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A hospital occupational therapist talking to a patient in a wheelchair

Hospital Staff


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

  • 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.



  • tell the patient and others the specific decision that needs to be made

  • ensure all options are canvassed

  • ask the patient about their will and preferences

  • ask informal support people, such as family and disability support workers, about the type and amount of support they can provide  

  • find out what organisations, such as supported accommodation providers and NDIS representatives, can do and possible constraints

  • tell the patient and those supporting them what the hospital can provide up to and post-discharge

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

Collaborating is when you


  • correct misunderstandings

  • reconsider options in the face of new information

  • ​ensure everyone involved in discharge planning contributes to the discussion

  • follow formal processes that may be required

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



The patient with intellectual disability will be supported in the decision making when you and others involved in decisions

  • listen and act upon their preferences and concerns 

  • postpone decisions until all options have been explored

  • engage advocates if it looks like the patient's preferences are being overridden

  • ensure the decision reflects the person’s will and preferences and minimises any risks


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

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



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

In your workbook, write your responses to the following:

  1. Describe Lorraine's role in planning discharge for both Jeff and Cassandra.

  2. Describe Jeff's preferences and wishes.

  3. Explain if and how Lorraine, Lynne and Amelia demonstrated respect for Jeff's preferences.

  4. Describe Cassandra's preferences and will and how she expressed them.

  5. Explain why a final decision was postponed for Cassandra.

  6. Identify any other options that might have been canvassed for Cassandra that would ensure her rehabilitation continued in an environment that met her preferences.

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