Mum refused NHS funding for nursing home

Mrgrn

New member
Oct 23, 2019
1
0
Hello

New here and hoping for some advice. My mum is 80 in a few weeks. She was showing signs of dementia and we were in the process of getting her diagnosed (saw the psychologist and was awaiting an MRI scan). 3 weeks ago she contracted a UTI which led to delirium, which in turn has accelerated her dementia symptoms - she doesn’t recognise her home or the fact that she’s in hospital, as well as other serious cognitive problems. She is now doubly incontinent (previously was with her bladder only). Her mobility has deteriorated due to other health issues and we were looking to get a carer, but is now worse and she needs help with everything including now the toilet. She has also been diagnosed with vascular dementia.


I should also add I’m her son, who doesn’t live with her, and I have a sister (who has a 5 month old baby) who lives with her and cares for her.


So mum has been in hospital for three weeks. Last week the OT and doctor said she’s about as well as she’s going to get, that it’s too much of a risk for her to go home, and that the best thing would be to go into a nursing home. They said she needs 24 hour care, and the home care that would be provided (carers calling 4 times per day and no overnight care) would be insufficient. She fell over twice in the hospital, and they have alarmed her chair as she keeps trying to get up and leave. My sister and I agreed she should go into a home, mum not keen when we’ve mentioned it (yet to have a proper talk to her about it).


Where I need advice is dealing with the social worker. My mum doesn’t have much in the way of wealth, and is on full benefits. She phoned last week to say she will carry out an assessment on my mum. I said ok. Today she calls and says she recommends that she goes home... apparently we need to exhaust the other care options. “I can’t go back to my manager and recommend we put her in a placement when she hasn’t had a care package before!” was the reasoning. When I asked how my sister was going to cope she said they can put adaptions such hoists. Hoists!!!!


Today some letters arrived to my mum’s. One was to offer her carers at a cost and set up the direct debit (just before all this we applied for care from the local authority). The other said she was not eligible for NHS funding care. A copy of the assessment was sent, which said she hasn’t been formally diagnosed with dementia (the assessment was carried out after the doctor told me she has vascular dementia ).


While I love my mum dearly a home is the best place for her... my sister can’t cope with a baby and mum. I’m working long hours and and help where I can, but we just can’t give mum the care she needs. I discussed with the doctor the possibility of putting her in the home 3 mins walk from me. He said he’d recommend it to social services - fat lot of good that was eh!


So she has said she will arrange a meeting between me, my sister, a nurse , the OT and herself on Monday. I would be grateful to know the best way to deal with this and would welcome any advice from those who have been in a similar situation.... the social worker seemed to suggest the only people who are completely bedridden get nursing care funded. Any chance my mum will get funding?

Thanks for reading if you made it this far!
 

Lirene

Registered User
Sep 15, 2019
243
0
Welcome to my world! I am waiting for funding for my husband who has advanced Parkinson’s, dementia, psychosis, hallucinations, paranoia and has broken the same hip twice in 6 months. He’s now been in hospital over three months.
Apparently many claims for NHS funding are being rejected at present and no one can say why. Maybe someone else here knows the answer. All I can say is please write to your MP, as I have done, and keep trying. Good luck, my thoughts are with you xx
 

Louise7

Volunteer Host
Mar 25, 2016
4,797
0
Welcome to the forum, and sorry that you are having such a problem with the social worker. Unfortunately from experience when someone is not self-funding the priority seems to be saving money, and social services would normally recommend a maximum of 4 care visits daily before considering a care home. In your Mum's case though the OT and the doctor have said that she needs 24hr care to keep her safe so the social worker has to take that into account. At the meeting on Monday stress to the social worker that your Mum has had two falls in hospital and will not be safe with just 4 care visits - who is going to keep her safe from falls when they aren't there? Hopefully the OT and nurse will support you with this.

With regards NHS funding it is very difficult to get fully funded care (CHC) however your Mum may be eligible for funded nursing care (FNC) if she has care needs which require the assistance of a registered nurse. This is only payable when someone is in a registered nursing home, not a residential home. For the social worker to say that only someone who is bed ridden can get FNC is rubbish - my Mum gets it and is not bed ridden. Unfortunately it's quite common for social workers to provide incorrect information with regards funding when it isn't within their remit. Did the letter that stated your Mum was not eligible for CHC state that she is eligible for FNC? It may be that she has been deemed to not require nursing care, in which case she wouldn't qualify for any NHS funding.

I hope the meeting on Monday goes well - keep repeating that your Mum will be at high risk of falls in- between care visits. If the social worker knows that your Mum will be at high risk of falls without 24hr care and still insists on discharging her home then they are knowingly placing your Mum at risk of harm. Make sure that you take good notes during the meeting with regards who was there and what was said, and take someone else with you if you can.

NB: I've just re-read your message and see that your sister lives with your Mum. Social services will expect her to help with the caring in between carer visits so you will need to explain why she will not be able to do this and look after a 5 month baby. You may have to try the option of 4 carer visits daily to show to social services that this wouldn't work.
 
Last edited:

notsogooddtr

Registered User
Jul 2, 2011
1,286
0
You don't need to explain why your sister is 'unable'to do caring,it is enough that she doesn't want to.She does not have a duty of care the local authority do.It's difficult but she needs to say she won't do it
 

Alex54

Registered User
Oct 15, 2018
356
0
Newtown, Wales
So she has said she will arrange a meeting between me, my sister, a nurse , the OT and herself on Monday. I would be grateful to know the best way to deal
Have a talk with your sister and agree beforehand what outcome you all want.
It sounds as though this is a very informal meeting and the absence of social services suggests the doctor wants to agree on a course of action before approaching social services.

