Planning for the Long Term
Long term housing options are where people can live well for as long as they wish. These options meet the needs and preferences of the person and are sustainable from a financial perspective. Planning for the long term means putting a plan in place that will sustain the person living out of hospital into the foreseeable future. When the long term plan has not been considered, this can lead to a breakdown of supports within the community resulting in a readmission to hospital.People are also more likely to be receptive to an interim discharge option if they know there is a longer-term plan. Therefore, planning for the long term may help to speed up discharge as well as prevent readmissions.Make sure to discuss long term plans in your handover to the person’s community support team. In particular, the support coordinator needs to know about any future needs, including changes to NDIS funding.
Top Tips and Tricks
- Consider if the person’s NDIS plan will continue to sustain them in the community. Are there enough hours and funds available? If not, discuss a plan of action with the support coordinator.
- Things to consider include therapy hours, future assessment needs, equipment hire or purchase, and support funding.
- Consider timeframes for plan reviews. NDIS decision making timeframes are generally longer in the community compared to in hospital.
Case Study
Azhar has a progressive condition and has just started using a standing lifter to transfer from bed. His OT recommended a ceiling hoist would be best for him long term, even though he does not require it now. Azhar’s team applied for High Physical Support SDA funding however the request was declined, as there was not enough evidence of his need for a ceiling hoist in the future. Azhar agreed to discharge to a property where a standing lifter can be used. The support coordinator and hospital OT discussed his long term needs, and made sure there was enough OT funding in his NDIS plan for a community OT to write an updated report with more evidence about his future need for a ceiling hoist and pursue a High Physical Support SDA outcome. Azhar is less likely to readmit to hospital due to a housing related need when his function declines in the future.View the PDF version of the Planning for the Long Term resource: View PDF