Facilitating discharge home from hospital is part of everyday practice for nurses. However, achieving effective discharge home for a patient with complex end-of-life care needs, with an uncertain prognosis, requires communication, coordination and provision of equipment. If such discharges are to succeed, commitment is required from all involved. They may challenge the values and beliefs of healthcare professionals. This article discusses the process of facilitating the discharge home of a patient with end-stage multiple sclerosis and a tracheostomy and gastrostomy in situ. The patient required a significant amount of care at home. The process involved educating her husband to undertake many of the roles normally carried out by nurses. The article discusses the challenges associated with this discharge. It is hoped that it may assist other professionals caring for similar patients. Permission from the patient’s husband has been obtained for this article. Pseudonyms have been used to maintain confidentiality (Nursing and Midwifery Council, 2008). Conflicts of interest: none
- Complex discharge
- Continuing care at home
- Discharge planning
- End-stage multiple sclerosis
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