1. Q&A: Medication - Thurs 22nd November, 3-4pm

    Do you have questions about medication and drug treatments for dementia? There's no drug to cure dementia yet, but it's often possible to relieve some symptoms.

    Our next expert Q&A will be hosted by Simon from our Knowledge Services team. He will be answering your questions on Thursday 22nd November from 3-4pm.

    You can either post questions >here< or email them to us at talkingpoint@alzheimers.org.uk and we'll answer as many as we can on the day.

CHC (Continuing Healthcare) support thread

Discussion in 'Legal and financial issues' started by stanleypj, Sep 22, 2015.

  1. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    9,912
    North West
    #1 stanleypj, Sep 22, 2015
    Last edited: Sep 28, 2015
    It's obvious that there will always be members caring for a person with dementia involved in trying to get CHC for that person and we know that this is often extremely difficult, for all sorts of reasons.

    It's also the case that over the years there have been a number of threads on topics that will be of interest to people involved in trying to get CHC. In addition, there are all kinds of online resources which will be at least worth a look.

    The aim of this thread is to collect links to the relevant threads and resources so that there is one place where people can, if they wish, start their search for information and support.

    I'll kick off with a link to someone else's thread where I've just posted a number of these links:

    http://forum.alzheimers.org.uk/showthread.php?86041-NHS-Continuous-Care-Meeting-for-Mum&p=1168255#post1168255

    But this thread will only work in the way intended if other members who are aware of threads that are supportive add their own links. Please help if you can.

    N.B. Some of the links in the post I linked to were incorrect. My apologies. They should now work.
     
  2. notsogooddtr

    notsogooddtr Registered User

    Jul 2, 2011
    771
    How do you go about getting an assessment?My Dad was assessed when he first when into NH in April 2014 but was turned down.His condition is so much worse now I think it's worth another try.Or would NH have to instigate this?
     
  3. Pete R

    Pete R Registered User

    Jul 26, 2014
    2,046
    Staffs
    I would speak to the NH to see what their opinion is but you can ask for an assessment at any time. Give your SW a ring.
    :)
     
  4. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    9,912
    North West
  5. nitram

    nitram Registered User

    Apr 6, 2011
    16,368
    Male
    North Manchester
    #6 nitram, Sep 23, 2015
    Last edited: Sep 23, 2015
    You can also do a Google search for a keyword or phrase on this forum or any sub forum, forum is best as it includes all sub forums. As usual Google will rephrase a phrase if it thinks you may have made a mistake.

    e.g. Google
    HTML:
    chc site:http://forum.alzheimers.org.uk/
    or

    HTML:
    "continuinghealth care" site:http://forum.alzheimers.org.uk/
    just copy and past the text into Google, entered as code to prevent TP wrapping
    HTML:
     [url] ...[/url]
    around the site url

    If you use the system a few times in succession you may get a Captcha challenge to prove you are human.
     
  6. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    9,912
    North West
  7. AlsoConfused

    AlsoConfused Registered User

    Sep 17, 2010
    1,958
    Our experience suggests families need to be as proactive as possible (sorry about using the awful word) when it comes to CHC.

    We weren't told about CHC as a possible option for Mum's care even though her Consultant said she had to be in a nursing home and was a high falls risk. The hospital hadn't done a CHC assessment of its own - they simply asked my naïve Dad whether Mum would be self-funding.

    When I started to gather evidence for the CHC assessment meeting I discovered the nursing home hadn't received key information from the hospital that would affect their judgements of the care Mum needed, the construction of their Care Plan and indirectly the feedback they gave to the CHC assessor.

    Even if a CHC assessor is good and impartial (not always the case), if they don't have the right information they won't make good decisions.
     
  8. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    9,912
    North West
    #9 stanleypj, Sep 23, 2015
    Last edited: Sep 23, 2015
    Thanks for the contributions so far. Please feel free to add any relevant links or info.

    It's helpful to hear of people's experiences though it's appreciated that members may not wish to share detailed information about the person they care/cared for on an open forum.
     
  9. nitram

    nitram Registered User

    Apr 6, 2011
    16,368
    Male
    North Manchester
    AlsoConfused's post raises another important concern, that of general ignorance about CHC and how a hospital discharge should be handled.
    This >>>AS factsheet <<<gives some details.

    All hospitals should have a formal discharge procedure which typically includes the standard >>>checklist<<< this will result in a decision as to whether the patient should be granted >>>FNC<<<, or>>>DST<<< or neither of the two.

    A forward care plan should also be produced.
     
  10. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    9,912
    North West
    People may or may not be aware that CHC funding is reviewed after the first three months and then at least annually but it can be reviewed at any time. Although people in receipt of CHC may be understandably anxious about losing CHC funding at these points. it should also be borne in mind that, if needs have increased, a review may also raise the level of funding.
     
  11. LYN T

    LYN T Registered User

    Aug 30, 2012
    6,967
    Brixham Devon
    #12 LYN T, Sep 28, 2015
    Last edited: Sep 28, 2015
    My late Husband received CHC and I have to say that the input from his CH and their exemplary records helped no end-so I advise everyone to regularly read the notes in your loved one's file, especially if you have been advised of an 'incident'-make sure that it is written up fully.

