Home Who We Help For Health Care Professionals Services HACDSP

Are you a hospital staff member?

Find out if someone you are caring for is eligible for support to transition from hospital to aged care. See eligibility criteria below:

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Aged care transition when you need it most

Delayed transition from acute care back home or into a residential care home can affect the long-term wellbeing of a person living with dementia and their families.

You can find out if the person in your care is eligible for the program through our eligibility assessment process.

Who is eligible for the HACDSP program?

The Hospital to Aged Care Dementia Support Program (HACDSP) is intended to support older people living with dementia who are at risk of delayed hospital discharge due to their dementia. A person is eligible for the HACDSP if:

they have dementia (diagnosed with dementia or suspected dementia/diagnosis not confirmed or have a history of progressive cognitive decline).
they are age 65 and over, or age 50 and over and an Aboriginal and Torres Strait Islander person, or otherwise eligible to receive Commonwealth funded aged care services.
they are an inpatient in an acute/sub-acute public hospital setting in an agreed site as described below under heading Eligible Locations and Participating Sites.
they have a current Aged Care Assessment Team (ACAT) or Regional Assessment Service (RAS) assessment and are eligible to receive Commonwealth funded aged care services.
they agree to receive DSA services, and there is current valid consent to participation in the HACDSP.

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Our team will help support transition to the right place through:

Understanding their social history by speaking to family or guardian, carer and aged care staff.
Meeting with the person living with dementia.
Working with medical specialists who have been involved in their care.
We can support conversations with a suitable aged care provider and share the dementia behaviour support strategies with them.
We work with the care team by providing practical on the ground advice and support through case management, tailored activities and behaviour support planning.
Onsite support as needed by Dementia Support Coach and Family Liaison Officer with regular check-ins.

Referral Process Step-Through

Step 1Referral

Step 1: Referral

Referrals are made by the hospital staff in eligible locations and participating sites. The process is easy and straightforward.
Click below to make a referral:

Make a referral

Step 2Initial review

Step 2: Initial review

Upon receipt of the referral, DSA will schedule a phone consultation to determine eligibility or suggest other pathways.

Step 3Assessment

Step 3: Assessment

Following the initial phone consultation a DSA consultant will then schedule a comprehensive face-to-face assessment to determine the care needs of the person living with dementia.
From this assessment the DSA consultant will create a comprehensive report to aid the transition back home or into residential care.

Step 4Transition

Step 4: Transition

After the Assessment, the HACDSP team will partner with the hospital to provide ongoing behaviour support and advice.
The HACDSP team can provide the assessment and support information to aged care providers as part of the discharge planning process.
They will then work with hospital staff, the person living with dementia, their family and the aged care provider to ensure that the transition is as smooth as possible.

Step 5Support

Step 5: Support

The HACDSP team will then prepare for and provide support during the transition. This will be a highly personalised service with individual advice, strategies and written recommendations for each person referred to the service.

Step 1Referral

Step 2Initial review

Step 3Assessment

Step 4Transition

Step 5Support

Step 1: Referral

Referrals are made by the hospital staff in eligible locations and participating sites. The process is easy and straightforward.
Click below to make a referral:

Make a referral

Step 2: Initial review

Upon receipt of the referral, DSA will schedule a phone consultation to determine eligibility or suggest other pathways.

Step 3: Assessment

Following the initial phone consultation a DSA consultant will then schedule a comprehensive face-to-face assessment to determine the care needs of the person living with dementia.
From this assessment the DSA consultant will create a comprehensive report to aid the transition back home or into residential care.

Step 4: Transition

After the Assessment, the HACDSP team will partner with the hospital to provide ongoing behaviour support and advice.
The HACDSP team can provide the assessment and support information to aged care providers as part of the discharge planning process.
They will then work with hospital staff, the person living with dementia, their family and the aged care provider to ensure that the transition is as smooth as possible.

Step 5: Support

The HACDSP team will then prepare for and provide support during the transition. This will be a highly personalised service with individual advice, strategies and written recommendations for each person referred to the service.

Giving Consent

It’s important to keep the person living with dementia informed and involved in decisions that affect their care. At DSA, we make this a priority. When this is not possible, it's important to gain consent from the legally appointed person responsible for their care.

Consent can be obtained verbally or written and will be followed up by the DSA assessor during the dementia assessment process.

As part of the assessment process, we may need to access records including those held by primary health care settings and acute care settings. As the Australian Government funded provider of this service, our privacy and confidentiality processes enable the sharing and accessing of this information to provide accurate assessments.

Eligible locations and participating sites

HACDSP is a national program operating out of selected jurisdictions. Below is a list of eligible locations and participating sites in each state. These have been determined by the Australian Government alongside State / Territory Health.

STATE

Eligible locations and participating sites

TAS

All of Tasmania (commencing initially in Hobart)

SA

Adelaide metropolitan area with hospital sites TBC

VIC

TBC

NSW

TBC

ACT

Canberra Hospital and North Canberra Hospital

QLD

Hervey Bay Hospital and Maryborough Hospital

WA

TBC

NT

Royal Darwin Hospital and Palmerston Regional Hospital

Frequently Asked Questions

Who is involved in this program?

The program will work alongside selected hospitals, families and aged care providers. Holistic support throughout the transition process will be delivered by a DSA team made up of Dementia Consultants, Family Liaison Officers, and Dementia Support Coaches.

I work in a hospital, can I refer someone?

Yes, absolutely, if you work in a hospital within an eligible location or participating site. You can refer over the phone or online. Most participating hospitals have specific referral pathways internally, so best to check this also.

Make a referral

My loved one lives with dementia at home, are they eligible for the program?

No, HACDSP is only for people who have been admitted into hospital. However, your loved one could be eligible for DBMAS or SBRT.

Make a referral

How much will this cost for my family?

This program is completely free.

How long will the program support my loved one once they have left hospital?

We will support your loved one until they settle into the long term care environment or until the referral goals have been met.

How to get started

If you are caring for someone at risk of delayed hospital discharge due to their dementia, simply call our 24-hour helpline on 1800 699 799, fill out the referral form or chat with us now. Our experienced consultants will be able to determine whether HACDSP is suitable.

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Get help today

Make a referral