Do you have the use of an Alzheimer's support worker? I would be lost without the help and support they have provided to me over the last few years.
 

Chaplin

Registered User
May 24, 2015
354
0
Bristol
Hello

New here and hoping for some advice. My mum is 80 in a few weeks. She was showing signs of dementia and we were in the process of getting her diagnosed (saw the psychologist and was awaiting an MRI scan). 3 weeks ago she contracted a UTI which led to delirium, which in turn has accelerated her dementia symptoms - she doesn’t recognise her home or the fact that she’s in hospital, as well as other serious cognitive problems. She is now doubly incontinent (previously was with her bladder only). Her mobility has deteriorated due to other health issues and we were looking to get a carer, but is now worse and she needs help with everything including now the toilet. She has also been diagnosed with vascular dementia.


I should also add I’m her son, who doesn’t live with her, and I have a sister (who has a 5 month old baby) who lives with her and cares for her.


So mum has been in hospital for three weeks. Last week the OT and doctor said she’s about as well as she’s going to get, that it’s too much of a risk for her to go home, and that the best thing would be to go into a nursing home. They said she needs 24 hour care, and the home care that would be provided (carers calling 4 times per day and no overnight care) would be insufficient. She fell over twice in the hospital, and they have alarmed her chair as she keeps trying to get up and leave. My sister and I agreed she should go into a home, mum not keen when we’ve mentioned it (yet to have a proper talk to her about it).


Where I need advice is dealing with the social worker. My mum doesn’t have much in the way of wealth, and is on full benefits. She phoned last week to say she will carry out an assessment on my mum. I said ok. Today she calls and says she recommends that she goes home... apparently we need to exhaust the other care options. “I can’t go back to my manager and recommend we put her in a placement when she hasn’t had a care package before!” was the reasoning. When I asked how my sister was going to cope she said they can put adaptions such hoists. Hoists!!!!


Today some letters arrived to my mum’s. One was to offer her carers at a cost and set up the direct debit (just before all this we applied for care from the local authority). The other said she was not eligible for NHS funding care. A copy of the assessment was sent, which said she hasn’t been formally diagnosed with dementia (the assessment was carried out after the doctor told me she has vascular dementia ).


While I love my mum dearly a home is the best place for her... my sister can’t cope with a baby and mum. I’m working long hours and and help where I can, but we just can’t give mum the care she needs. I discussed with the doctor the possibility of putting her in the home 3 mins walk from me. He said he’d recommend it to social services - fat lot of good that was eh!

Firstly, you’ve had some good advice but I would add, we have just been through something similar with my mum. As hard as it was we refused to let her come home as she has complex medical needs as well as mixed dementia. My dad is 84 and cannot cope with her 24/7 even with the support we could give.

While she is in hospital taking up bed space, you have a little more negotiation on your side. You should have been appointed a hospital social worker who can help you find your mum a suitable care home for her needs. If your mum is already have benefit support, it is likely the local authority will fund her care using her pension and pension credit to make up any shortfall.

it is a minefield but you must be firm and as someone else mentioned your sister does not have to be responsible for her care. Hospital to a residential or nursing home will be more beneficial for your mum than going home and waiting for another crisis to occur.

Hope you manage to make some informed decisions after your meeting.
 

Sirena

Registered User
Feb 27, 2018
2,332
0
From what you have said here about your mum, she won't get NHS funding because her needs - mobility, incontinence and other dementia symptoms - are classed as 'social care' rather than medical.

As others have said, your sister needs to say she won't accept your mother back to live with her because she can no longer meet her needs and it would put your mother at risk. The SW is likely to put pressure on her so she needs to be prepared to resist that. Hopefully your sister's stance, plus the input of OT and the nurse, will lead to a move to a care home.
 

Philbo

Registered User
Feb 28, 2017
853
0
Kent
Hello @Mrgrn

If it helps in any way, my "long-story-short" summary, regarding my wife's dementia journey:-

  • diagnosed with FTD Jan 2014
  • discharged from memory clinic Jan 2016
  • roller-coaster ride for the next few years
  • mobility continues to deteriorate, especially in last year, though could still get her to the pub
  • 2 weeks respite in LA-run care facility late July 2019 (well needed holiday with family)
  • She ended up in hospital with UTI and had lost her mobility (which also led to double incontinence)
  • Discharged after a week back to care facility for assessment (LA case worker assigned)
  • Case worker (LA) carried out a best interest assessment/meeting (input from hospital, OT, care facility assessment report, family etc)
  • Outcome - requires residential nursing care (Nursing Home)
  • Wife is just below the upper threshold for LA funding, so telephone "financial assessment" done
  • In the meantime, placement team seek out NH vacancies
  • Wife moves into NH late September - LA rate accepted by NH
  • Finance team conclude that wife's contribution will be equal to her state pension plus half of her small work's pension
  • NH application for NHS FNC accepted (arranged completely by NH - we had no involvement - direct transaction between NHS and NH

To be fair to our local authority, the case worker was terrific - though I had dearly wanted to continue caring for my wife at home, I just knew this was no longer realistic (in my view anyway). So I was dreading ending up in a situation similar to you, should they insist on care at home. So our outcome was sad, but in my wife's best interest. My son's partner, who works in the care industry, was primed to ask/challenge if necessary, but was fortunately not needed.

It sounds like the meeting you mention is arranged for Monday is a best interests meeting? The advice to have someone else with you is great, as is a clear idea of what you and your sister want to happen. So I hope you get some agreement and definitely be firm that she cannot be discharged until a care package is agreed that meets all her care and safeguarding needs.

Good luck
Phil