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Care after illness or hospital discharge (reablement)

Care After Illness Or Hospital Discharge Panel

Getting back on your feet after an illness or hospital stay is an important step towards regaining your independence.  However, this can sometimes be challenging, especially for older adults.  This is where reablement services can be a lifesaver.

Most people receive this type of care for around 1 or 2 weeks, although it can be free for a maximum of 6 weeks. It will depend on how soon you can cope at home.

What is reablement care?

Reablement is a short-term, focused intervention designed to help you regain the skills and confidence you need to live independently at home following an illness, surgery, or a fall. It's not about doing things for you, but rather working with you to relearn or rebuild your abilities to perform everyday tasks.

Benefits of reablement care

Benefits of reablement services include:

  • Improved mobility: Reablement can help you regain strength, flexibility, and coordination, allowing you to move around your home safely and confidently.
  • Increased confidence: By relearning essential skills, you'll feel more empowered to manage your daily life independently, boosting your overall well-being.
  • Reduced risk of hospital readmission: Reablement can help prevent unnecessary hospital stays by ensuring you have the skills and support you need to manage at home.
  • Maintaining independence: The ultimate goal of reablement is to enable you to live comfortably and safely in your own home for as long as possible.

Who can benefit from reablement?

Reablement is particularly beneficial for older adults recovering from:

  • Hospital stays: Following surgery, a fall, or an illness that has impacted your mobility or daily living skills.
  • Deterioration in health: If you've noticed a decline in your ability to manage everyday tasks, reablement can help you regain those skills.
  • Falls: Reablement can help assess your risk of falls and provide strategies and support to prevent future incidents.

How does reablement work?

The reablement process typically involves the following steps:

  • Assessment: A healthcare professional will assess your individual needs and abilities, focusing on daily tasks like washing, dressing, bathing, preparing meals, and getting around your home.
  • Goal setting: Working collaboratively with the healthcare professional, you'll establish realistic and achievable goals for regaining your independence.
  • Tailored support: Based on your assessment and goals, a personalised plan will be developed. This might involve:
    • Occupational therapy: An occupational therapist can help you relearn or adapt daily living tasks, such as dressing, bathing, or cooking.
    • Physiotherapy: A physiotherapist can develop an exercise programme to improve your strength, balance, and mobility.
    • Social care support: Social workers can assist with tasks like shopping, preparing meals, or transportation if needed.
    • Equipment adaptations: Modifications like grab bars in the bathroom, raised toilet seats, or dressing sticks can make your home safer and easier to navigate.
    • Review and progress: Your progress will be regularly monitored, and the reablement plan will be adjusted as needed to ensure you're on track to achieve your goals.

Types of reablement services

Reablement care is typically delivered by a team of healthcare professionals, including:

  • Occupational Therapists
  • Physiotherapists
  • Social Workers
  • Nurses
  • Care Assistants

When you can get free short-term care and how to get it

After leaving hospital

Care can help you recover from an illness or an operation.

Hospital staff should arrange care before you leave hospital.

Speak to the person in charge of you going home (discharge co-ordinator) to make sure this happens. Information:

Your hospital won't get involved after you leave.

After a fall or short illness

Care can help you avoid going into hospital if you don't need to.

If you or someone you know falls or needs help because they're ill, speak to your GP practice or social services.

They should be able to arrange for someone to come to your home and discuss what you need.

If you have started to find everyday tasks difficult

You can get help with daily tasks. This can help you learn new ways of doing things before needing paid home help.

If you find everyday tasks difficult, contact the council and ask for a needs assessment. This will identify the type of care or equipment you need.

What care you'll get

A team with a mix of people from the NHS and social services will help you do the things you need to do to stay independent.

This might include getting dressed, preparing a meal, or getting up and down stairs.

They might care for you at first, but will help you practice doing things on your own.

Your team might include:

  • a nurse
  • an occupational therapist
  • a physiotherapist
  • a social worker
  • doctors
  • carers

They'll start with an assessment that looks at what you can do. You'll agree together what you want to do and set out a plan.

The plan will include a contact person who's in the team and the times and dates they'll visit you.

Care options in Plymouth 

  • Home care: Trained carers can visit your home to assist with personal care, meal preparation, medication reminders, and light housekeeping.
  • Equipment loan and purchase: Mobility aids like walkers, wheelchairs, or shower chairs can significantly improve independence. The NHS or social services might offer loan schemes, or you can purchase equipment privately.
  • Reablement services: These short-term programmes focus on helping you regain independence with daily tasks through physiotherapy, occupational therapy, or speech and language therapy.
  • Day care services: Day care centres offer social interaction, meals, and activities while providing respite for carers.
  • Residential care: For those requiring more extensive support, care homes offer a supervised living environment with 24/7 care.

Who can help me?

Plymouth City Council's reablement service is called Independence @ Home Reablement Service

Age UK Plymouth provides support and advice for older adults in Plymouth, including information on reablement and other care options.

If you find everyday tasks difficult, contact the council and ask for a needs assessment. This will identify the type of care or equipment you need. You can also call 01752 668000 and select the adult social care option.

What to do if you're unhappy with your hospital discharge

You can complain if you're unhappy with your hospital discharge, or the discharge of someone you know.

For example, if:

  • the hospital plans to discharge you before you think it's safe
  • you don't think your discharge assessment was done correctly

Speak to the hospital staff who arranged your discharge.

It might help to get advice from the Patient Advice and Liaison Service (PALS).

Read more about the NHS complaints process.



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