Helping NDIS Participants in Hospital: The Dos and Don’ts
It is fair to assume that nobody likes going to the hospital. For some, this process might not be a big deal, however for many NDIS participants a hospital admission can be a very stressful and anxiety inducing time. As a registered NDIS provider in Cairns, knowing what to do if ever a hospital visit arises with our participants is of crucial importance, and depending on how we as support workers respond to this situation can either make it slightly easier.
It is important to understand what aspects of going to the hospital participants find particularly difficult. For some, these can include changes to their everyday routine, sensory issues associated with being in unfamiliar environments, previous trauma experienced in the hospital, or changes to their medication – to name a few. With all things considered, it is our role as support workers and providers to ensure our participants feel the most relaxed as can be throughout the hospital admission process.
But how do we do this effectively? Here, we discuss the Dos and Don’ts to consider when helping NDIS participants in Hospital.
The Do’s of helping your NDIS Participants in Hospital
Ensuring your participant’s transition to the hospital goes as smooth as possible should start with the prep before they are admitted. Rather than waiting until the last minute to scramble together all the important information the hospital will need to know, collate this together into a folder that can be taken to the hospital with the participant. Not only will the hospital be grateful for this, but your participant will have one less thing to worry about. Important information to bring could include:
- Their NDIS number and participant details
- Their transition plan
- Medications, Medications Chart, doses and any known allergies
- Details of their mobility and any AT equipment that is required
- Details of any behavioural support, personal needs, or sensory sensitivities
- Their day-to-day routine
- Emergency contact details
- Communication preferences or a guide on how to appropriately communicate
DO bring some personal items
In addition to their medications, keys, wallet, AT aids, phone and charger and to help make your participant feel the most comfortable they can be during their stay at hospital, bringing some comfort items from home can go a long way. Being in an unfamiliar environment can be very triggering for many individuals, so by bringing some items that reminds your NDIS participant of home can help prevent them feeling overwhelmed.
DO inform the hospital staff how is best to communicate
There is a lot of uncertainty that comes with being admitted into hospital, especially for participants who may struggle to comprehend what is happening around them and keeping them in the dark will only make things worse. Your NDIS participant may find communicating difficult – especially when they are surrounded by people they do not know. Helping the hospital staff understand the most appropriate ways to communicate with your participant is crucial. For example, for NDIS participants who are non-verbal, they may have other techniques they use to communicate via e.g. communication cards, pictures, a particular communication device, or gesturing to items to ask what they require. Other participants may have an intellectual disability and struggle to comprehend complex and elaborated sentences. In this instance, inform the hospital staff to be mindful of this and to use language that is more straight-forward to understand.
Additionally, the Behavioural Escalation Response Team, or BERT, are available to assist with providing support for individuals with intellectual and neurodevelopmental disabilities. Available at Cairns Base Hospital, the BERT team works with both participants and their support workers to ensure the best quality of care can be achieved during their visit.
DO help your participant speak up if something isn’t right
One main priority when helping our NDIS participants is helping them to have a voice. Being under the care of the hospital and medical professionals does not mean your participant loses their right to speak up if they feel something is wrong. However, they may lack the confidence or the ability to vocalise how they are feeling. It is our job as support workers to help recognise the signs indicating our participants are feeling uncomfortable, in pain, or their general mood and body language is different to usual, and to help them inform the hospital of this. So, one major DO on this list to help advocate for your participant!
As a support worker in Cairns, you can call ‘Ryans Rule’ if you feel like your participants medical state and needs are being ignored. This is a three-step process that allows you to raise concerns over the health and treatment of your participant if you feel they are not making any improvement. Once you call Ryans Rule, a doctor or nurse must conduct a clinical review.
The Don’ts of helping your NDIS participant in Hospital
Now let’s discuss the don’ts – which in a lot of instances, are related to the ‘A’ word – Assumptions! It is easy to assume that hospital staff are the bearers of all knowledge. While this might be true when it comes to all-things medical, they do not know everything about your participant and all their individual traits and needs. So, for our first ‘don’t’, it is not assuming the hospital has met your participant before and somehow knows everything about them. Instead, ask if they require any further information and explain what works best for them.
