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Father comforting son with intellectual disability as they wait in Emergency

Family / Close others

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 an adult 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.

  • A hospital may have incorrect information about where a person lives.

  • It is important that hospital staff have accurate information about the type and amount of support available in the person's home.

  • Disability support staff do not receive 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

 

As a family member or close other, you will need to tell hospital staff

  • about where the person lives

  • the type and amount of personal or medical support available in their home

  • what you know about the person's preferences about where they live and who supports them

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

Collaborating â€‹is when you

 

  • correct misunderstandings

  • reconsider options in the face of new information

  • contribute to the discussion

  • work towards options preferred by your family member

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

Supporting

 

Your family member will feel supported 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 can be explored

  • advocates are engaged if formal processes are not progressing

  • the final decision reflects your family member'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 family member/ close other with intellectual disability to hospital. 

Quality hospital care requires that discharge planning involves the person with disability, family and/ or disability support workers and their managers (for those living in supported accommodation), 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 and for all to ensure 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. 

Consider your family member/ close other with intellectual disability in either Jeff or Cassandra's situation of not being able to return immediately to their home on discharge from hospital.

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  1. Describe what you think would be their preference(s).

  2. Explain how they would express their preferences and will.

  3. List the people who you think should be involved in the discharge meeting.

  4. List the specific information you would want to share at the meeting.

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