A Home from Hospital service for older people.

Current policy and practice emphasises much more than ever before a need for purchasers and providers to reduce appropriately the length of hospital stay. Consequently, a number of early discharge “schemes” have been developed. This paper presents the findings from an evaluation of a “home from hospital” (HFH) scheme. The HFH service provides a maximum of six weeks intensive domiciliary care for older people on their discharge from hospital. The aim of the service is to facilitate early discharge from hospital and to assist patients to regain independence. The study reported here elicited the views and perceptions of clients and professionals involved in the HFH scheme about the quality, efficiency and effectiveness of the service. Seventy-five clients were discharged from hospital to the HFH scheme during a two month period and those who consented to participate in the study were interviewed after discharge from the HFH service (n = 40). Participants had attended hospital for various conditions but the largest group were fracture patients. Hospital staff and community based professionals completed a questionnaire about the service. Overall, clients and professionals perceived the HFH scheme as a beneficial service, though some minor problems existed at an individual level. Clients’ dependency levels generally decreased during their time on the scheme. Research using a controlled design is necessary in order to draw firm conclusions about the cost-effectiveness of a HFH service. Overall, home-from-hospital appears to be an effective model of an early discharge scheme worthy of further attention.

'A Romanian Perspective on Brian Friel's Translations'

Based on the premise that the history of the representation in drama of the Ulster "Troubles" has been characterised by a move from direct to metaphorical engagement, this paper seeks to explore the signficance of Brian Friel's Translations as a "Troubles Drama" with reference to a production of the play I directed for the Hungarian Theater of Cluj in the Fall of 2001. Interpreting a play about language in a language other than the one in which it was originally written proved to have many implications for the rehearsal process and led me to experiment with the image theatre techniques of Augusto Boal. The nature of Cluj/Kolozsvar as a bi-lingual city added to the complexities of the process, as did my own status as an English-speaking director in a Hungarian-speaking environment. The extraordinary neautre of the wider geopolitical context at the time of the production proved to be the final ingredient in what became an exceptional empirical process of discovery. The discussion of the particular production is placed in the wider context of an exposition of a theory of "cultural gravity" as an alternative to "liminality" in helping to assess the cultural signficance of geopolitical boundaries.