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Transition Care

The Transition Care Program provides short term support and assistance for older people after completing any necessary acute and sub-acute care in a hospital.
The Transition Care Program helps to regain independence after a hospital stay (Source: Shutterstock)
The Transition Care Program helps to regain independence after a hospital stay (Source: Shutterstock)

It aims to help in improving an individual’s independence and confidence.

The program provides goal oriented, time limited and therapy focused care for older people at the end of a hospital stay.

It can be delivered in the individual’s own home or in a ‘live in’ setting, which must be a home like, non-hospital environment with space available for therapy.

To be eligible for transition care, an older person must be an in patient of a hospital and have been assessed by the Aged Care Assessment Team (ACAT) or Aged Care Assessment Service (ACAS) if you live in Victoria.

Transition care can be provided for a period of up to 12 weeks, with a possibility to extend to 18 weeks if assessed as requiring an extra period of therapeutic care. Seven weeks is the expected average.


Transition care provides a package of services which include a range of low intensity therapy services and nursing support and/or personal care services.

Low intensity therapy services may include physiotherapy, occupational therapy, dietetics, speech therapy, podiatry, counselling and social work.

Personal care services may include:

  • Assistance with showering and dressing
  • Eating and eating aids
  • Managing incontinence
  • Transport to appointments
  • Mobility and communication


An approved provider may charge a contribution fee to the cost of your care.

The maximum fee is 85% of the basic daily rate of a single pension for care delivered in a ‘live in’ setting, or 17.5% of the basic daily rate of single pension for care provided at home.

Access to transition care is decided on a needs basis, not on an individual’s ability to pay fees.

Talk to your hospital social worker or discharge planner to find out more details about the Transition Care Program.


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