Mum is in the hospital, and I’ve been told she might need transition care. What happens after the assessment, and how do we get started
If your mum has been assessed for transition care while still in the hospital, it can feel overwhelming to figure out what comes next. Transition care is designed to help her recover and regain independence after a hospital stay. Here’s a step-by-step guide to help you through this process.
What Happens After the Assessment?
- Receiving the Assessment Outcome
- Your mum’s assessor will explain her eligibility while she is still in the hospital.
- She will also receive a letter confirming:
- The decision on eligibility.
- The services she is eligible for.
- The reasons and evidence supporting the decision.
- A copy of her support plan.
- Referral codes if this method of referral was discussed.
- Finding a Transition Care Provider
There are two ways to arrange transition care:- Your Assessor Refers You: The assessor can connect your mum directly with a suitable provider and coordinate her transfer from the hospital to the care facility or home.
- Self-Referral: If you’d like to choose a provider, you can use the referral code provided in the approval letter. Call My Aged Care on 1800 200 422 or use the Find a Provider Tool to search for options.
- What is a Referral Code?
- A referral code is a unique number that allows a provider to access your mum’s assessment and support plan.
- If the code is lost, you can find it by logging into your My Aged Care Online Account or calling My Aged Care.
- When Will Care Begin?
Timing is important with transition care:- Care in an Aged Care Home: Must start within 24 hours of hospital discharge.
- Care at Home: Must start within 48 hours of discharge.
- What if We Need to Delay Care?
- Care can be delayed if the hospital is confident your mum can be discharged safely and you have adequate support at home.
- Remember, approval for transition care is valid for 28 days. If no place is available within that time, a reassessment will be needed.
- Do We Have to Accept the First Provider or Services?
- No. You and your mum can ask questions and ensure you’re comfortable with the provider and services before agreeing to them.
If Mum is Not Eligible
If the assessment shows she’s not eligible, the letter will explain why. There are other options available:
- Other Government-Funded Services: Your support plan may suggest alternative services.
- Non-Government-Funded Providers: Explore private options if immediate support is needed.
- NDIS (for those under 65): Call 1800 800 110 to check eligibility.
Need Support or Have Questions?
- Discuss any concerns with the assessor or request a review of the decision (details will be in the letter).
- Call My Aged Care on 1800 200 422 for guidance and support.
This process can feel complicated, but you’re doing the right thing by staying informed and advocating for your mum’s care. Remember, help is available every step of the way.
