Care after hospitalization (EN)Zorg na ziekenhuisopname
You may require care after visiting the outpatient clinic or being admitted to our hospital. If so, Isala’s transfer nurse can help arrange certain types of care. This leaflet explains what the transfer nurse can do for you and what you can do yourself.
Transfer Bureau and external care providers
Isala works closely with home care organizations and a large number of nursing homes and care homes in the region. The advantage of this is that the transition between the different institutions is properly coordinated and that the most suitable care can be provided. The Transfer Bureau plays a coordinating and mediating role in meeting your need for follow-up care and supports you and the department in which you are a patient in order to arrange the care as soon as possible.
Important things to know when requesting follow-up care
Care for each other (i.e. routine care)
The law assumes that household members will look after each other. This is referred to as ‘routine care’. Under current legislation and regulations, healthy partners are expected to support you with personal and domestic care if you need care for less than three months. Adult children living at home are expected to help their sick parents with regard to home help. You are not eligible for reimbursement for this routine care.
Personal Care Budget (PGB)
If you purchase care via a Personal Care Budget (Persoonsgebonden Budget, PGB), the hospital can advise you but it cannot mediate in this respect.
If you have problems regarding your housing situation before you are hospitalized, you are responsible for resolving them yourself. Isala will not mediate in these cases; if necessary, you can request support from your municipal authority.
What can you do yourself?
Restart home care
If you already receive home care and your care requirements remain unchanged after you are discharged from hospital, you or your family members can restart this care yourselves. This can be done by contacting the relevant home care organization.
Home help is covered by the Social Support Act (Wet Maatschappelijke Ondersteuning, WMO). If you only require home help, you can arrange this yourself with your municipal authority. We advise you to apply for home help in plenty of time, so that it is available as soon as you leave Isala.
Small medical devices which you require at home, such as crutches, a wheeled walker, walking frame or a bed, can be rented or purchased through a home care shop (thuiszorgwinkel) or your pharmacy. The home care organization can support you with requests for medical devices. If you have a medical need for special devices or equipment, such as a high/low bed with a special mattress, we can request such devices for you.
Contact the lending/rental service on the day of delivery to find out what time the items will be delivered.
If you are unable to cook on a temporary or permanent basis, you can make use of a meal service. You must make arrangements yourself for a meal service. Ready-to-eat meals are available from various suppliers, such as butchers, greengrocers and supermarkets. You can also obtain information from your municipal authority about meal service suppliers, the various options and the costs.
Having a personal alarm at home enables you to alert a monitoring station in an emergency so that you can get help quickly. For information on the purchase and reimbursement of a personal alarm, please contact your health insurance company. The home care organization can support you in this. It may take several weeks to obtain a personal alarm once you apply for one, so make sure to submit your request in plenty of time. Personal alarms can also be arranged by means of an urgent request, which often involves additional charges.
You and your family are responsible for arranging transportation when you are discharged from hospital. If your health prevents you from using your own transportation or a taxi to travel home or to a follow-up institution, the nurse will look into the best method of transportation with you. The possibilities include a wheelchair taxi or a non-urgent care ambulance.
What can Isala arrange?
Requesting follow-up care through the Transfer Bureau
The department nurse will consult with you about whether you need follow-up care and will register you with the Transfer Bureau with your consent. Examples of follow-up care are home care, admission to a care institution or a stay in a hospice, for which you will subsequently receive an indication.
If you require personal care, we will determine with you whether the care is considered routine care or home care.
Preferred home care organizations
If you require home care, you can express a preference for one home care organization. The Transfer Bureau will approach this home care organization first. If this organization is unable to meet your requirements or if you do not have a preference, the Transfer Bureau will make arrangements with a different home care organization in consultation with you. We recommend that you familiarize yourself with healthcare providers before being admitted to Isala. If you do not have a preference, the transfer nurse will discuss the various options with you, after which you can still make a choice.
Palliative terminal care
If your doctor has told you that you have a short life expectancy, the transfer nurse will arrange to speak with you and your family/loved ones. During this conversation, we will discuss the different care options available, fitting with your wishes and your situation.
If you are eligible for admission to a nursing home or care home after your stay in hospital, you can indicate which ‘home’ you prefer. We advise you to consider this beforehand. The Transfer Bureau will assess whether you are eligible for residential care. It will contact your preferred institution to find out whether there is a place for you. If you are unable to be admitted to your preferred institution, the Transfer Bureau will search for another place where you can stay in the short term.
Once your medical treatment has been completed, it is important that you receive suitable care as soon as possible. You cannot remain in the hospital while you wait for a place in your preferred ‘home’.
Acceptance of preferences
If you or your family/loved ones do not accept the proposed solutions for residential care, the responsibility for arranging follow-up care will be transferred from the hospital to your family/loved ones. They must then arrange a suitable solution before your discharge date. This date is determined by the specialist who treats you. If you are legally competent, your preference takes precedence and your family or loved ones must accept your choice.
Temporary residential care/care hotels
If you wish to stay somewhere else to recover after being discharged from hospital, you can temporarily ‘stay’ in a care home or private care hotel. The costs for this stay are met by you and will vary from one care home or care hotel to another. You can contact your health insurance company to find out whether you are eligible for any reimbursement for this stay. Nursing care can be provided in such a setting if necessary. The Transfer Bureau can inform you about this and arrange this while you are in hospital.
Under the Long-term Care Act (Wet langdurige zorg, Wlz), a personal contribution must be paid to the Central Administration Office (Centraal Administratie Kantoor, CAK). The amount of this contribution depends on your total income. Contact details for the CAK can be found in this leaflet.
The costs of home care come under basic health insurance and are not subject to a personal contribution.
For questions on follow-up care during your stay at Isala, please contact the nurses in your department or outpatient clinic.
You can also phone 038 424 50 00. The Transfer Bureau is open Monday through Friday from 8:00 to 17:00.
Useful websites and phone numbers
Care Needs Assessment Center (Centrum Indicatiestelling Zorg, CIZ)
088 789 10 00
Central Administration Office (Centraal Administratie Kantoor, CAK)
Care at home (under Social Support Act): 0800 – 1925
Residential care: 0800 – 0087
Information on Personal Care Budget
0900 -742 48 57
Association of family-based carers and volunteers
0900 - 20 20 496
Care comparison site
Ministerie van Volksgezondheid, Welzijn en sport
Bekijk ook het stroomschema 'Zorg of ondersteuning bij chronische ziekte, lichamelijke beperking, ouderdom of dementie' op de website van de Rijksoverheid.
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