REDHS Transition Care Program (TCP) has 2 bed based and 1 community based positions. TCP is available for up to a 12 week period, based on patient goals and outcomes achieved.
Transition Care provides short-term support and active management for older people at the interface of the acute/sub-acute and residential aged care sectors. It is goal oriented, time-limited and targets older people at the conclusion of a hospital episode who require more time and support in a non hospital environment to complete their restorative process, optimise their functional capacity and finalise and access their longer term care arrangements.
The potential for further recovery will vary according to the individual. Therefore, the services provided will vary from individual to individual, ranging from those that further improve physical, cognitive and psycho-social functioning thereby improving the person's capacity for independent living, to those that actively maintain the individual's functioning while assisting them and their family and carers make appropriate long-term care arrangements.
An outcome of transition care is that inappropriate extended hospital lengths of stay and premature admission to residential aged care are minimised. However, it should be stressed that transition care's primary function is therapeutic, rather than administrative.