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Disability support worker comforting a person with intellectual disability as they wait in Emergency

Disability Staff

Discharge

In the first scene, you will again meet Amelia,  Jeff's disability support worker, and Jenny, a nurse, followed by a discharge planning meeting involving Jeff, Lynne, his sister, Amelia and Lorraine, a social worker. 

In this scene are Cassandra, Frank, her father, Johnno, her disability support worker, and Lorraine, the social worker. They are joined by Anita, from the NDIS, and Eddy, an NDIS support coordinator.

Applying the Framework

Diagram showing the four framework processes, with the Knowing segment highlighted.

Knowing that

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  • People with intellectual disabilities have the right to make decisions and exercise choice and control over their daily lives.

  • No one has the right to make decisions on behalf of a person with intellectual disability unless a guardian has been appointed, which will be for specific decisions.

  • It is appropriate to consider the supports a person needs to make a decision, rather than whether or not they have the capacity to make a decision.

  • At discharge, it may not be possible for family or disability support staff to meet the person's needs in the short and/or long term.

  • Disability accommodation, such as a group home, is staffed by disability support workers, who do not have medical or health training.

  • People who have NDIS funding can have it reviewed if there has been a change in their support needs.

Diagram showing the four framework processes, with the Informing segment highlighted.

Informing

 

Disability support staff (or family) may need to

  • ask what specific decision needs to be made

  • ensure all options are canvassed

  • ask the person about their will and preferences

  • tell people involved in the discharge meeting the type and amount of support they or the service provider can provide the person 

  • find out from their managers what their service can do and possible constraints

Diagram showing the four framework processes, with the Collaborating segment highlighted.

Collaborating is when you

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  • correct misunderstandings

  • reconsider options in the face of new information

  • ​contribute to discussion about post-discharge accommodation options

  • offer to follow formal processes that may be required

Diagram showing the four framework processes, with the Supporting segment highlighted.

Supporting

 

The person with intellectual disability will be supported in the discharge decision-making when

  • their preferences and concerns are listened to and taken into account

  • decisions are postponed until all options that best meet their will and preferences have been explored

  • advocates are engaged if formal processes are not progressing

  • the final decision reflects the person’s will and preferences and is the least restrictive option

Summary

Knowing something about the hospital system and discharge planning will be useful background when you accompany a person with intellectual disability to hospital and/or are involved in their discharge planning.

Quality hospital care requires that discharge planning involves the person with disability, family and/ or disability support workers and their managers, and others who can provide information and support the person. Good discharge planning also relies on a hospital staff member, such as a social worker or discharge nurse, to coordinate the process. Everyone in the meeting is responsible for ensuring the human rights of people with intellectual disabilities to make decisions and exercise choice and control. 

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You can find further information in Resources about support for decision making, the NDIS and Hospitals, and advocacy for people with intellectual disabilities.

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Activities

These are provided to support your learning, individually or in a group. You can write responses in the workbook sections available for download. 

Re-watch the scene of Amelia and nurse Jenny discussing Jeff's imminent discharge.

Write down your responses to the following in your workbook.

  1. Describe the misinformation that the nurse, Jenny, seemed to have in relation to disability support and accommodation.

  2. Describe your reaction to Amelia informing Jenny of where Jeff lived and any additional information you think could have been useful.  Identify additional information would you provide?

  3. Explain how you might maintain collaboration with Jenny to ensure good support for Jeff.

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