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Is it worth our while to investigate CHC funding plse?

Discussion in 'Welcome and how to use Dementia Talking Point' started by AlsoConfused, Jul 31, 2015.

  1. AlsoConfused

    AlsoConfused Registered User

    Sep 17, 2010
    1,953
    Hi All ... not even sure I've got the CHC abbreviation right:confused:.

    I know the bar for NHS funded care (for dementia sufferers going into residential care) is set very high. It'd take me ages to work my way through the Decision Support Tool (?) and I'm reluctant to spend the time on it unless there's at least some chance we might get Mum's care paid for.

    As far as I can see, the only domains(?) on which Mum might score as severe are the extreme unpredictability of her behaviour which sometimes causes bone-breaking falls. I think the hospital regard Mum as a high risk for falls, especially as she now leans backward when walking. Mum's intensely distractable (eg suddenly taking her hands off the bannisters and reversing direction while climbing the stairs). Mum has no awareness of risks now and no ability to remember, understand or follow instructions.

    Items of lesser importance I'd have thought are that Mum's non-compliant moderately often with carers and family members (eg over getting up, taking medication, taking fluids and food, etc). She can be physically aggressive but mostly isn't now.

    If a "1" represents no chance of getting NHS funded care and a "10" a racing certainty of getting such care, where do you think my Mum might score? I tend to feel she'd be no more than a "2" or possibly a "3" ... but I'd like to ask TP experts what they think!

    Hoping for your advice ....
     
  2. jeany123

    jeany123 Registered User

    Mar 24, 2012
    19,036
    Durham
    Hello Alsoconfused, I am sorry I don't know anything about this but I will put it at the top of the posts and see if anyone else can help,

    Best wishes Jeany x
     
  3. LYN T

    LYN T Registered User

    Aug 30, 2012
    6,962
    Brixham Devon
    It's always worth a try. My late Husband received CHC but I'm pretty sure that was because the CH staff kept such good records-so if your Mum is still at home (?) it will be down to you. If she is in a CH/NH ask the Manager's opinion and ask them to start the ball rolling.

    Unpredictability, complexity and intensity is the key to most people getting the funding; my OH also received several 'high' scores that all went towards him qualifying.

    Good luck

    Lyn T XX
     
  4. piedwarbler

    piedwarbler Registered User

    Aug 3, 2010
    7,188
    Female
    South Ribble
    My mum qualified for CHC, eventually, and after a protracted battle with the PCHC (now the CCG). :( I did find my way around the decision support tool. In the meeting, with the specialist nurse, I was allowed to voice my feelings about what level Mum was at. They mostly disagreed but on one count they agreed to change the recorded level, as far as I recall (it was 3 or 4 years ago, and I probably posted about it on here). As I recall, it was Mum's grade 4 pressure sore that helped her qualify.

    I would say, is your mum's primary need for care based on health? If you think it is, then I think it might be worth fighting for. It does depend on you, though, and your capacity for a fight. I was having cancer treatment when my mum was going through it all, and it did take it out of me. I just felt so angry that my mum's health needs weren't being supported well enough (as I saw it), and that made me want to fight. That was my personal experience of it.

    I hope you find a way that feels right for you.
     
  5. Saffie

    Saffie Registered User

    Mar 26, 2011
    22,499
    Female
    Near Southampton
    Lyn, I think Pete must have scored 'severe' for behaviour and that is nearly always guaranteed the funding so I've been told.
    Unpredictability isn't a catergory in itself but it certainly figures hightly in the overall context of the DST tool as do complexity and intensity - though exactly how the latter is judged I don't know as judgements seem to vary so much.
    Falls seem to feature under mobility though of course involve unpredictability. The fact that my husband couldn't walk, nor barely move at all made him only moderate in mobility which seems ridiculous.
    His primary needs were very much health based but that didn't seem to matter.
    It's always worth a try, AC, as different authorities vary in theheight of their bars and in their generosity. Good luck - 'cos you'll need that too!
     
  6. AlsoConfused

    AlsoConfused Registered User

    Sep 17, 2010
    1,953
    Thanks everyone. I'll print out your comments and pass them on to my sister ... if we both have a go, maybe we'll be able to come up with a convincing case.

    Thanks again.
     
  7. LYN T

    LYN T Registered User

    Aug 30, 2012
    6,962
    Brixham Devon
    Sorry all if my post was misleading:eek: Yes Pete did have severe for behaviour and cognition. The 'highs' as far as I remember were for nutrition (drastic weight loss-at that time 'unexplained') . His behaviour didn't follow any pattern so was classed as 'unpredictable' , 'complex' and 'intense'. His mobility was 'high' and he had several falls-although he mostly just sank to the ground.--but he needed someone with him at all times. His skin viability was also 'high'-sores and a skin condition. There were other highs-but I don't have the paperwork to hand at the moment-I don't like to read it.

    It was ridiculous that Dave didn't receive a much higher score due to his lack of mobility. I must say when Pete was initially assessed (after my appeal) the person doing the checklist knew what he was talking about (if only they all did) and Pete received the CHC within an hour.

    Good luck everyone if you do go down this route

    Love

    Lyn T XX
     
  8. canary

    canary Registered User

    Feb 25, 2014
    10,788
    Female
    South coast
    I thought it might be helpful to copy and paste the definition of the high and severe category of mobility taken from the CHC decision tools

    High: "Completely unable to weight bear and is unable to assist or cooperate with transfers and/or repositioning.
    OR
    Due to risk of physical harm or loss of muscle tone or pain on movement needs careful positioning and is unable to cooperate.
    OR
    At a high risk of falls (as evidenced in a falls history and risk assessment).
    OR
    Involuntary spasms or contractures placing the individual or others at risk."

    Severe: "Completely immobile and/or clinical condition such that, in either case, on movement or transfer there is a high risk of serious physical harm and where the positioning is critical."

    I thought that might help clarify things a little
     
  9. piedwarbler

    piedwarbler Registered User

    Aug 3, 2010
    7,188
    Female
    South Ribble
    I think that what Canary has quoted helps explain the difference between high and severe. When my mum was bed bound, they said that it actually reduced her needs as she was no longer at risk of falling. I know. Crazy. Then, when she got the grade 4 pressure sore, that was when she became suddenly severe.
     
  10. Saffie

    Saffie Registered User

    Mar 26, 2011
    22,499
    Female
    Near Southampton
    When I queried the grading of Moderate, I was told that the nurse had said he didn't struggle when he was being hoisted. He couldn't because he was incapable of it and also terrified! I think this is where behaviour will become involved too, not to mention the predictablilty too.
    If an excuse for downgrading is there, they will find it!
    I'd read some of the threads concerning CHC funding as it might shed more light on it for you. Just search for CHC.
     
  11. piedwarbler

    piedwarbler Registered User

    Aug 3, 2010
    7,188
    Female
    South Ribble
    Yes, Saffie, and also I recall the nurse saying to me that for the breathing you have got to be on oxygen basically to be given high or severe. Which means of course they will downgrade if they possibly can. Not a job I would want to do.
     
  12. AlsoConfused

    AlsoConfused Registered User

    Sep 17, 2010
    1,953
    Thanks yet again.
     

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