Leaving Hospital: Care Options for Older Adults
Hospital to home aged care for older adults: discharge planning, the Transition Care Programme, restorative care, and arranging a safe recovery.
Why this moment matters
Start with the discharge planner
The Transition Care Programme
Restorative care through Support at Home
Bridging the gap while funding is arranged
Setting the home up for recovery
If ongoing care is needed
Frequently asked questions
What support is available when an older person leaves hospital?
Several options: the Transition Care Programme (up to 12 weeks of therapy and support), the Support at Home Restorative Care Pathway for short-term rehabilitation, and private or interim care to bridge any gap. Start by speaking to the hospital discharge planner or social worker.
What is the Transition Care Programme?
A short-term programme, up to 12 weeks, for older people who are medically stable and ready to leave hospital but need time to recover function. It provides physiotherapy, occupational therapy, nursing, personal care and case management, delivered at home or in a live-in setting. It needs an aged…
How do I get help arranged before discharge?
Ask to speak to the hospital discharge planner or social worker early in the stay. They assess what you will need at home, help arrange it, and can refer you for an aged care assessment. Ask what can be set up before you leave and who organises it.
Can I get care immediately if funding is not ready?
Yes. Private home care can start immediately with no means test and be scaled back once government funding arrives. You may also access interim Support at Home funding or entry-level CHSP services, plus family and community help, to bridge the first weeks home.