Transition Care Programme
About the Transition Care Programme
No one wants to stay in hospital longer than they have to but sometimes we need a little more care. If you are older or have an age related condition, our Transition Care Programme can support you for up to 12 weeks when you leave hospital. The programme allows you to continue your recovery while you plan your long term care.
Your hospital discharge team will organise an Aged Care Assessment before you leave hospital. They will work out your options and together, we will create a care plan which can adapt as your needs change.
While on the programme you will have a dedicated case manager who will work with you to plan the next stage of your care. The care you receive will depend on your needs and where you receive your care.
We will also work with your health care team to make sure you get the care you need. Whether you need health or personal support, your case manager will help you navigate the system and connect with the services you need.
We can support you with:
- Health professionals such as physiotherapists, occupational therapists and social workers
- Personal Care (eg: showering & dressing)
- Housekeeping and help around your home
- Shopping
- Meals
- Equipment to make life easier
- Management of appointments and travel to appointments
- In–home respite care
Click here to find out how you can get help through the Commonwealth Home Support Programme.
A daily fee for the Transition Care Programme is charged by the Commonwealth Government and medication costs are separate.
*The Transition Care Programme is jointly funded by the Victorian State Government and Australian Commonwealth Government.
Monash Health also offer a service to help Aboriginal and Torres Strait Islanders access to aged care services including:
- Diabetes education
- Psychologists
- Dietitians
- Speech Therapists
- Support groups for elders and families
For For the Aboriginal Access Team, please contact: 9791 7747