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Introduction

This booklet is here to support you as you recover from your stay in the Medical Acute Dependency Unit (MADU). It offers guidance to help you adjust as your care needs change—whether you're moving to a ward or heading home. It also helps your loved ones understand what you're going through, so they can support your recovery and rehabilitation during your hospital stay and beyond.

Stepping down from MADU

Once you're medically and physically ready, you'll move from MADU to a ward or be discharged home. It's normal to feel nervous—this means you're improving. On the ward, care will feel different, with fewer nurses and an open bay setting. You'll have a call bell to ask for help when needed.

The MADU team will hand over your care to the ward team or complete a discharge summary with any follow-up referrals if you're going home.

Getting back to everyday life

Leaving hospital can feel challenging and it’s normal to worry about coping at home. Setting small daily goals—like walking short distances or making a snack—can help you track progress and feel more confident. 

You can use your MADU diary if you have one. Before discharge, you might notice changes in how you feel or what interests you. If loved ones don’t understand, try to talk openly with them—it can really help.

Who can I ask for help? 

After discharge, your GP will receive a summary and take over your care. They can refer you to other community services if needed.

Mobility and Physical Activity

After a hospital stay, it's common to feel weak or tired. Starting rehab early helps your physical and mental recovery. This could be with your ward staff. Your physiotherapist may guide your exercises and how often to do them—please refer to the leaflet they’ve given you.

  • Bed and chair exercise 
  • Balance exercise 

Respiratory Physiotherapy 

You might be reviewed by a respiratory physiotherapist during your stay to optimize your chest if indicated. Please refer to the separate leaflet prescribed to you by your physiotherapist. 

  • Airway Clearance Technique 
  • Breathlessness management 
  • Cough control technique
  • Sinus management 
  • Self-management booklet (COPD/bronchiectasis only)
  • Pulmonary rehabilitation exercise booklet

Fatigue management 

Fatigue is common after hospital admission. While it often improves within weeks, it can persist longer for some. Activity may worsen fatigue, sometimes with delayed onset. Managing fatigue involves planning, pacing, and prioritizing tasks that are important and meaningful to you.

Social life and hobbies

After discharge, you may feel different about activities you enjoyed. Socialising might feel overwhelming—start small by seeing one or two friends briefly. Concentration and memory may be affected, making tasks like following a TV program difficult, but these usually improve over time.

Eating well to get better

Hydration is essential for recovery

  • Aim for 1.5–2 litres of fluid daily, unless you have a prescribed fluid restriction
  • Dehydration can cause dry skin, fatigue, and headaches

For chronic lung conditions (e.g., COPD, bronchiectasis)

  • Reduce caffeine intake can aid sputum clearance

If you received nutrition via a nasogastric (NG) tube

  • Transitioning back to solid food may be challenging due to: 
    • Reduced appetite
    • Sore mouth and Altered taste
    • Painful swallowing
  • Follow any modified food or drink recommendations from your Speech and Language Therapist until reviewed by the community team if referred

Your care team during hospital stay

During your time in hospital, you’ll be supported by a multi-disciplinary team (MDT) working together to meet your medical and rehabilitation needs. Here’s a brief overview of who may be involved in your care:

  • Doctor – Lead your medical care, conduct daily ward rounds, monitor your condition, and coordinate with the team to ensure safe and effective treatment.
  • Nurse – Provide day-to-day care, support your mobility with physiotherapists, and keep your loved ones informed about your progress.
  • Healthcare Assistant (HCA) – Help with personal care such as washing, dressing, eating, and moving, and assist nurses with monitoring your observations.
  • Physiotherapist (PT) – Support your breathing and lung health, and help you regain strength and mobility as you recover.
  • Speech and Language Therapists (SLT) – Assess and manage swallowing, communication, and oral secretions. They guide you through any changes in eating, drinking, or speaking.
  • Dietitian – Assess your nutritional needs and create tailored plans to support your recovery, considering your medical condition and treatment.
  • Occupational Therapist (OT) – Help you manage everyday tasks and assess cognitive and physical challenges. They offer strategies and adaptations to support your independence.

Resources

Contact us

If you have any queries relating to this information, please contact the Respiratory medicine service.

About this information

Service:
Respiratory medicine

Reference:
W/052

Approval date:
1 November 2025

Review date:
1 November 2028

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Important note 

This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.