Dementia Support Line
Things to consider after a person with dementia leaves hospital
There are different places a person with dementia may be discharged to after a stay in hospital. This will depend on their needs. There are also various options available if the person needs care and support after leaving hospital.
- Preparing for a hospital stay when a person has dementia
- How to support a person with dementia during a hospital stay
- What happens when a person with dementia is discharged from hospital?
- You are here: Things to consider after a person with dementia leaves hospital
- Hospital care for a person with dementia – other resources
Hospital care
Deciding where a person with dementia will live after leaving hospital
After leaving hospital, the needs of a person with dementia may have changed. They may need more support than they did before going into hospital. If this is the case, where they move to may have to change.
Sometimes this will be temporary, such as being discharged to a smaller community hospital or care home until they fully recover. Sometimes, this change will need to be permanent in order to keep the person safe.
Who decides where the person with dementia will live after leaving hospital?
Depending on the person’s individual circumstances, all options for where they live should be discussed with:
Generally, the person will choose where they wish to live once they are discharged from hospital.
If the person with dementia is not able to decide where they will live, who decides for them?
Some people with dementia will be unable to make this decision for themselves. This is known as lacking ‘mental capacity’ to make the specific decision.
If the person with dementia is not able to decide where they will live, someone else will have to make this decision for them.
Who makes this decision will depend on which country the person lives in, and whether they had already put plans in place.
Where should the person with dementia live after leaving hospital?
In their own home
Some people will recover in hospital and will be able to continue with their life as before. If the person lives at home, they may still benefit from extra support, such as:
- equipment to help with daily living
- visits from a paid carer.
These small changes could help someone with dementia keep their independence and help reduce the risk of returning to hospital.
In assisted living
Some people with dementia may be able to move in with friends or family who can help care for them.
Sheltered housing or extra care housing may also be options for the person. These are set up so that the person with dementia can live independently but has support on hand should they need it. You should check what is available locally and whether it can provide all the help that is needed.
As the person’s dementia progresses, their needs will change and increase. This means that a care home may be the most appropriate option for them.
Moving more than once in a short period of time could make the person feel very disorientated or unsettled. Take this into account when looking into options for assisted living and the level of care they are able to provide.
In a residential care home
Maintaining independence can be helpful for people with dementia, so options for living at home or living with extra support should be considered first. However, some people with dementia will not be able to live independently – for example, if they cannot care for themselves or stay safe.
If this is the case, they may need to move into a care home, where staff can support the person with daily care. This can include help with:
- eating
- washing
- dressing
- going to the toilet.
Some people have trial periods in residential care when they are discharged from hospital. This can help when deciding whether residential care is the best option for the person, without committing to it.
Before the coronavirus pandemic, people were sometimes able to stay in hospital until a room became available in their first choice of care home. Due to changes in the hospital discharge process, this is no longer possible.
This may mean that the person with dementia has to move into a care home that is not their first choice. For example, it may be further away from family, or cost more than the person is able or willing to pay.
If this happens, it can be useful to check the standard rate for care home fees in that area.
In a nursing home
Staff in care homes support with daily living, but do not provide nursing or medical care. If someone has difficulty moving, issues with continence or medical needs, a nursing home may be better suited for them.
Like residential care homes, nursing homes support residents with their daily care needs, but they can also provide help with nursing care. They must always have a registered nurse present to provide the medical support that the residents need.
Who will pay if a person with dementia needs care and support after hospital discharge?
Coronavirus funding for care after discharge
During the coronavirus pandemic, any care that a person needed following a discharge from hospital was paid for. Since 31 March 2022, this funding is no longer available.
Each local area now has their own agreement on how care may be funded once someone leaves hospital, prior to the assessment of their long-term needs. Ask the case manager responsible for the discharge what funding may be available, or ask for a copy of the hospital's discharge policy.
Assessment for longer-term care needs
If the person with dementia needs longer term care, these will be assessed, along with their finances.
The assessment should take place while the person is recovering, and their long-term care needs are clearer. Except in rare circumstances, the assessment should take place after the person has left hospital.
The person's care needs should always be assessed prior to their finances. Some types of care are also ‘means-tested’. This means that qualifying for that care will also depend on the person’s income and capital – for example their savings. How quickly the assessment will happen will vary between different areas.
What longer-term support is available to a person with dementia after hospital discharge?
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Deciding where the person will live will depend on their situation. For example:
Whoever the decision-maker is, they must consider what is in the person’s best interests.
Can family and friends of the person with dementia be involved in deciding where they will live?
Family and carers should always be asked for their opinion when deciding where a person with dementia will live.
Some people may not have friends or family who can help represent them. If this is the case, an independent mental capacity advocate (IMCA) should be appointed to help ensure that the persons’ views and wishes are taken into account. A professional (usually a doctor or social worker) should organise this.
How are the best interests of the person with dementia protected in this decision?
There may be concerns that moving a person who lacks mental capacity to a care home or nursing home may limit their freedom. This is because they would be supervised and would not be free to leave. If someone’s freedom is limited, this is known as a ‘deprivation of liberty’.
If someone’s proposed care may result in them being deprived of their liberty, the care will need to be ‘authorised’. This means that an assessment will take place to ensure that the care is in the person’s best interests. The assessment will also make sure that there isn’t another workable option that would be less restrictive.
If a person cannot decide where to live following discharge from hospital, this decision will be made by professionals as part of the discharge process.
The decision will usually be made by the social worker. They must consider the person’s needs and wishes, as well as any advice from the doctor or consultant. Carers and relatives should also be involved in these discussions.