Someone who was independent before going into hospital may now need help getting washed and dressed, moving around safely, preparing meals or taking medication. They may be using new equipment, feel weaker than before or need more support while they recover.

Sometimes families have very little time to work out what needs to be in place before discharge. Abbey Care can help plan the care needed at home.

If needed, one of our team can assess the person while they are still in hospital. This gives us the opportunity to understand what has changed, what support will be needed when they get home and whether any equipment or other arrangements need to be in place before care begins.

We can liaise with ward staff, occupational therapists, physiotherapists and discharge coordinators so that everyone involved understands how the person will be supported at home.

Returning home can feel daunting. Someone may be worried about moving around safely, coping on their own or whether they will be able to get back to doing the things they did before. Having a care worker there to reassure and encourage them can help as they regain their confidence.

Where there is new equipment or advice from an occupational therapist or physiotherapist, we make sure this is reflected in the person’s care plan and that our care workers understand how to support the person and use any equipment safely.

If a client or family needs help that we can’t provide ourselves, we can help them work out who may be able to help and, where appropriate, put them in touch with the relevant service or professional.

After leaving hospital, some people receive support from community occupational therapists, physiotherapists or other therapy services to help them regain strength, mobility and independence.

You may hear this described as reablement – helping someone rebuild their abilities and confidence following an illness, injury or hospital stay, with the aim of getting as close as possible to their previous level of independence.

For example, after a hip replacement a physiotherapist may provide exercises and goals for the client to work towards. Where these can safely form part of our care visits, our care workers can encourage and support the client to follow the agreed programme.

An occupational therapist may be working with someone on everyday activities such as getting washed and dressed, preparing something to eat or moving safely around their home. Our care workers can support those goals too, giving the person the time and encouragement to do what they can for themselves rather than automatically stepping in and doing it for them.

As we see the client regularly at home, we can also notice how things are progressing. If someone is doing more for themselves, or if they are struggling with something that had previously been going well, we can feed that back and liaise with the appropriate professional where needed.

The care someone needs immediately after leaving hospital may be very different from what they need a few weeks later.

At first, they might need several visits throughout the day to help with getting up and dressed, meals, medication, mobility and settling safely for the night.

As their strength, abilities and confidence improve, they may start doing more for themselves again. We can review the care with the client and their family and reduce the support where appropriate. That might mean changing what happens during a visit, adjusting visit times or reducing the number of visits.

The aim is for the care to reflect what the person needs as they recover, rather than continuing at the same level simply because that was what they needed when they first came home.