HELP WITH DST FOR CHC ASSESSMENT

Mrnkar

Registered User
Oct 28, 2017
25
0
Hi, New to all of this so I'm sorry for the long and completed story regarding my father who was diagnosed with vascular dementia in July but for the past 5 years they thought he might have Lewy Body Disease.

He had been in hospital for 4 months until May then discharged to a care home where within 3 months he had either attended a&e or been admitted to hospital. Almost from the start they had problems with him refusing, food, drinks, medication & personal care. Very abusive behaviour & sexual speech.This lead to confusion, dehydration & AKI which had also occurred while he was in the hospital the first time.
At the end of August he was rushed to hospital again with dehydration, chest infection, delium and AKI. He is still there at present.

He has a list of other medical conditions including COPD, Frontal lobe infarction, CABG, Pacemaker & Diabetes.
Whilst in hospital a CHC assesment was arranged as they say he now needs 24hr nursing care, but a few days before it was due a DOLS had to be put in place for his not complying with anything ie food, drink, medication, turning in bed etc.

The DST was completed last week which i attended my father refused to attend.
At the end of completing the DST they said he hasn't reached the cretia but will get FNC instead, There was a number of inconsistencies ie they said he was eating and drinking fine. He had taken all his medication etc, which i of course pointed out so they said they would check.
I have now received the completed DST forms. It has gone to the CCG for final decision and i of course am building a case for appeal.

His score was 3 high, 3 moderate and 5 low. I believe 2 of them should be severe based on medical evidence which they have overlooked.

My main question is although they have given him a High for behaviour i believe it should be severe. The problem i have and believe me I have searched and searched the internet for an answer is, the difference between the two is do with planned interventions. High says usually responsive to to planned interventions and Severe says outside the range of planned interventions. There lies my problem. Is a DOLS classed as a planed invention or not.

If anyone has an answer to this i will be forever gratefully. Thank you for any help received.
 

Pete R

Registered User
Jul 26, 2014
2,036
0
Staffs
Welcome to TP,

Everyone who is "detained" in a CH or hospital needs a DoLS and will have no relevance to how the DST is scored.

All the best with your appeal. :)
 

Mrnkar

Registered User
Oct 28, 2017
25
0
Thanks sorry i don't understand what you mean by detained. Could you explain that to me please.

They had to apply for the DOLS and the hospital telephoned my brother and told him they had to impose a DOLS urgently as his life was in danger.
 

Kevinl

Registered User
Aug 24, 2013
6,064
0
Salford
Hi Mrnkar, welcome to TP
There's a long running thread on CHC (link below) which you might find interesting or depressing. Whichever way you look at it getting CHC for someone with AZ seems near impossible.
As Pete says a DoLS is a bit of legal paperwork to keep someone in a certain place it's not a healthcare issue so I don't see it would be relevant to the CHC.
K

https://forum.alzheimers.org.uk/threads/chc-continuing-healthcare-support-thread.86059/
 

Mrnkar

Registered User
Oct 28, 2017
25
0
Thanks I will have a look at it as am already finding out what a minefield it is.
 

Pete R

Registered User
Jul 26, 2014
2,036
0
Staffs
Thanks sorry i don't understand what you mean by detained. Could you explain that to me please.
Sorry was a bit short for time when I posted that.

DoLS stands for Deprivation of Liberty Safeguards. Everyone who is not free to leave (not the only reason but can also include all the things your Father is refusing) a CH or Hospital is technically being detained by the "State". This is normally down to their mental capacity in that they would be a danger to themselves or others if they were not deprived of their liberty. The reasons could be a short term mental illness or because of their Dementia.

The DoL Safeguards apply to everyone of the above in that the LA or Hospital has to make an assessment of the reasons for the deprivation to make sure there is nothing else that can be done so the individual is not so restricted.

Due to an immense backlog most DoLS take months or even years to be processed. This in itself does not make any detention unlawful and The Mental Capacity Act allows professionals to make "best interests" decisions whenever needed.

My Mom (luckily a very passive Dementia sufferer) needed a DoLS because she was not free to leave her NH even though she never wanted to leave or made any such attempt. The assessment never took place due to the back log.

However with someone with behavioural problems like your Father unfortunately a more "hands on approach" may be needed and the DoLS process can be fast tracked. The hospital did the right thing in informing you of this but it does appear they did not explain the process in the right way.

Therefor a DoLS in itself is not a reason for a DST score to go to severe or affect it in any way. You need to gather information from elsewhere to get that severe and in that I wish you all the best.

:)
 

Mrnkar

Registered User
Oct 28, 2017
25
0
Thanks that explains it a bit better. So forgetting the DoLS back to my original question, if anyone knows the answer what is classed as outside the range of planned interventions usually mean.