Discharge from hospital

What is the discharge process?

Once a brain injury survivor has been medically treated and they have completed their program of early rehabilitation, they might be ready to be discharged from hospital.

This stage can come with mixed emotions among survivors and their families. There may be a sense of relief that the survivor is able to leave hospital, alongside perfectly valid concerns over what may happen next.

As long as the discharge process is carefully managed, the survivor should continue receiving the support and care that they need after leaving hospital.

Below we offer information on things to consider during the discharge process to ensure a successful discharge from hospital after brain injury.

What questions need answering during the discharge process?

The discharge process requires careful preparation and discussion. This should be done through a formal discharge meeting. It should involve the brain injury survivor, the survivor’s family, hospital or rehabilitation staff, social services staff, and possibly the survivor’s GP.

Things that will need to be considered include:

• What remaining difficulties does the brain injury survivor have – physical, cognitive, emotional and behavioural? 
  

• Will the survivor be safe in their home environment? Can a home visit be arranged to check this? 
  

• How will the survivor’s continuing needs for rehabilitation be met? 
  

• What type of support and follow-up will there be at home? 
  

• What medications will the survivor need? When should they be taken, and for how long? 
  

• Could there be any risk to others (e.g. children in the family) if the survivor returns straight home? 
  

• Have the survivor and their family been advised on how best to manage the survivor’s remaining problems and those that might develop later?

A written discharge plan may then be produced with a copy to go to the GP.  Families can also request a copy of this.

Where will the brain injury survivor go next?

Before being discharged from hospital, a brain injury survivor should have their outstanding health and social care needs assessed by their medical team. This is a vital step, as they might need ongoing rehabilitation (such as physiotherapy or speech and language therapy), or adaptive equipment and support to be provided if they are returning home.

Once health and social care needs have been identified, these should be outlined in a care plan by the healthcare commissioners and/or the local authority.

A meeting should then be had in which the care pathway and its funding will be discussed. Social services staff should attend the meeting, together with hospital or rehabilitation staff, a continuing healthcare assessor, a social worker, close family members and possibly the GP.

A written discharge plan may then be produced, with a copy to go to the GP. Family members that are involved in the discharge process can also request a copy of this.

Close family members should be kept involved in discussions throughout the discharge process. If you are a family member of a brain injury survivor being discharged from hospital and you do not feel that you have been properly involved in these discussions, it might be useful to get support from an independent advocate. NHS patient support services should be able to help you with this.

Where the brain injury survivor goes next will depend on what their ongoing needs are. They may be discharged to a rehabilitation unit, a residential or nursing facility, or return home with arrangements made for ongoing support if needed. For more information on this, visit Ongoing care.

Arranging a staged discharge

If it is decided that the survivor will return home, it might be a good idea to ask for a staged discharge, or ‘trial run’, first. This could involve them coming home once or twice a week, with an overnight stay before they are formally discharged from hospital.

Arranging for a staged discharge can help the survivor and their family to find out if any adaptations will be needed within the home (e.g. a wheelchair ramp) while maintaining contact with the hospital or rehabilitation staff.

An occupational therapist from the hospital, rehabilitation team or social services should also visit the home to assess any adaptations that may be needed.

What information should be provided at discharge?

On leaving hospital, the patient and family should be given contact details of the neurological rehabilitation team, so that they have someone to contact for advice in the future.