As you age, there could be a need for additional recovery time after a hospital stay. The therapeutic care occurs once you’re discharged from hospital and continuing your recovery. It ensures that patients reduce their hospital stay for an extended period of time, while continuing to get the therapy and support they need.

Transition care is a short-term programme that may involve low-intensity therapy such as allied health, social work, nursing or personal care. The aim of the programme is to allow more recovery time with support, after you’re discharged from hospital. It allows  many older Australians to continue living within the community, by maintaining or improving functionality.

Via this program, entry into an aged care facility may be delayed, either temporarily or indefinitely.

Where do I Stay When I Enter This Program?

You may be cared for in your home or in some cases you may need extra support in an aged care home, or a combination of both. Transition care is not intended to be delivered in a hospital type of environment.

The program delivers short-term care for a period of up to 12 weeks. Under certain circumstances, there is a possibility of extension of the program for up to 18 weeks. An additional assessment determines wheteher there’s a need for more care/ therapy, and whether you meet the eligibility requirements.

To be eligible for transition care you need to be an older person who is an inpatient at a hospital and has been told that you are ready to leave the hospital. To arrange this flexible care, ask to speak to a social worker at the hospital where you are an inpatient.

Next, you’ll need an assessment by the Aged Care Assessment Team (ACAT). Approval by the ACAT assessor to enter into transition care remains valid for 4 weeks after they sign off on the approval.

If you meet the eligibility requirements, transition care arrangements are made prior to your discharge from hospital. The program commences within 48 hours of hospital discharge to the home. When receiving transition care via a short stay in a residential aged care environment, delivery of care commences immediately after being discharged from hospital.

Notably, transition care eligibility will also be affected if a person is already accessing other forms of aged care support services. Additionally, you can’t access this type of flexible care while receiving respite care or short-term restorative care.

The Assessment Process With the ACAT