I am reading your posts with interest. My mother in law first went into a residential home in February this year. By June the home said they were unable to cope with her behaviour. Of particular difficulty is her fixating on a particular male resident (although not exclusively one) and then not wanting to be apart- trying to get into his room at night, following to the toilet, touching and kissing. The men (or their families) then expressed distress or confusion. She also becomes aggressive when carers try to prevent her from doing this or when relatives come to take them out. We then moved her into another home a few weeks ago (they were fully aware of the issues) and now they are also saying she has to leave for the same reasons. We are concerned about whether anywhere will cope and not aware of any single sex units in the area (Surrey/Kingston). Had involved ss and Cmht but had very little guidance. Wondering about chc funding that might meet costs of a specialist unit (if we can find one).
Applying for NHS Continuing Health Care
- Thread starter Nancyf68
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Interesting that you say you have had very little guidance from SS or cmht. We had not had any contact from SS (apart from requests for payment) since the day dad went into the home. We were advised this is because he is self funding! And the cmht were last involved even further back. When they were contacted again they declined to open his case again as he has a diagnosis and there is nothing else they can add!!
That is bad- I can't understand how they can close his case when the need is ongoing. Ss and cmht only involved at all with MiL because I phoned to ask for help after issues with home. To be fair to the cmht they did then come in and assess but unfortunately it hasn't made any practical difference. Ss had to be involved as it became a safeguarding issue but again that didn't extend to supporting us with the placement. I think if they can see there is a family involved, they will leave to us wherever possible.
I think you're right. Once they know there is family supporting they tend to leave us to it. I for one have felt very abandoned.
One thing that was mentioned in the last assessment was if mh team become involved they may section him and have to move him to the local mh hospital. Believe me I will fight that one!
One thing that was mentioned in the last assessment was if mh team become involved they may section him and have to move him to the local mh hospital. Believe me I will fight that one!
I know that sounds scary but let me reassure you that it might not be as bad as it sounds.
My father is also sectioned (Section 3) as well as getting CHC. As I mentioned in a previous post, it is sometimes necessary to have up to three members of staff to change him for example, and that level of restraint would not be possible without the Section in place. From what I can see, it is a very fair process, done in the patient's best interest, and regularly reviewed. In fact, at the last review meeting, it was my mother and I, along with the marvellous staff and resident psychiatrist who wanted it kept in place. The only one who was putting the case for it to be lifted was the solicitor 'representing' my father - who hadn't even laid eyes on him till that day! The panel (1 medic, 1 lawyer and 1 lay person) agreed to keep it in place.
Having said that, the mental health hospital my father was in for a few weeks was not the best place I have ever been. I think it was just the shock of seeing so many people displaying various extreme behaviour, and some a lot worse than my dad - although he himself was completely oblivious to it! It was actually worse for us visiting, so keep that in mind, plus the fact that the hospital stay will only be temporary to assess his needs. As I said earlier, the upshot was that my father is now in a fantastic, small, caring NHS Unit - under section.
What is awful, and hard to come to terms with, is that someone has come to the point where they need sectioning, but basically it just allows them to receive the care and treatment they need. I hope that reassures you a little.
So dads panel hearing was today not Wednesday. They have informed me that they decided dad needs to go to a specialist emi nursing home so that sedatives can be given but that he did not meet the threshold for chc. Very frustrating as they are weighting this on the current ch not being able to administer the medication. What the GP actually said was he didn't want to prescribe sedatives because of the increased risk of falls!! I shall be appealing.
Hi Nancy
Your situation sounds a lot like the one we were in. Sadly my dad passed away on the 30th July. He had vascular dementia and was in nursing home. We had CHC meetings back in February but they said dad wasn't complex and intense enough so he was only awarded FNC. Back in May dad had a fall and then never got out of bed again. I asked CHC to do a review which took so long to organise that dad had died before they did it. However, last week we heard that he has been awarded CHC retrospectively from the day he took to his bed.
