Returning home after a stay in hospital will doubtless be a welcome relief, but also a time of anxiety, particularly for an elderly patient who lives alone or needs after-care and support. Their safety and well-being are at the heart of the hospital discharge process.
When the time comes for your elderly parent or relative to be discharged from hospital you will need to know how the discharge process works, what to prepare and what happens after they leave hospital.
How discharging elderly patients from hospital works
Almost as soon as someone goes into hospital, hospital staff, which may include a discharge co-ordinator, will start planning for a return to their home (home or a care home). When doctors decide that the person no longer needs to receive medical treatment in hospital, there should already be a plan in place for their swift and safe discharge. A hospital’s aims are that 1) the elderly patient is ready to leave; 2) they will be safe where they are going, and 3) that any further support is put in place.
Since July 2022 “Discharge to assess” or “Home First” has been introduced for patient discharge. If the patient is deemed fit to be discharged, but likely to have long-term care needs, the Local Authority is no longer required to carry out a care needs assessment prior to discharge from hospital. This will take place once the patient has returned to their residence.
And, the NHS is now obliged to include carers and family members as early as possible in the discharge planning process.
The hospital discharge process
The first step is a discharge assessment which will determine whether more care is needed after leaving hospital. This is made in collaboration with the patient and, with their family or carers.
If the patient needs little or no care it is call a ‘minimal discharge’. If further care is needed, it is a ‘complex discharge’, and a care plan will be put in place. You can find out more about this in our guide to what happens after hospital discharge.
The discharge process begins well before the day of discharge, with hospital staff and co-ordinators constantly reassessing someone’s needs for when they are discharged. The aim is for everything to be in place so that they can be discharged when a doctor gives the medical go ahead.
Discharge planning for elderly patients
It is the hospital staff and the discharge co-ordinator’s responsibility to make sure that the patient is ready, that it is safe and that the patient will have everything they need when they get home. While it is the hospital’s responsibility, they will do this with the patient and their family, so there is some preparation you may need to do before your parent or relative is finally discharged.
How the hospital will prepare for the discharge of an elderly patient
While every situation might be slightly different, consideration will be given to most of the following for the patient to be discharged from hospital:
Your hospital discharge checklist
In addition to helping the hospital organise the items above, there are some simple things that you and your family can do to help make the discharge process easier for elderly relatives.
The benefits of a personal alarm after hospital discharge
Many families decide to invest in a personal alarm system for their elderly parent after being in hospital as they can be at greater risk of having a fall. A personal alarm provides a level of security and reassurance for families so that should an elderly parent fall, a 24/7 monitoring team will be able to quickly assess the situation and get help to them. You can get personal alarms with built in fall detection, GPS capabilities, or ones with a simple emergency button.
Care for elderly patients after hospital discharge
After an elderly patient has been discharged from hospital, and it is determined that they may need further help when they get home, a care and support plan can be made.
This is done by a member of social services. There may be a delay currently in this taking place due to a backlog of assessments post pandemic etc, but it should be done usually the day or two after discharge from hospital. This can include a care needs assessment; and a carers assessment for a primary carer which is particularly helpful if that is an elderly spouse or partner. Your relative might also be assessed for NHS continuing healthcare.
It may well be a good idea for a family member who is not necessarily the primary carer to be present when a care plan assessment is done to be able to contribute, ask and answer questions, and to understand the results.
FAQs for discharging elderly patients from hospital
What is discharge to assess?
Discharge to Assess is a strategy employed by NHS England especially when dealing with older patients who may need further care and support after being discharged from hospital. The idea is to continue the assessment process after discharge, instead of delaying hospital discharge in order to assess.
What are the criteria for discharge from hospital?
The criteria for hospital discharge will vary between hospital (hospitals have their own discharge protocols and processes), conditions and where the elderly patient would be discharged. It is the hospital's upmost priority to make sure that they don't require any further primary care from the hospital and that they are being released into a safe environment.
Can you discharge a family member from hospital?
No. It is the hospital's decision to discharge a patient, unless the patient wishes to self-discharge. Throughout your elderly relative's stay in hospital it is advised to be involved in discharge discussions so that you can understand the reasons why someone is or isn't being discharged from hospital.
Can you self-discharge from hospital?
Although not advised, you can discharge yourself from hospital at any point.
Who discharges you from hospital?
Once a doctor has determined that it is medically safe to discharge an elderly patient from hospital it is the job of discharge coordinators, and potentially social care staff, to make sure that they are being discharged into a safe environment and that they can be assessed for further support if needed, once being discharged.
Can a hospital discharge you if you have nowhere to go?
If an elderly relative is unable to be discharged home for whatever reason, there are other options that a hospital will consider for discharge. Community hospital wards or care homes might be considered, especially if there are further needs that will need to be attended to following hospital discharge.
What are the different types of hospital discharge?
There are two types of hospital discharge, minimal and complex, that are determined after an initial assessment. A minimal discharge means that little or no support will be needed after discharge. A complex discharge recognises that further support will be required.
When can a COVID patient be discharged from hospital?
Whenever a doctor determines they are medically safe to do so. Having COVID does not change a patients ability to be discharged, but will be kept in mind for example if they were to be discharged into a care home, does the care home have the ability to properly isolate them from other residents?
Who are Taking Care?
Taking Care are Which?’s approved personal alarm service, helping over 170,000 people feel safer living independent lives.