    CHC Funding is written about, and questions asked, on a frequent basis on this Forum; people often list the problems their LO is experiencing and as heartbreaking as it is to know someone with Dementia if the symptom is classed as 'low needs' or 'Social Care' then CHC will not kick in. Your LO will need 2 'severes' to advance to an assessment. For example if a person is incontinent that would be classed as 'social care'. If a person's incontinence causes skin problems that requires cream to be administered twice a day-that would probably be classed as 'low needs' if the condition is controlled. Even that is open to interpretation as the NHS mantra is 'a managed need is still a need' but quite often that is ignored and a score is given as 'no needs'. If the skin was broken or bed sores developed then perhaps the decision would be medium needs. If the bed sores were frequent, or infected, or continuous and were difficult to treat then the decision could possibly be 'severe'. However, a 'severe' score could be given in the 'behaviour' domain if the PWD was aggressive when treatment was given whatever level the skin problem/bed sore.

    In another example I know of one person on this Forum whose late Husband had a leg amputated; on his CHC checklist his mobility did not receive a severe score even though his mobility was zero and he had to be hoisted from bed to chair etc. Puzzled? Yes, me too! The crux of the matter was that he was not violent/or aggressive when being transferred. My Husband was scored much higher -even though he had two legs to walk on! Why? Because he fell a few times and was very shaky when walking. The falls were not serious enough for Hospitalisation but he needed a Carer with him at all times-not just only for the walking but because he was a danger to other residents. There was concern that his aggression was out of control at times and, if left on his own, it was possible he could inflict harm on others. So, the walking problem had a knock on effect to other domains i.e. cognition (no understanding that he needed help to walk) and behaviour. Pete scored 'severe' in behaviour and cognition and 'high' for mobility.

    The thing is when being awarded CHC funding it appears to be all about intensity/complexity and unpredictability. To use my late Husband as an example again-he could start the day full of smiles (although that was quite rare:eek:) then as soon as personal care started he was punching, pinching, trying to bite and screaming. The point being that sometimes he was ok-sometimes not. However, no-one managed to discover what the trigger was. Again this illustrated complexity/ unpredictability and intensity-adding to the 'severe' score in 'behaviour'

    Now in case anyone thinks that I am voicing my own opinions on why CHC Funding should be/should not be awarded-I'm not. I think the standards are open to interpretation; not just variances between each CCG but also the way individuals 'read' the domains. It's a scandal -I have no ideas how it can be resolved but I hope this probably over simplified explanation may just help a bit.

    Keep fighting everyone.
     
  12. AlsoConfused

    AlsoConfused Registered User

    Sep 17, 2010
    1,958
    I couldn't agree more, Lynn.
     
  13. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    9,912
    North West
    I agree entirely Lyn.

    The 'Checklist' link in nitram's post #10 (above) will be helpful to people who are relatively new to the process. It explains the checklist which is the first hurdle to overcome and would normally be used by a professional with, one would hope, the help of someone who knows the person well, to see whether there seemed to be a clear case for a person to be formally assessed for CHC funding.

    If you read the document carefully you may well see how it could be open to interpretation - and this is only the first stage.
     
  14. nitram

    nitram Registered User

    Apr 6, 2011
    16,368
    Male
    North Manchester
    "It explains the checklist which is the first hurdle to overcome and would normally be used by a professional with, one would hope, the help of someone who knows the person well, to see whether there seemed to be a clear case for a person to be formally assessed for CHC funding.

    If you read the document carefully you may well see how it could be open to interpretation - and this is only the first stage."


    This flowchart shows the process both before and after the checklist.

    It's limited to CHC and does not show that FNC (Funded Nursing Care) is another possible outcome of the checklist.

    I've posted the flowchart before but I don't think it's directly linked on this thread.
     
  15. missmarple

    missmarple Registered User

    Jan 14, 2013
    206
    Great idea to group all the CHC questions on one thread. Managed to get it for Dad on the basis of challenging behaviour. Really I could have applied at least 1 year before he got it as his behaviour was horrendous then, requiring 2 carers to manage during the day. But no one told us about it, it's only because I work in a hospital that I picked up enough information to get the confidence to apply.
    Have a feeling I'll be posting on here again soon, when they try and take the CHC away...
     
  16. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    9,912
    North West
    I'm glad people are finding the thread useful. If you have any further info, feedback or news PLEASE post. That way even more people may become aware of it and get and contribute information.
     
  17. AlsoConfused

    AlsoConfused Registered User

    Sep 17, 2010
    1,958
    Just a stray comment ...

    We're at the stage where we've had the CHC Checklist assessment meeting and the assessor told us Mum had got through the first stage. I'm unsure whether that decision's irrevocable (haven't had time to check it!).

    I'm finding dealing with the CHC office very stressful as they seem much less committed to transparency and ordinary helpfulness than most organisations I've come across. They seem to want us to remain very passive and to simply wait on their communications to us.

    Are we unlucky?
     
  18. LYN T

    LYN T Registered User

    Aug 30, 2012
    6,967
    Brixham Devon
    The 'first stage' only refers to the checklist:( Your Mum will now go onto the assessment stage -that's when the scores are discussed, then it usually goes to 'panel'. I say 'usually' as my late Husband was awarded CHC Funding within the hour of passing the assessment, it didn't go to panel.:confused:

    I'm not sure if you are 'unlucky'; from other posts on this Forum the whole procedure seems a complete nightmare with little reference to the 'guidelines' that should be followed.

    I think that what I experienced when applying for CHC for Pete was against the norm:eek: -someone who knew the guidelines and had quite a lot of compassion for what Pete was going through
    love

    lyn t xx
     

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