1. Expert Q&A: Benefits - Weds 23 October, 3-4pm

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Do we have to pay

Discussion in 'Legal and financial issues' started by simonwhu, Jul 21, 2015.

  1. simonwhu

    simonwhu Registered User

    Oct 6, 2014
    19
    Since October mum has been in a care home. Now costs £735 which we've had to sell her bungalow to pay for.

    She is also incontienent. I've been told that as she has two conditions the NHS should be funding this. Is this correct?
     
  2. Beate

    Beate Registered User

    May 21, 2014
    11,713
    Female
    London
    I am afraid it isn't as simple as that. CHC funding requires at least two A's in a particular checklist but incontinence isn't regarded as problematic enough. CHC funding is extremely difficult to get (behavioural issues would be one aspect), and even if you get it, it can be taken away again if for example any aggression or violence calms down. If dementia and incontinence qualified, a lot of people would get funded!
     
  3. simonwhu

    simonwhu Registered User

    Oct 6, 2014
    19
    Someone today told me ahout a clip on This morning from September 2014 and I played it..She's defo not violent. As placid as she always has been
     
  4. katek

    katek Registered User

    Jan 19, 2015
    191
    #4 katek, Jul 22, 2015
    Last edited: Jul 22, 2015
    You don't have to be violent to get CHC but people who are would score in the 'Behaviour' domain, and if they managed to get 'Severe' for this, plus a 'Severe' in Cognition, they would qualify for CHC.

    I didn't see the TV clip, but in your original post you mentioned having 'two conditions', by which they may have meant scoring in two domains. However, it is not simply a question of scoring - you have to score 'Severe', which demands very high needs indeed. The domain of 'Continence' doesn't even go up to Severe anyway, so she would have to score in another domain which has that level (not all of them do). For example, in 'Nutrition', you would have to be fed intravenously to get Severe. People with AD do not necessarily have these other needs, so if they manage to get CHC, it is generally for Cognition and Behaviour.

    As Beate says, qualifying is very difficult, and your mum would not meet the necessary criteria.
     
  5. simonwhu

    simonwhu Registered User

    Oct 6, 2014
    19
    Thanks for help guys. So frustrating isn't it..all that tax for nothing
     
  6. marionq

    marionq Registered User

    Apr 24, 2013
    5,853
    Female
    Scotland
    This is new to me. Does epic wandering count as a behavioural issue which warrants CHC.. John needs 24 hour supervision which I am struggling with and getting the run around from social services despite all the police and doctor reports.
     
  7. missmarple

    missmarple Registered User

    Jan 14, 2013
    206
    My Dad also has epic wandering which puts him and the public at risk as he is liable to kick off if he wants something (to enter a car, a home, to help himself in a shop) and can't get it. I believe that more or less swung it for him and he got CHC. Definitely worth asking for a checklist assessment MarionQ, asKateK says if you score severeon cognition AND behaviour you usually get CHC. It sounds like you have been masking the problem (for all the right reasons) by taking car eof things and averting crises.
    Important point in CHC assessments "a met need is still a need" eg his safety needs are severe but you have been taking care of them (if I've read your post correctly).
     
  8. katek

    katek Registered User

    Jan 19, 2015
    191
    Re wandering - I think it all comes down to the extent of risk (either to self and others), and how this can be proved. If you have police and doctor reports, that should count for a lot in the 'Behaviour' domain. You mention social services, but has John actually had a CHC assessment? Social services would have a role to play in this but it would be organised by the local CCG (Clinical Commissioning Group) as the funding body as part of the NHS. The qualifying bar is very high, and there is something of a postcode lottery involved too, as to how big the CHC budget is in different areas. However, you should push for CHC funding if you feel John should qualify.
     
  9. marionq

    marionq Registered User

    Apr 24, 2013
    5,853
    Female
    Scotland
    Miss M this is indeed news. Since last October life has been an increasing nightmare of watching John like a hawk, following him when he refuses to listen, peeling him off fences and poles to get him home. When he started getting lost within our immediate area and getting on buses, disappearing for a ten hour stretch, walking unnoticed out of daycare the social services received so many reports they approached me and said to start looking for a care home. Over the last month they have multiplied my stress levels with their incompetence and neglect.

    His psychiatrist phoned the Mental Health Officer to complain about the poor performance of their staff and allegedly this is to be put right. When they came to do a financial assessment the notion of CHC was never mentioned.

    Thank you
     
  10. katek

    katek Registered User

    Jan 19, 2015
    191
    Have just read this after I posted my own reply, and agree completely with what you say!
     
  11. nita

    nita Registered User

    Dec 30, 2011
    1,802
    Female
    Essex
    If you can't get CHC but still have a nursing need and are in a care home, you may be able to get NHS Funded nursing care:-

    http://www.nhs.uk/chq/Pages/what-is-nhs-funded-nursing-care.aspx

    I think you may be eligible if, for example, your Mum needs some type of nursing care. I imagine this may be for treating pressure sores but others may know more.
     