Make sure you attend the meeting and go to the home the day before to make sure all his care notes are up to date and all falls ect are logged. Ask for photo copies of anything significant so you can bring it up at the meeting. If you think he should get it tell them so! Ask the nurse in charge her thoughts. Ask the GP also.
If you want to know anymore I'd be pleased to help.
M
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Your situation sounds a lot like the one we were in. Sadly my dad passed away on the 30th July. He had vascular dementia and was in nursing home. We had CHC meetings back in February but they said dad wasn't complex and intense enough so he was only awarded FNC. Back in May dad had a fall and then never got out of bed again. I asked CHC to do a review which took so long to organise that dad had died before they did it. However, last week we heard that he has been awarded CHC retrospectively from the day he took to his bed.
Make sure you attend the meeting and go to the home the day before to make sure all his care notes are up to date and all falls ect are logged. Ask for photo copies of anything significant so you can bring it up at the meeting. If you think he should get it tell them so! Ask the nurse in charge her thoughts. Ask the GP also.
If you want to know anymore I'd be pleased to help.
M
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Aside from the whole CHC issue, I am wondering what the legal situation is regarding whether the staff at the emi care home have authority to give your father sedatives against a GP's advice, not to mention that it may be against your father's and/or your own wishes (I am not sure if you have PoA).
In my previous post I mentioned that my father was sectioned, which permits the nurses/doctors to give certain treatment they deem necessary for his own good e.g. administer medicine covertly. At the review meetings - assessing whether the Section should or shouldn't be lifted - this is one of the key points the tribunal look at - i.e. are we still happy for them to be able to do this? This, therefore makes me wonder about the whole legal position with someone like your father who is not sectioned. What are his rights?
His GP rightly said that sedation increases the risk of falls. This could well lead to an emergency hospital admission and a possibly lengthy stay - something one would want to avoid at all costs for someone with advanced dementia. And, of course, it would also cost the NHS considerably - something (apart from the other issues) that you might want to point out at the appeal meeting!
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Thank you. We were present at the assessment but were advised that could not attend the panel hearing. I have made an apt to see the GP next week and the ch are asking for an urgent referral to the mental health team. One thing that was not taken into consideration was phycological and emotional wellbeing. We were told this could not be assessed because of the dementia, I have since been given some very good literature giving guidance on how it must be assessed. From what the information describes dad has some issues. He is constantly wringing his hands, does not interact with anyone and basically shuts himself away (keeping his eyes tight shut even when awake!)
Can you please explain what FNC is and whether this is available through NHS?
Thank you that has given me a lot to think about. I have an apt with GP next week to discuss his advice as I feel this was misinterpreted. We are also asking for a new referral to the mental health team as I think their input is now required.
Marts did you have to do anything to get the CHC awarded retrospectively? My father was assessed at the end of July and remained with FNC but was bed bound (due to sores they said). They said to let them know if he was starting palliative care but it all happened so quickly. He deteriorated quickly from 8th August and died on 15th August. He didn't eat much at all from 8th. He only had one palliative injection on 15th August.
Is CHC always awarded as the person is in the very last stage? No one has said anything about it to me.
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Is CHC always awarded as the person is in the very last stage? No one has said anything about it to me.
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"Is CHC always awarded as the person is in the very last stage? "
If an 'appropriate clinician' is prepared to sign:-
The individual fulfils the following criterion:
He or she has a rapidly deteriorating condition and the condition may be entering a terminal phase. For the purposes of Fast Track eligibility this constitutes a primary health need. No other test is required.
https://www.gov.uk/government/uploa...143/NHS-CHC-Fast-Track-Pathway-tool-FINAL.doc
CHC is automatic and normally reviewed after 3 months.
If an 'appropriate clinician' is prepared to sign:-
The individual fulfils the following criterion:
He or she has a rapidly deteriorating condition and the condition may be entering a terminal phase. For the purposes of Fast Track eligibility this constitutes a primary health need. No other test is required.
https://www.gov.uk/government/uploa...143/NHS-CHC-Fast-Track-Pathway-tool-FINAL.doc
CHC is automatic and normally reviewed after 3 months.
