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Table 1 Checklist for observation and assessment of patients used by the staff during the CRA stay in preparation for the discharge planning process and to help decide on the type of services to be offered afterwards

From: Like a hotel, but boring: users’ experience with short-time community-based residential aftercare

Area Cues
Self-care Hygiene, food preparation, diet, cleaning, washing, shopping, exercise/activities, and mastering substance abuse problems
Medicating Self-medicating, misuse of medicines, need of support with medicating
Economy Assess needs of any support to manage finances, e.g. pay bills
Social network Assess the social network, relationships, and participation in any social activities
Housing Visit the residence together with the patients – assessment of the facilities in the residence, such as cooking and cleaning
Primary care services Assess present follow-up services and other tailored services
Leisure time Assess patients’ hobbies and interests
Facility Assess patients’ technical aid needs
Mobility Assess the need for assistance to take the bus, visit public offices, cultural and leisure activities
Job/education Assess present education and job – arrange job/education or activities together with the patients
Before discharge The contact person organizes a meeting with the patient and community agencies for assessment and approval of tailored services.
The follow-up services must be up and running at home at the expected date of discharge. The general practitioner has received discharge summary from the CRA.