If you’ve recently spent time in hospital following an illness or surgery, you might be feeling weakened and more vulnerable than usual. Perhaps you’ve organised for some temporary respite care after leaving hospital but ultimately, the plan is to return home. If so, Transition Home Care may be what you need.

What is transition care?

The Transition Care Program was established in 2004 and, nationally, 4000 transition care places have been allocated, lasting an average of around 60 days.

The type of care offered through the program is designed to give you more time and support after leaving hospital, so you are set up to return home and are not pressured to move into residential care before you’re ready to do so.  A transition care package may include therapeutic and restorative services, such as physiotherapy, occupational therapy, nursing, personal care and the support of a social worker if you feel you need this.

Home Care Package vs. Transition Care

Unlike Home Care Packages, which are assigned by the Commonwealth Government through My Aged Care, transitional care packages are managed at a local level, by state and territory governments. They work with community-based and private providers to organise care you may need. 

As the client, you have choice and flexibility when it comes to choosing how this care is delivered. For example, you may choose to spend some time in respite after leaving hospital before changing to home-based care. These packages may also be suitable if you have been diagnosed with dementia and may need extra support after you’ve been discharged from hospital and return home.

How do you access transition Home Care?

As Transition Care Packages are specifically designed to ease your move from hospital to home, you can only access the care directly after discharge.

This means you must be assessed as eligible by an Aged Care Assessment Team (ACAT) whilst still an in-patient.

These teams are an important part of the government’s aged care program and are made up of medical, nursing and allied health professionals. Their role is to conduct a thorough assessment of you, taking into account physical, medical and psychological and social factors. 

Based on this assessment, they will decide if you are eligible and, if so, offer you a package designed to meet your current needs. This assessment is carried out in consultation with the hospital staff who have been looking after you. They can tell you what services are available in your area and design a post-discharge transition care plan for you.

What if you need to extend your care?

Transition care packages provide care of up to twelve weeks and you can choose to receive this care in a hospital,  in a respite facility or at home. If you feel you need it, you can request an extension of care by up to 42 days. The team will consult with your doctor and others involved in your care and decide whether an extension is required.

Further information

If you'd like to chat to a Care Adviser about Transition Care, or any other Home Care services, call CareAbout on 1300 036 028.