This resource supports acute hospital staff in their discharge planning for patients who are in the last twelve months of life. Patients may be stable, deteriorating, unstable or actively dying.
The aim of the resource is to make discharge safe and secure for patients, families and carers, whether it is to the person's home, residential aged care or a disability service.
This guide links to a range of other resources.
Ready for community palliative care - in context
The Ready for community palliative care resource aligns with Victorian and national standards for end of life care.
The last twelve months of life
Identifying what stage a person is at in their illness, helping them and their family to make decisions, and seeing how the palliative care consultancy service can help.
Advance care planning
Advance care planning means making a plan for future health and personal care, should the person lose their decision-making capacity.
Discharge planning at end of life
The fundamentals of an effective and safe discharge from hospital to palliative care in the community.
Referring to community services
Detailed guidance about referring people for care in the community, including specialist community palliative care.
Allied health and successful discharge
Allied health staff enhance a person's quality of life and safety, and support successful discharge home.
Actively dying and wanting to be at home
Advice about what do when a person wishes to die at home, including assessment and communicating with the person's carer.
Information and advice about supporting carers in their role at home and in other community settings.
Access to injectable or sublingual medicines can be crucial for effective palliative care in community settings.
When someone is discharged from hospital into the community, their general practitioner will need support to continue care for that person.
Reviewed 28 February 2017