“Where are these people coming from?” Exploring the experiences of older people and their families after returning home from hospital for further care and support

Discharge to Assess (D2A) is a process embedded in statutory guidance in England, aimed at supporting people to leave hospital once they are medically stable, with further assessments carried out in the community. Local health and social care teams are responsible for identifying ongoing needs and arranging appropriate support. This study examined the policy’s impact and explored the experiences of older adults who returned home for continued assessment and care. Semi-structured interviews were conducted (8 older people, 2 family members in the East of England). Data were analysed using reflective thematic analysis. Four themes were identified: Not having control in my own home; Determination to maintain independence; Desire to be heard and included in assessment and care planning; Role of family members in promoting and supporting independence. Post-discharge support for older adults remains under-developed, with person-centred care often constrained by limited carer time and systemic pressures. Social care professionals are well positioned to support hospital-to-home transitions, but face challenges in delivering holistic assessments. More equitable support for older self-funders is required, and research into the links between models of person-centred assessment and hospital re-admission rates.