Don’t assume regular supports will continue as normal
A hospital admission usually means all regular supports have been ceased temporarily. For SIL participants living with multiple people who are funded overnight, it is important to check with the service provider how this will operate for the duration your participant is in hospital. Do not just assume you know how this will operate.
With this said, some participants may wish to continue using some of their funding while in hospital so their Support Workers can visit them. This is referred to as ‘Concurrent Supports’ and is allowed providing it has been approved by the NDIA, the hospital, the Service Provider, and the participant themselves must give consent for funding to be used from their plan. However, the NDIA will not approve of this for everyone – they will only fund Concurrent Supports if there are specific circumstances. Some of these include;
- If the participant has communication needs and relies on Support Workers to help them communicate
- If the participant has behavioural support needs and needs a Support Worker present to help them regulate, stay calm, and feel safe.
- If the participant needs a support worker to help them access information and engage with medical treatments safely
Don’t assume being discharged means life is back to normal
Once your participant has been discharged do not assume everything will resume as it was before they were admitted. It is important to ensure all relevant information and formal documentation regarding changes to their general health condition is collected, do not leave the hospital without a discharge summary. It is crucial to make an appointment with your participants regular Doctor within a week of discharge
Some important information to consider includes:
- Follow-up appointment times and dates
- Changes to daily medication or PRNs
- Updates to AT equipment or manual handling SOPs that are required
- Updates concerning personal care needs or mobility
- Care need adjustments
Once you have gathered this information, pass this on to fellow support staff and to the Support Provider to ensure everyone is kept in the loop and participants feel confident they are in the best hands. As for the provider, it is their responsibility to amend and update participant Care Plans so that all information is relevant and up to date.
Don’t assume NDIS funding will cover everything
Unfortunately, the NDIS does not cover everything for participants during their stay in hospital and it is important to be mindful of this, especially for those who will be staying in the hospital long term. For instance, the NDIS does not cover any “Acute, subacute, emergency and outpatient clinical services delivered through public or private hospitals”. They also do not claim to cover any additional hospital in the home services or any “Sub-acute, palliative care including in-patient and out-patient services delivered in the person’s home or clinical setting”.
Its also important to be aware of the hidden fees associated with long-term hospital stays. For instance, the Queensland Health website states patients who stay in hospital for more than 35 days long will be charged a small fee, unless subject to an Acute Care Certificate. This fee is typically indexed against the aged pension and thus, fees will increase in line with pension increases. So, make sure to keep track of how long your participant has been in hospital for and help them contact the right people they need to assist with paying any potential fees.
Don’t ignore if you think your client is underfunded
Are you concerned your participant is underfunded? Sometimes, the current plan your participant is on no longer reflects their needs – especially after a hospital admission has revealed a change to their health. It is part of our job as support workers to raise this concern with the appropriate people who can help investigate this further. You first port of call should be the Support provider who should then direct you to speak with the Social Worker and NDIS Liaison officer at the hospital. Moreover, the provider can get in touch with the appropriate bodies – such as support coordinators, who can then request a plan reassessment or change in circumstances review for your participant.
Sometimes however, this is not enough and support for your participants needs may still not be adequately funded. In these instances, knowing how to help your participant take this further and providing them support throughout the process is essential. Introducing them to ‘Rights in Action (RIA)’, should be your next step. RIA are a non-profit, community-based organisation in Cairns that advocate for individuals with disability and mental health needs. They can assist your participant to appeal a decision the NDIS has made with regards to the amount of funding they have provided.
The most important thing to remember is that the participant comes first! Hospital admissions can be an anxiety-inducing time for anyone, so ensuring our participants feel safe, cared for, and heard during this time is crucial to relieving some of their stresses. Just like anything in life, hospital admissions can be unpredictable but helping your NDIS participants prepare as best they can will go a long way.
References
https://www.qld.gov.au/health/support/shared-decision-making/ryans-rule
file:///C:/Users/admin/Downloads/Supports-that-are-not-NDIS-supports.pdf
https://www.cq.health.qld.gov.au/patients-and-visitors/health-costs-insurance-and-support
https://rightsinaction.org.au/
https://metronorth.health.qld.gov.au/hospitals-services/bert