Post No 53…Hospital discharging; the convalescent journey

Introduction

Respite care in care homes is useful for a range of reasons, including regular breaks for carers, as a trial, or perhaps on a convalescent basis. Convalescent care is very common, because being medically fit to leave the hospital is not the same thing as being ready to return home.

This post looks further into what convalescent care is, and why so many families choose it as a route to get a loved one back home.

What is convalescent care?

Convalescent care is a short-term agreement between a person and a care home. It is sometimes simply referred to as respite care, or sometimes as step down care. Convalescent care mostly occurs following a person being admitted into a hospital setting.

In the world of the NHS, there is a huge issue of over occupancy within hospitals. We see it most acutely in the winters, with people stuck is ambulances outside waiting to get into A&E, but it is now becoming a problem throughout the whole year.

Convalescent care represents a way for hospitals to complete much needed discharges, and sometimes they will do this on the D2A pathway in order to speed up the process. When a person is medically fit to leave, the hospital does not want them to have to stay in hospital for longer than is necessary, and in most cases, neither does the person.

For older people, spending time in hospital can be quite challenging, especially in the winter. With hospital teams overrun, the risk of muscle wastage from spending long periods in bed is a very real concern. Older people can also take longer to recover their strength, and even if the hospital are no longer providing medically intervention, the person sometimes simply isn’t ready to safely return home.

Hence, convalescent care is needed.

Where will I find convalescent care?

Most care homes will provide respite care, which means they can provide convalescent care. It is important to note however that care homes providing this service are not necessarily rehab centres, whose purpose it is to rehabilitate a person through care and physio / other therapies. Care homes offering convalescent care provide a service for people to continue resting, be well cared for, be fed and watered, and to give them the time they need to recover their strength.

If you are looking for this type of care, you should be able to find (from the homes website) if they offer respite care or not, and from here you can enquiry further by calling the home.

It is important to note that many smaller care homes are consistently full up, and as a result they may not offer respite care. In larger purpose-built care homes, there are more often spaces available due to the number of rooms the homes have, so these might represent a better chance of finding availability.

What happens after the respite stay?

The main concept behind convalescent care is for the person to get well enough to leave the care home and go back to their own home, but this transition can sometimes be tricky. Again, a person might be ready to leave the care home, but are they well enough to go back home and be safe?

At this stage, some families will opt for further support but this time from a domiciliary provider, essentially, they are continuing the convalescent journey but in the persons own home.

This can be a useful idea because it softens the transition between being in a 24-hour care environment (both hospital and care home) to being back at home, and represents the final stage in the convalescent journey.

The amount of care required can be assessed when the person is in the care home, and by speaking with the home, families can get a good understanding of what the challenges would be like when the person does return home, and put a care package to fill in any gaps if required.

Once the person is back home with a package of care, the package may sometimes continue or families may choose to stop it, depending on the recovery of the person and how well they are adapting to being back home. If the package is removed, it suggests that the convalescent journey has been successful and the person can hopefully remain at home safely, which is the overall goal of setting up convalescent care in the first place.

Conclusion

Convalescent care gives families time to further assess the situation, which is something that is not always available in a hospital setting. With that time, more informed decisions can be made and I think this one of the most valuable elements to convalescent care.

It also represents a method to help individuals get out of a hospital setting, avoiding bed blocking and susceptibility to Hospital Acquired Infections (HAI’s), which again can be of great benefit to both the hospital, and to the patient.

For anyone who is in the position of needing additional support, you can send me an email to book a consultation, or look through some of the other useful content on both The Care Whisperer, and The Dementia Whisperer websites.