  12. missmarple

    missmarple Registered User

    Jan 14, 2013
    206
    Sorry to slightly highjack this thread Simon.
    Marion it sounds like it could be a classic case of him potentially qualifying for CHC, but no one telling you. For 9 months my Dad required 2 carers a day to keep him safe, he still managed to get into situations where the police needed to be involved. An EMI refused to take him as they said they wouldn't be able to manage. No one at any point suggested CHC and it's only because I work in a hospital and was able to discuss it with discharge nurses here that I started to get an idea about applying. He was paying for all this care himself.
    My suggestion is you request a checklist assessment ASAP. Dad's was done by his key worker at the dementia team, and a social worker (who'd never met him previously) they were quite positive, it was sent on to the CCG who sent 2 nurse assessors about 3 weeks later. That was the tougher bit, but with preparation I still managed to put a good case forward, hingeing mostly on his behavioural problems.
     
  13. katek

    katek Registered User

    Jan 19, 2015
    191
    #13 katek, Jul 22, 2015
    Last edited: Jul 22, 2015
    A good point but I think Nursing Care can only be awarded after an assessment for full CHC, and is given when the patient doesn't meet the full criteria but does have some nursing needs.

    Simonwhu - this might be worth exploring. The first step would be requesting that the checklist for CHC be done for your mother. She would have to pass this in order to go on to actual assessment for CHC. As said earlier, she would be very unlikely to qualify for this, but as Nita says, may qualify for the funded Nursing Allowance if they consider she has some nursing needs.
     
  14. marionq

    marionq Registered User

    Apr 24, 2013
    5,853
    Female
    Scotland
    Thanks again Miss M. I have been allocated the Team Leader from social work as a result of the complaint from his psychiatrist so we'll see if she mentions it when she comes out this week. I am usually very positive about professionals until they prove me wrong but my recent experience with social services has shocked me as my dealings with NHS Scotland and Alzheimer's Scotland have been so good.

    Once you get the length of needing long term care social services feel like the enemy despite all the platitudes about wanting to help.

    What's going on?
     
  15. katek

    katek Registered User

    Jan 19, 2015
    191
    #15 katek, Jul 22, 2015
    Last edited: Jul 22, 2015
    If the Team Leader doesn't mention CHC, make sure you do! Insist that the checklist is done, and start putting together evidence ready for the actual assessment - which you are entitled to attend and contribute to.
     
  16. missmarple

    missmarple Registered User

    Jan 14, 2013
    206
    MarionQ I don't want to bludgeon you, but my experience is you have to take the initiative with CHC. The only time I have observed it being put forward for a patient by professionals (in hospital at least) is when it's a clear cut case of limited prognosis (less than 3 months) and people are fast tracked home with a package of care. Otherwise it only tends to happen if a clued up and determined relative takes the lead on it and pushes.
    So if the SS team leader does not mention it, make sure you do and request an assessment!
     
  17. Not so Rosy

    Not so Rosy Registered User

    Nov 30, 2013
    580
    Have to say I had the exact opposite experience to missmarple.

    Both Mum and Dad qualified for CHC funding because of Dementia. Both cases were driven by SS, not me. After all it's in their interests to pass the burden back to the NHS. Neither had a limited prognosis.

    Maybe it's a different stance if you are self funding at the time of applying.
     
  18. exhausted 2015

    exhausted 2015 Registered User

    Jul 5, 2015
    624
    Female
    stoke on trent
    lasting power of attorney

    Hello. Does anyone know how straight forward it is to obtain power of attorney for both financial and health and wellbeing just about to look into it and think maybe I have to do it sooner than later
    Thanks in advance
     
  19. nita

    nita Registered User

    Dec 30, 2011
    1,802
    Female
    Essex
    Hello exhausted,

    There is a lot of advice on this already in the Legal section. If you put "POA" or "power of attorney" into the search engine on this site, you will come up with a lot of information. Otherwise, start a new thread and you will get plenty of replies.

     
  20. canary

    canary Registered User

    Feb 25, 2014
    10,531
    Female
    South coast
    Marionq - the definitions of severe and priority in behaviour are:

    Severe:
    ‘Challenging’ behaviour of severity and/or frequency that poses a significant risk to self, others or property. The risk assessment identifies that the behaviour(s) require(s) a prompt and skilled response that might be outside the range of planned interventions.

    Priority:
    ‘Challenging’ behaviour of a severity and/or frequency and/or unpredictability that presents an immediate and serious risk to self, others or property. The risks are so serious that they require access to an immediate and skilled response at all times for safe care.

    If you think he comes in either of these categories then I would push for CHC.

    If anyone is interested in the official definitions of all the domains then google "CHC decision tool" and you will find a pdf that can be downloaded. Its a very long gov piece, but about halfway through there is a very nice chart with all the definitions in it.
     

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