Help The financial side of life?

[ccfc1987]

Hi, apologies if this is a familiar question/topic. Im sure it is.
Without boring you all with the detail, after 3 years of caring for Dad, Mum (we all) took the decision to place dad in a Nursing home over the easter weekend, his first home wasn't close by to his family, so this week he moved. The new place seems great and although dad would sooner be at home of course, the carers all seem to be fantastic. As if its not bad enough 'losing' a loved one in this way, we now have to try to pick up the pieces for Mum in a financial sense. Dad always did this for them, so she's a little rusty, as to their(her) financial picture. For now (and I am sure that I will have more question to ask of you good people) the real purpose of the posting is to ask re the financials of Dads nursing care. Mum met with the social services and it seems like Dad will have to be subjected to an "appraisal" to determine his level of disability, both Physical and Cognitive. He has vascular dimentia, and has had mini strokes.He is unable to even lift himself in the chair physically, let alone move limbs and requires transferring using a hoist. His mental ability and ability to talk is now almost diminished completely. Does anyone have any experience of this "Test" and how it works, what are the levels that they look for, and how secure/unbiased is it? How long will it be before dad has the appraisal, can we as a family be there when it is undertaken? We are clearly of the opinion that Dads need is full and absolute and as such he should be given full allowance financially via this 'test', the ramifications for Mum should he not would be far reaching? any info greatfully received.
Many Thanks

 

[blue sea]

Hi
This is a very complex area and I would strongly advise you to read the excellent leaflets on nursing and continuing care assessments on this website and the Age Concern one. You, as close family, are certainly entitled to be present at any assessment and the most immediate next of kin should be invited. My experience was that assessment for the nursing rates were objective, but the ones for continuing care (this is for full funding of personal and nursing care)are very budget driven. There is a past history of primary care trusts turning down most dementia patients for continuing care and it is an area the Alzheimer's Society members have fought hard for over the years. There is plenty of advice on the site, and the phone help line is another excellent source of help. It is so hard to cope with financial worries when you have so much more to deal with emotionally and practically.
Blue sea

 

[chip]

I came across the continuing care error. Although my husband is younger as well.He was in a Nursing Home for 15weeks but after being there for 8 weeks they struggled to handle him as he needed one to one care and they didn't have the staff to do that. The problem was he still tried to get up and walk and he just kept falling. He doesnt have TIA'S but has seizures. As he needs one to one they now have agreed on continuing care and we are waiting on a place to come up. Please make sure they take things into account as its so unsettling for them and familiy when things change. Can the home handle one to one care if it is needed? What will happen if another TIA happens? Will it mean constant going back and forth into hospital? I would find these things out first.

 

[Clive]

Hi CCFC

The assessment you get from SS will probable be little more than working out how much Dad has to pay, but I have no knowledge of this as my mum lived alone and consequently has to pay the full bill as she had both house and savings.

I think what you have in mind when you say “Dad’s need is full and absolute” is that, in your opinion he should receive “NHS Continuing Healthcare” which is when all the Nursing Home charges are paid by the NHS, as would happen if he went into hospital.

If you feel up to trying to understand how the NHS assess a person for free NHS Continuing Healthcare you might like to go to the following link and download and print off the details. (This is the 2007 version).

http://www.changeagentteam.org.uk/_library/DST.doc

In my experience (in my area) the NHS assessment is done on paper by a Summary Nurse sitting in an office. She gathers information from GP, hospital, nursing home, social services, A&E etc. The person’s health needs are split into eleven domains (areas of health like behaviour and incontinence) and to succeed in getting free NHS Healthcare the patient has to be assessed as having one Priority or two Severe, or possible a Severe and four High domains.

If your dad had a Priority domain he would just get the free NHS Continuing Healthcare without any problem. You would not have to do anything ! All fees paid for Dad !!

However if he was borderline and assessed with say a Severe and four High domains of need the Summary Nurse's report would have to go before a Multi-disciplinary Panel and you would be given the option of reading the report and commenting upon it, and also sitting in on the Panel meeting. (However the panel will not let you stay in the room whilst they make the decision. Nor will they tell you their decision verbally. You have to wait until it comes by letter).


It is very very unlikely that your dad will qualify for the free NHS Continuing Healthcare BUT it can make such a huge difference to both the financial and mental welfare of the family it is worth knowing how it is assessed and to ask about it (and apply for it) at every stage.



You did not mention in your post whether you had a Lasting Power of Attorney. If you haven’t you need one.

Best wishes

Clive

 

[ccfc1987]

Hi again, thanks for responding. Apologies for not responding to your kindness earlier. To be honest my head is in a spin here, as a loving son of both father and mother, I am distraught with worry and anxiety about both of their situations and what the future months hold. I guess im in denail at the moment and would really like to bury my head in the sand and wish it would all go away, but then I cant do that.This is just so unfair.

Clive in your last response you suggested that I get an enduring power of attorney, should I or my siblings(sisters) apply for this, or should it not be Mum's position. In addition should I do this through a solicitor or through one of those home packs available on line?
Thanks to one and all for your input.

 

[rhallacroz]

HI There
Yes it is a minefield but one that you need to be heavily involved with. I have intermediate care for my dad nobody likes to call it continuing health care. However it is a large package as I care for him at home with my mum. I made sure that I was fully aware of the criteria and used the excellent Dept of Health Website. I requested all the publications from the Dept of Health Website and was fully aware of my rights. I also spoke to my local councillors and mps and basically rallied the troops. I cant stress how important it is to know your rights. Join as many forums as possible get support from your local carers society. Speak to anybody and everybody. Phone to the Dept of Health helpline they are really so helpful.
Your parents are entitled to support and am sure you will make sure they get it. Continuing Health Care is needs driven and should not be resource driven. Good luck

 

[Clive]

Hi ccfc

You posted “Clive in your last response you suggested that I get an enduring power of attorney, should I or my siblings(sisters) apply for this, or should it not be Mum's position. In addition should I do this through a solicitor or through one of those home packs available on line?”

First let me say that the enduring power of attorney (EPA) has recently been modernised and is now called a Lasting Power of Attorney (LPA). You can get all the information (and forms) from the government’s official Public Guardian site which is

http://www.publicguardian.gov.uk/index.htm

Technically it is your dad who is setting up the EPA though it is you (or your mum) who will be doing the organising, and you (or mum and sisters) who would be named as the Attorneys.

Having read your post I suspect you may find your dad has passed the mental stage up to which he can set up an EPA and therefore you will find you need to move on to the next stage which is contacting the Court of Protection.

All the information you need for either an EPA or the Court of Protection is on the Public Guardian web site.

You may prefer to use a solicitor. If you do employ a solicitor you should ask for a quotation and confirm that the price includes any fees that the Public Guardian / Court of Protection will make. Solicitors can charge what they want for their service !

If you have any concerns the Alzheimer’s Society Help Line is always worthwhile as they can offer advice, even if it is only telling you who to contact. Posting on Talking Point also gets you information from people in similar position to yourself.

All the best

Clive