedures that should be in placeHSE Code of Practice Integrated Discharge Pla Code_of_practice_for_integrated_discharge_planning.pdf (4.04 MB, Adobe PDF)  . 

The day to day comfort, personal care and hygiene needs of the individual who is being discharged home will also need to be planned for. It is advisable to clarify with the hospital occupational therapist, physiotherapists, social worker as well as the nursing and medical team the extent of help that the individual requires. They will also be able to give specific guidance as to how you may be able to respond to the care and hygiene needs and will also help you to access homecare and nursing packages to facilitate the discharge of the person home.

The Irish Cancer Societyhas produced a booklet aimed at assisting those who want to care for a seriously ill family member or friend at home. This publication addresses the specific preparations you may need to consider including the practical, emotional and physical support that are particular to caring for someone seriously ill at home.

The Irish Red Cross provide detailed guidance on all aspects of caring for someone in the home in their book Helping You to Care. They have also produced a smaller booklet on the same  topic which can be downloaded directly by clicking here

There are a number of organisations that are dedicated to supporting carers including the Carers Association  and Caring for Carers Ireland . These organisations as well as the Irish Red Cross provide training courses to family members and or friends so they can provide the care with added confidence.

As well as the often obvious practical tasks that need to be attended to, there are emotional, psychological and spiritual needs that should be considered to ensure that all concerned are supported as the person comes home from hospital. Although most people who are ill look forward to their discharge home, and their family members are anxious to care for their loved in comfortable and familiar surroundings, there are often anxieties and stresses that can be difficult to articulate when planning discharge and concerns about ability to cope from the perspective of the carer and the person who is ill.

Dscussing and seeking help for the practical aspects of care can be most beneficial to ensuring successful discharge. Where possible it is important to involve the person being cared for in when planning and discussing aspects of their care, considering their preferences for care and plans for future as their illness progresses. All members of the nursing, medical and therapy team have a role in assisting in this area, and you may find that the Social Worker, Occupational Therapist and members of the Nursing Team can be of particular assistance in dealing with the emotional and psychological adjustment that is required. The Directory of Voluntary Organisations will direct you to local contacts.

When planning discharge from hospital of someone who will have ongoing and potentially increasing care needs, it can be helpful to ask friends and neighbours for practical assistance. Friends and neighbours are often willing to help in practical ways (such as shopping, cooking, school runs or baby sitting) which can relieve the burden of the primary carers. Planning a rota of care amongst those who are willing and available to provide hands on assistance and/or respond in emergencies is also helpful.