challenging behaviour and implications for funding costs

[ald64]

I am a man in my late forties who lives with his widowed father who has his property in his own name.My father was diagnosed with mixed dementia 2011.The disease has progressed this year.I had put into place in the early part of the year two 2 hr slots with an intention of expanding this to care with showering and the serving of a lunch meal.This resulted in my father refusing to shower and after about 6 weeks he hit the male carer in the face and asked him to leave through swearing.In the summer he became aggressive with myself and i had to resort to car journeys to calm him in the evening.He also had an altercation with a postman.i eventually had to call 111 which resulted in social services sending in carers to for five hrs at night to observe my father.several agressive incidents occured over a period of 10 weeks or so but i intervened to stop any injury to the carer.One carer who was very experienced told me that I was wrong to restrain my father as i was affecting his classification and I was a fool to myself.Our savings level means we are fully liable to pay for care but iI am confused because we have not had to pay for the observation carers.I have now been told he needs to go in a care home because he has been seen wakling down his drive which is close to a country A road and he was near the edge of the road.The social worker has been phoning at work asking difficult questions which I find has made me very stressed because i am trying to work.My Brother said that the social worker told him he did not think he would qualify for CHC.We had tried to introduce him to a home for respite becoming possibly permanent which we were going to fund but they refused because we were honest and admitted he ciould be aggressive.I have learnt from other posts that social workers can bias there interpretation of guide lines towards saving government money.I would be grateful if any one has any opinions about this please.

 

[J W]

There will be others who can comment better on this, i am sure they will but in the meantime search the forum for CHC funding.But yes take what the social told you with a very big bucket of salt, its all about saving money.

Below is a post on this forum.




Hi,
You will need to check out Pamela Coughlan.
Her case was a major victory in making the NHS abide by the law and provide free care to anyone who is ill or disabled.
Since that victory ALL and EVERY CHC assessment should comply with the Coughlan test.
This means that if your relatives health needs are the same or greater than Pam Coughlans then you have a clear case for CHC funding.
The other cases of interest are the Booker case and Grogan.
The high court ruled in Grogan that the NHS decision to provide free health care at the point of need to ms Grogan was fatally flawed and the NHS had moved the goal posts in defining her needs.
She won her case.
The NHS certainly do not want another Coughlan or Grogan case so they will do their utmost to remain out of court.
There is lots of interesting reading out there just google it.
Good luck.
Mick

 

[J W]

Here is another thread.


http://forum.alzheimers.org.uk/showthread.php?49469-Chc

 

[Cornishman]

Hi

As a first step, it would be useful to familiarise yourself with the NHS own guidelines and procedures.

https://www.gov.uk/government/publi...inuing-healthcare-and-nhs-funded-nursing-care

I'm no expert, but have some experience of dealing with the NHS and to a lesser extent Local Authority Social Services.

What is clear from my experience and from what also I've read amongst the various discussion threads in this forum, there is a definite trend for parts of the NHS to attempt to abrogate their moral, but more importantly, statutory, duty to care for people that demonstrably are entitled to such care. They do this, often in collusion with LA social services, by being selective during the assessment process, ignoring or marginalising needs, all in order to produce "evidence" (note inverted commas) to demonstrate an individual's needs are insufficient to qualify for CHC funding. You might wonder why this is so - sadly it's all about saving money rather than about the important issue of ensuring someone's care needs are being properly addressed. Quite simply, if the NHS can convince themselves the individual's needs are not sufficient to be wholly their responsibility, that responsibility then transfers to LA social services who (unlike the NHS) are permitted to means test, so very commonly...hey presto!...the individual is made to pay from their own resources, including infamously if they own a house being made to sell it in certain circumstances.

We sold my parents' house in 2003 to pay for mother's care. In 2009 she was granted CHC funding (at last) - not because the money ran out (although that was getting close), but because she qualified as being eligible though a CHC assessment.

In 2013 they took CHC eligibility away for reasons that wouldn't stand up to any right-thinking person's scrutiny and by a very questionable and cavalier application of the NHS' own laid down processes. So now we're paying again. (We've since been told by the care-home they've "reviewed" every person in the CH getting CHC with a thinly disguised exercise in taking every eligibility away if they think they can.)

So my advice is tread carefully, don't be bullied by going along with things you don't immediately understand or disagree with, and take time out to consider anything before making agreements or undertakings. I also recommend you seek advice through the Alzheimer's Society volunteers scheme who can tailor advice to your father's specific situation.

Good luck and best wishes.

 

[J W]

Thats a good reply from Cornishman.

We went to a CHC assessment very naive and it was refused, and have been getting as much info as we can for the next time we ask for assessment, for we feel things will get even worse than they are now, which are pretty bad at present to say the least.