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Care Homes and 1-1 Care

Discussion in 'I care for a person with dementia' started by Jen48, May 9, 2015.

  1. Jen48

    Jen48 Registered User

    Dec 28, 2013
    19
    My father went into a nursing home which is for people with dementia at the beginning of April, he hasn't settled at all well and contracted a urine infection as soon as he moved in which meant a few hours on a drip in A and E. When he went back to the care home he became quite aggressive towards the staff and difficult to manage. The home suggested he was put on 1-1 care which meant someone was with him all the time, this is incredibly expensive on top of the weekly care home fee (£14 an hour, 24 hours a day). I ring every day to find out how he is and go to visit a few times a week but I never really feel I get enough information from the staff and worried that the reviewing process may not be as efficient as I would like. Has anyone else had similar issues? it is also so tricky as my mum who is 88 goes with me to see him, but I'm always running off to see the staff and find out how he is. They are nice and seem ok but they always appear so busy which I know they are and it must be a tough job being a carer or a nurse. I just feel we should be getting more information or maybe an impartial person who could visit and assess his needs and whether he still needs to be on 1-1 as he does appear to be calmer. He is privately funded and Social Services can't help. If anyone has any advice I would be very grateful.

    Many Thanks
    Jen48
     
  2. Karjo

    Karjo Registered User

    Jan 11, 2012
    481
    if your father is already in a nursing home and they feel they cannot manage unless he has one to one care then I think he perhaps needs to be assessed for Continuing Health Care. If his needs are so great he requires one to one 24/7 then I truly do not think he should be having to fund his own care and pay for this one to one. if the one to one is simply for his entertainment that is one thing, but if he is continually aggressive and it is for his and others safety then that is another matter.I assume he has a CPN who can look at his medication to see if anything can help his behaviour.(without over sedating him) If not maybe he needs to be admitted to an NHS assessment unit who can look at his care needs. unfortunately there is no magic wand here but I get so cross when I hear stories like yours where it is suggested a poor soul needs one to one care , but they have to pay for it themselves! The nursing home should have a pretty good idea of the criteria involved for CHC and whether your Dad is likely to meet this criteria. Unfortunately it is probably not in their interests for him to get this as they cannot cope already, and they would get less money if he is on CHC compared with you funding privately. One to one CHC is pretty rare as you can imagine the cost of this. (Though still maybe cheaper than hospital so you never know)
     
  3. Angela T

    Angela T Registered User

    Jul 13, 2014
    187
    France
    My mother went into a NH after a fall and a 4-week stay in hospital.

    The NH manager suggested 1-on-1 care 24/7 to help my mother settle and to prevent further falls for the first 2-3 weeks. We paid £10 an hour (on top of the fees, she is self-funding), and after 3 weeks 24/7 it was reduced to daytime only and this was maintained for another 2 weeks.

    By then, we all felt that the risk of further falls was reduced, and could be managed by the staff - who now keep a close eye on my mother

    I agree it is expensive if it is prolonged... I was also asking regularly about my mother's progress during those weeks, because we did not want to continue the I-on-I indefinitely, but the NH manager was always VERY helpful, and so were all the staff.

    They are all incredibly busy, but always have time to speak to me when I call, and I never feel I am bothering them. I think that is important...

    I hope this helps, and that you get the information you need to assess your father's needs asap.
     
  4. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,781
    Salford
    Hi Jen
    I'm with Karjo, see if you can get any funding although I suspect it will be an uphill struggle. It's a difficult one to say if he needs 1-2-1 care 24/7 and at the eyewatering amounts of money you can see why if he's even vaguely problematic the home would want it if you have the ability to pay.
    My wife get's disruptive if I leave her alone for more than a few minutes and it is hard to put up with but that's the disease not her, left alone she becomes quite angry trying to get out of the house and banging doors looking where "everyone" is, the calmness he displays may evaporate if the 1-2-1 was taken away, you could get assessed but until you try it you won't know, all a professional can do is give you their best guess about what will happen, there are no certainties with AZ.
    K
     
  5. Beate

    Beate Registered User

    May 21, 2014
    11,713
    Female
    London
    The care home can suggest 1:1 care but ultimately they are not the ones deciding this. Self-funding or not, a proper assessment should be made and eventual funding options explored before they should even think about asking for more money!
     
  6. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,781
    Salford
    True, but if you declined the 1-2-1 care they could say they couldn't cope with him and ask you to go elsewhere. I'm not saying they'd do that to be vindictive he might genuinely be too disruptive to the other patients. An assessment can be done as I said any they can give you their opinion, but his care must involve at least 4 or 5 carers and I'd be more interested in what they had to say. As I said the home may have a vested interest in taking your money but equally they also have a better idea of the real situation. I wonder if it would influence the assessors opinion knowing you are self funding as opposed to the council picking up the bill.
    K
     
  7. Gigglemore

    Gigglemore Registered User

    Oct 18, 2013
    526
    British Isles
    Perhaps you could make an appointment to have a meeting with the manager so that he/she can consult the staff and give you an informed update on the position. Mention that if 1 to 1 still required you would like their assistance in claiming CHC. Also check that his meds have been reviewed to ensure that no tweaking is required to help reduce his aggression. I'm sure others will have suggestions of what else to raise, but a formal discussion might help you get a better feel for things.

    He/she should also be able to advise if, for example, he regularly sleeps certain hours of the night - could the 1 to 1 be removed for that period.
     
  8. jasmineflower

    jasmineflower Registered User

    Aug 27, 2012
    335
    I'm with Karjo as well. Ask for a CHC assessment. If the needs are so great that your father needs 24 HR 1:1 care because of behaviour or risk of falling he should qualify. This is exactly the same reasons my mother in law receives CHC.

    Make sure you ask for an assessment , read up on it and learn what they are looking for and make sure you are there and fight your corner. They will try to downplay every category.
     
  9. Jen48

    Jen48 Registered User

    Dec 28, 2013
    19
    Thank You

    Thank you all for your really useful advice and info. I will definitely ask about CHC funding.

    Thanks again
    Jen48
     
  10. Karina A

    Karina A Registered User

    Jan 30, 2016
    10
    Hi
    Your cpn may be able to help you with the application, my mothers has been invaluable.
    Good Luck
     
  11. Karina A

    Karina A Registered User

    Jan 30, 2016
    10
    Sorry cpn = community psychiatric nurse.
     
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