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NHS HIGHLAND: Home is best for recovering patients

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By Jane Buckley

Often when a loved one is admitted to hospital we say: "Well, at least they’re in the right place." What we mean is, they are close to clinical professionals when they need to be.

Once someone has been diagnosed and has started treatment, their needs are usually different. At this point, they need to be moving about as much as they can safely, getting back to a familiar routine, and in surroundings that help them to relax and rest.

In fact, once someone is well enough to go home, staying longer in hospital can reduce their independence. It increases risk of infection and reduces muscle strength and fitness – this is known as ‘deconditioning’. Deconditioning can cause mental health problems as well.

In other words, the best place to recover is at home. This is known as the Home First approach.

Home First brings together different types of support to allow people to recover at home. This helps them to maintain their independence.

When someone arrives in hospital, we aim to set a date for them to return home. The team in the hospital will work towards discharging them by this date. They will try to ensure any care you need is in place by this date. Sometimes we recommend carrying out a care assessment after someone has gone home, rather than before. This is called ‘discharge to assess’ and aims to improve people’s experience by getting them home quicker and allowing the assessment to take place in their normal surroundings.

Sometimes we hear from family members of patients who are worried that they won’t cope at home. That’s understandable when you care for someone and want the best for them. Patients are only discharged from hospital when our healthcare team have agreed they are fit to continue their recovery either at home, or in another healthcare setting outside of the hospital, such as a care home.

At the moment, we are seeing a lot of very sick people being admitted to hospitals in the Highlands, who need acute care. That can mean pressure on beds, and sometimes we may discharge a patient who is fit to move on, even if they or their family would like more time to arrange ongoing care. We’ll do everything we can to smooth the transition out of hospital, while ensuring we have the beds we need for people who are critically ill.

There are some things people can do in hospital to keep moving and get ready to go home. This includes getting dressed each day, being as mobile as possible, and using things they would usually have at home like glasses, hearing-aid, watch or diary.

If your loved one is in hospital, you can help them with eating, dressing and walking if you need to. Hospital staff can show you how to do this.

If we think your loved one is ready to go home, please work with us. It may be that they would benefit from you being around for a few days while they find their feet again and have their care assessment. Support like this could help them to get home and recover faster, and will also help people who need to be admitted to hospital to be seen more quickly. If you are a local employer, please consider giving your staff the flexibility they need if they are supporting someone home from hospital.

Jane Buckley, NHS Highland's head of operations: acute medical services/unscheduled care.

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