If a client is being discharged from hospital
after a long stay, it is vital their home is fit for habitation.
Chris Caple believes a visit to the local Home Improvement Agency
is one of the best places to start.
I have an older client who is soon to be
discharged from hospital. But her house is cold and damp and in
need of repair; she owns the property but has no savings or
capital. What practical and financial help is available to her?
The NHS Plan and the National Service
Framework for Older People are the two most recent policy documents
to have restated the importance of preventive social care in
enabling older people to maintain their independence.
These documents also agree that for most
people this is best achieved by providing adequate and appropriate
levels of support, so they can continue to live in their own homes
for as long as they wish and are able to.
Indeed, the NHS Plan outlines new investment
to the tune of £90 million for intermediate services that
“ensure active recovery and rehabilitation and prevent unnecessary
loss of independence”.
The client mentioned in this week’s question
is in the exact situation to which all this rhetoric most readily
applies. She should then benefit from the limelight being given to
services that facilitate supported discharge from hospital, prevent
re-admission to hospital or other long-term care and allow people
to continue living in their own homes.
Your first port of call could be a Home
Improvement Agency (HIA). It will be able to evaluate the property
and advise on the repairs and improvements that need to be carried
They will also have a list of reputable local
firms who can do the work and, on behalf of your client, they will
oversee any work carried out to make sure it is satisfactorily
HIAs can also advise on the availability of
grants to assist with the cost of improvements, adaptations and
repairs and often help clients to access unclaimed benefits and
disablement allowances as well. The HIA could also look for any
charitable sources to fund work.
For someone who owns their home but has no
other savings, another option is an interest-only loan, sometimes
known as equity release. The client may be able to claim assistance
from the Departmrnt of Social Security towards interest payments,
keeping the costs affordable.
Although many older people are wary about
borrowing money, the savings on energy costs plus the additional
welfare benefits obtained as a result of advice from an HIA will go
a long way toward covering the repayments on such a loan.
A growing number of HIAs actually provide
“home from hospital” services. These projects normally receive
referrals from hospital-based occupational therapists who will
carry out a pre-discharge home assessment to identify specific
problems with a patient’s housing conditions that may hinder their
recovery and long-term health.
These referrals can result in an HIA
facilitating anything from minor adaptations such as handrails, to
major work such as the installation of stairlifts and central
In the meantime, it may be that your client
would benefit from a short period of rehabilitative care or
convalescence, depending on the nature of her stay in hospital and
how close to full recovery she is.
Either way this will not only serve as a
transitional period to help her prepare for her return, but will
also mean some of the work to her home can be completed before she
If your local HIA has a home from hospital
project attached to it then they should also have information about
the availability of local rehabilitation and convalescence
By 2002 primary care trusts will be required
to have an intermediate care implementation plan outlining where
and how convalescence and rehabilitation will be provided in their
area. In the meantime, most of these services are provided in
residential care homes.
Some parts of the UK, however, do have
convalescence homes or cottage hospitals, which provide such
services and may be a more appealing to an independent client.
Chris Caple is assistant director,