NHS Continuing Care Question

[nitram]

You can't really blame the CHC team, they received the checklist on 8[SUP]th[/SUP] May and 29 days later that is 6[SUP]th[/SUP] June, delays in them receiving it are outside their control, they may however be lenient in the circumstances.

I would write to the SW and say that completing a checklist on 10[SUP]th[/SUP] Feburary and it not being received by the CCG until 8 [SUP]th[/SUP] May is completely unacceptable. I would impress on him that if he cannot persuade the CCG to alter the effective date of receipt you will escalate your concern about his performance. Be prepared for him to have gone off sick/gone on leave/gone on a training course/... on the 11[SUP] th[/SUP] February, they always seem to do this kind of thing!!

 

[elizabeth20]

Decision Support Tool Meeting

Hi just some information/advice please. Mum is still in hospital as when she was due for discharge last week a nurse told me that she was completing a CHC checklist this has gone through now and mums assessment for funding is next week in the hospital.

I am slightly bewildered as mum was admitted into hospital from home with a UTI she was really poorly and her Alzheimer's was off the scale!! She has had some 'funny' episodes whilst in hospital but generally speaking, cognitively she is about the same.

I have read lots about assessment on this site and on care to be different. I feel as though I'm going into battle but don't know what I'm fighting for.

Mum owns her own home contributes financially to some of her care lives alone and has been supported by carers and family (me) for several years but it is fair to say she has deteriorated a lot in the last few months her mobility is very poor and she struggles to feed herself sometimes.

I want her home and if she gets nhs funding great - whoopy do. If they assess her needs as severe but not severe enough for CHC then will they say she needs to go into a care home for 24/7 care and not allow her home.

I thought great when the checklist had gone through (I haven't seen it) but is this going to bite me in the proverbial I wonder? By completing this checklist has the nurse scuppered any chance of mum going back to her home?

Also the lady from the NHS CHC team who rang yesterday seemed very laid back about the whole DST thing and I pretended I didn't know much about it just to see what was said. She said it can go ahead without you but you can go if you want!!!! I asked was it multi disciplinary she said yes the social worker will be there (not the social worker who has been doing mums reviews another one apparently?) and a nurse from the hospital and someone from CHC team. I said did she know mum had AD she didn't and said well it might be a good idea for you to go so that you can answer questions.

I'm dreading it. I'm not very assertive and tend to get upset when I don't understand or if I feel an injustice is occurring.

Any advice would be great. I just want mum home but I feel it is all out of my hands now.

 

[whendoesitend]

Thanks nitram

Elizabeth, a urine infection and dementia/alzheimers is evil - it really affects them. Any infection does

I'm talking from a little bit of research and personal experience so I could be VERY wrong - please DO NOT take this as golden.

From what I'm aware - if she is funded by SS then if she goes into a care home she will have to sell the house once the money runs out unless there's other sources of funding or another person living there over 60. If she is funded by the NHS there is no financial assessment and she can keep the house as the NHS cover all the care. Apparently it's very hard to get and very hard to keep once you do have it. (Grandad has been allowed it but I'm not expecting it to stay)

Unless she is a danger to herself/others and there is someone willing to look after her I don't think they can force her into care. If there's not enough support at home for someone I think they may be able to then if someone lacks capacity?

I would definitely be present if you can - then you can give background from a clear position rather than your mum giving fogged answers. You can also tell them things that the doctors/nurses can't as obviously they only know what she's like when she's there and poorly. Google for the paperwork and make notes

Don't be scared. You are the best person to help and press points they don't even know about. They can't take her away from you

 

[Sindy B]

Discharge from hospital

My Dad has advancing dementia; he was admitted to hospital through A&E after falling at home and being on the floor for some hours. Turns out he had an infection (Sepsis) and was frail and dehydrated. He was in the acute hospital for two weeks and was then discharged to a local hospital for rehabilitation. He's been there for five weeks.

He has no permanent affects from the fall - no broken bones or anything like that. He did however have a problem getting back on his feet due to his right knee being very weak; for three weeks they were investigating physical reasons for this and his rehabilitation consisted of being hoisted into a wheelchair/chair and back into bed again. He is doubly incontinent now too. About 10 days ago the hospital called a family meeting and told us he couldn't walk (but they could offer no reason for this) and couldn't manage his continence so he would have to go into full time care. He couldn't go home due to the risks of falling and hygiene. Several things were missing from their assessment including a review of his Alzheimer's (his last specialist review was two years ago) and input from Social Services (he had been receiving care at home prior to his admission).

The hospital agreed to get these reviews done and since then, my father has started to walk (they eventually provided a Zimmer frame tho he isn't always using it) which the hospital told us wouldn't happen.

But their opinion as to the possibility of him being discharged to his own home hasn't changed and they very nicely, but firmly, tell us it is "not a safe discharge".

My father is adamant he wants to go home and becomes extremely anxious and distressed whenever he thinks he should be going home, but doesn't. The hospital say he hasn't got capacity to make an informed decision. Though in other aspects of his care they ask for his consent or advise me of the wishes he has expressed to them when the family isn't there.

I fully accept that he is going to reach a stage - probably quite soon - when he will have deteriorated to such an extent that he needs full time nursing care. But the hospital's insistence that anything other than 24/7 care is too risky doesn't fit all of the facts, or the person that we see in front of us today.

It seems that after weeks of them waiting on tests about his knee - when in fact he could have walked all along with the right encouragement and the improvement in his general health - they are now expecting the family to make a quick decision about a care home, before we've had time to weigh up all the options.

They have done a CHC assessment - I only discovered this by looking through his notes, we weren't involved - and he doesn't qualify (not surprised). He may qualify for NHS nursing care - but again we haven't seen the assessment and haven't been asked to contribute.

We don't have power of attorney.

Any advice?