Continuing Health Care (again) and a mum who's all but given up!

Grable

Registered User
May 19, 2015
215
0
Mum's in a care home and has been since mid-July. She didn't want to go, but knew she had to do it, because she wasn't coping, even with carers going in 3 times a day. She also has oesophageal cancer, which means she can't swallow anything except the most sloppy of foods - that will get worse as the cancer progresses, although it's not progressing as fast as we had been led to expect. Mum hates mushy food and always has, so she tells us the food is 'horrible' and she rarely eats more than a couple of forkfuls. Her diet is supplemented with Fortisip. On 26th September, she fell and badly bruised her wrist - x-rays showed no fracture. On 28th September, she fell again, this time fracturing her hip and landing in hospital for 2+ weeks.

Now she's back in her care home. She can bear her own weight to transfer from chair to wheelchair, but hasn't been able to walk at all - prior to the last fall, she was walking with assistance. The care home was very good in fighting her corner to have her back and have got her a profile bed, we fought to have bed rails (both falls were at night when she really shouldn't have been out of bed without a carer present, given her fall risk) and she has a 'rotunda' to help her transfer.

Mum doesn't do anything now at the CH, apart from sleep. I think she's bored out of her wits, but she won't take part in anything and has withdrawn completely into herself. This is affecting the number of visits she's getting from old friends, too, which used to cheer her up a bit. Everything is 'horrible'. She tells me she's in pain, but when asked if she wants extra painkillers, she tells the carers 'no'. All fight and life has gone out of her, it seems.

When we were applying - before Mum went into the care home - for Council Tax Exemption on the strength of her dementia diagnosis (October 2015), her GP said she wasn't mentally impaired. You could have fooled me! Now I'm wondering about applying for Continuing Health Care. I've looked at the checklist and I think there's a pretty good case, but given the unhelpfulness of her GP before, I'm wondering if it's worth trying? If successful, does it mean that the care home would be funded? Does it have to be wholly funded, or is it possible to 'top up'? Would she need to move elsewhere, or would it fund her where she is? If we needed to move her to a nursing home at some point, would the CHC agreement go with her?
 

nitram

Registered User
Apr 6, 2011
30,307
0
Bury
If successful, does it mean that the care home would be funded?
A care plan will be produced and whatever is considered necessary fully funded.

Does it have to be wholly funded, or is it possible to 'top up'?
Top ups are only lawful for 'additional services totally unrelated to the individual’s primary health needs'. Identifying such additional services and thus allowing top ups is becoming a fine art.

Would she need to move elsewhere, or would it fund her where she is?
It depends on the home fees and what the CCG will pay, also there could be an argument that a move was not in her best interests.

If we needed to move her to a nursing home at some point, would the CHC agreement go with her?
The CHC would have to be reviewed in light of her increased medical needs and a new care plan produced.
 

Grable

Registered User
May 19, 2015
215
0
Thanks, Nitram. That's very helpful.

I wonder if there are any hints on how to put a claim in the strongest way?
 

susy

Registered User
Jul 29, 2013
801
0
North East
With my dad it was the district nurses that really helped. We got fast track CHC funding. However I'm not sure how long this will go in for.
I wonder if age concern or the Alzheimer's society could help you put a case forward. Or at least give you some good ideas along the way.
It is such a hard time for you right now. I hope some help comes your way very soon xx
 

nitram

Registered User
Apr 6, 2011
30,307
0
Bury
My initial advise is to contact everybody involved in your Mum's care. get, and record, as much evidence of events that you can.

Concentrate on the DST domains that can be assessed as priority or severe, assessments in other domains only become useful in complex cases.