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Transition Care

Transition Care

A short term program, offering additional recovery time when you’re ready to leave hospital, offered in your home, at an aged care home or at a health facility.

What is transition care?

As you age, sometimes you may need additional recovery time when you are ready to leave hospital, and additional time to make a decision regarding the best place to live in the long term. This type of care given to you when you are recovering is called transition care.

Transition care is a short term care programme that may involve low-intensity therapy such as Physiotherapy, nursing care (e.g. wound care) or personal care.

Where do I stay when I am in transition care?

You may be cared for in your home or in some cases you may need extra support in an aged care home or a health facility that is separated from the hospital. Transition care is not intended to be delivered in a hospital type of environment.

How long does transition care last for?

Transition care can be provided for a period of up to 12 weeks. The programme might be extended to 18 weeks if you have been assessed as requiring more time for care.

Am I Eligible?

  • To be eligible for transition care you need to be an older person who is an inpatient at a hospital and has been told that you are ready to leave the hospital.
  • To arrange transition care, ask to speak to a social worker at the hospital where you are an inpatient. Transition care will be arranged prior to your discharge from hospital.
  • To be eligible for transition care you will need to have been assessed by the Aged Care Assessment Team (ACAT) and received a letter of approval that states that you are eligible for transition care.

The Assessment Process

Arrange A Meeting

Phone My Aged Care to arrange an assessment.

Have A Meeting

Have a meeting with the Aged Care Assessment Team.

Receive Outcome

Receive the outcome of the assessment from My Aged Care.

1. Phone My Aged Care to arrange an assessment

  • If you have been referred for a comprehensive assessment, an assessor from an Aged Care Assessment Team (ACAT) will contact you to arrange a time to visit.

2. Have a Meeting with the Aged Care Assessment Team

  • The Aged Care Assessment Team (ACAT) will call you to arrange a meeting time.
  • You may give the assessor permission to talk with your support people (e.g. a family member or carer) and you may want to have a support person present during your meeting.
  • You will develop a support plan with the assessor during your meeting. The support plan will include the services and care that best meets your needs, based on your current circumstances.
  • The assessor will then make a decision about your care needs, your eligibility to receive care and the level of care that best meets your current needs.

3. Receive the outcome of the assessment from My Aged Care

  • If the assessment determines that you are eligible for support services, then you will receive a letter of approval from ACAT. Sometimes there is a waiting period and it is important that if you have any concerns about the waiting time that you discuss this with the assessor at the time of your meeting.
  • If at any time your circumstances change, you can contact My Aged Care at any time to receive a new assessment.

If you disagree with your ACAT assessment, you can write to the Secretary of the Australian Government Department of Health, outlining your concerns regarding the outcome of your assessment. You have 28 days to do this from the date of your approval letter.

Moving into residential aged care is not the end of your life

How Much Will It Cost?

The Australian Government might subsidise transition care however you will be expected to contribute towards your care financially if you are able to do so.

The service provider may charge you a daily care fee when accessing transition care. For more information about transition care and associated costs, go to www.myagedcare.gov.au or phone 1800 200 422.

It is important to know that different service providers may charge differently. It is important to discuss the costs involved in respect to your care with your service provider prior to receiving services.

Keep browsing other services below or for your personal aged care summary head here.