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Transition Care

Transition care aims to aid your recovery following a hospitalization by providing short-term, specialized care and support to accelerate the restoration of your functional independence and self-assurance, thereby minimizing the requirement for prolonged care and support services.

What is Transition Care?

Transition care aims to facilitate your recuperation following a hospitalization by rendering brief, specialized care and assistance to hasten the restoration of your functional autonomy and self-assurance, and prevent the necessity for prolonged care and support services. Your care plan is customized to your specific requirements and aspirations, and administered in the most suitable setting to assist you in attaining them. This may comprise an aged care facility, your residence, the community, or a combination thereof, as your recuperation progresses and your needs evolve.

What services Can I receive?

Transition care offers various services, and the care and support you receive will be tailored to your individual requirements.

  • Therapy services:

  • Physiotherapy

  • Occupational therapy

  • Podiatry

  • Dietetics

  • Speech pathology

  • Counseling services

  • Social work to connect you to wider community support

  • Social activities, including lifestyle, cognitive, and general exercise programs

  • Nursing support:

  • Clinical care provided by a registered nurse, such as:

  • Pain management

  • Wound care

  • Oxygen therapy

  • Medication assistance

  • Dementia support

  • Catheter care

  • On-call access to specialized nursing services

  • Personal care:

  • Assistance with everyday tasks, including:

  • Bathing, showering, personal hygiene, and grooming

  • Maintaining continence or managing incontinence

  • Eating and using eating aids

  • Dressing, undressing, and using dressing aids

  • Moving, walking, wheelchair use, and using devices and appliances to aid mobility

  • Communication, including addressing difficulties resulting from special conditions, such as dementia.

What will it cost?

You are not required to undergo a means assessment for transition care, although providers may seek information about your ability to contribute (to a reasonable extent). Importantly, your access to transition care will not be impacted by your capacity to pay fees.

Although providers collaborate with you to set their fees, the government specifies the maximum amounts. Currently, the maximum rates are:

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  • $12.14 per day if you receive care at your residence or in the community (equivalent to 17.5% of the single age pension).

  • $58.98 per day if you receive care in a residential setting (equivalent to 85% of the single age pension).

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Transition care can be provided in your home, the community, an aged care facility, or a combination of these places. Therefore, if you relocate between settings during your care, the overnight accommodation site determines the fee you will be charged.

Where do I receive services and for how long?

What are the locations for transition care? The site for your transition care will be determined by your recovery needs. For intensive care needs, a temporary stay in an aged care facility with round-the-clock care and support may be suitable. For moderate care needs, services may be provided at home or in the community. As your care requirements evolve during recovery, you may receive care in a combination of locations. Your transition care provider will coordinate and supervise all aspects of your care and assist you in transitioning between sites.

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What is the duration of the program? If you meet the eligibility criteria for transition care, you may receive services for up to 12 weeks (84 days). In some instances, you may be eligible for a six-week (42-day) extension, which requires another assessment.

Moreover, there is no restriction on the number of times you can apply for transition care, even within the same year. If you qualify, you will be authorized to receive services again.

How do I become eligible?

If you are a senior and:

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  • Currently a patient in a public or private hospital.

  • Informed that you are prepared to be discharged from the hospital.

  • Could benefit from receiving short-term services, you may qualify for transition care.

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