Transition Care Program (TCP)

What is the Transition Care Program?

The Transition Care Program helps older people get back on their feet after a hospital stay.

It provides short-term care for up to 12 weeks, including social work, nursing support, personal care and allied health care. State and Territory governments are the approved providers of transition care.
Transition care helps you recover after a hospital stay. It provides short-term specialised care and support to help you regain your functional independence and confidence sooner, and avoid the need for longer term care and support services.
Your care is tailored to your needs and goals, and is delivered in the most appropriate place to help you meet them. This could be in an aged care home, in Swan Hill District Health, in your own home, out in the community, or a mix of these locations, as your needs change with your recovery.

What help is available?
There are a range of services that transition care can provide. The exact care and services you receive will be based on your specific needs.

Therapy services

Low intensity therapy to help you recover sooner and safer:

  • Physiotherapy
  • Occupational Therapy
  • Podiatry
  • Dietetics
  • Speech Pathology
  • Counselling services
  • Social work, connecting you to wider community support
  • Social activities such as lifestyle, cognitive, and general exercise programs

Nursing support

Clinical care carried out by a registered nurse:

  • Pain management
  • Wound care
  • Oxygen Therapy
  • Medication assistance
  • Dementia support
  • Catheter care
  • On-call access to specialised nursing services

Personal care

Personal assistance with everyday tasks:

  • Bathing, showering, personal hygiene and grooming
  • Maintaining continence or managing incontinence
  • Eating and eating aids
  • Dressing, undressing, and using dressing aids
  • Moving, walking, wheelchair use, and using devices and appliances designed to aid mobility
  • Communication, including addressing difficulties arising from special conditions, such as dementia

Who is eligible?

A person must get an assessment with an Aged Care Assessment Team (ACAT).

They may be eligible if they’re an older person and:

  • A patient in a public or private hospital
  • Has been told that they’re ready to leave hospital
  • Would benefit from receiving services for a short period

If eligible, they must enter transition care as soon as they leave the hospital

More information can be located online at the following links:

Hear from one of our consumers over on the “Our Stories” page:


TCP Brochure


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