May I just say that of all the paperwork I have been sent regarding CHC funding, your file is the of the most use to me. I guess it's because paperwork is just words, but when the words relate to a person and their degree of deterioration, it's much easier to relate to your relative's situation. My assessment was only 2 weeks ago but the assessor said I wouldn't get funding for my husband as he wasn't into the next category since the last assessment 6 months ago. I must wait until I hear finally, but I find it difficult to accept, as at the last full assessment he wasn't on any medication. Since then he has been prescribed an anti psychotic drug due to his violence and agitation, which has been increased x 4 over the months since the last assessment. He is also given a sedative so that carers can approach him to wash and shave him. The GP said that he is dangerous and the psychiatrist said that he was in the severe category of AD. He is doubly incontinent, can't communicate or feed himself and has limited mobility. How ill do you have to be to qualify for funding?
Thanks once again to Blancr and I must say my admiration for such an articulate presentation of facts.
Liz
Hi Liz,
Your situation is truly horrible - I can imagine fewer things worse than losing your life's partner in this way. For me, I'm one removed in that I'm merely supporting close friends who are traveling this journey.
As you know, the funding decision turns on the balance between clinical and caring support requirements. In our case [AAAA] is difficult to manage and has unpredictable clinical needs. However she is not so difficult as to justify heavy sedation hence the balance of clinical need falls in our favour.
In your case (and paradoxically) I suspect that the CHC takes the view that because your husband does require heavy sedation this makes him predictably 'easier' (nothing is easy in this territory) to manage. If his medication and its dispensing is uncomplicated and predictable then this can be managed by 'caring' staff with clinical inputs funded within the Nursing Allowance.
Not sure I'm helping really but the one thing I have learned is that CHCs are forced, in their decision making, to strip away the emotion and deal with the cold hard facts of actual need versus the budgets within which they have to work.
All we can do is make sure that the information they use in coming to their decisions is accurate and that the judgements they apply to those data are fair and logical. In our case they failed on both counts but, when the evidence of their failure was put in front of them, they quickly (and to their credit) conceded and reversed their decision.
It took me quite a while to get my head around this whole subject. It's so emotionally charged that it's almost impossible to see the wood for the trees. But, in the end, it comes down to one equation - clinical nursing versus caring inputs - and we get ourselves into trouble with it because the empirical evidence is often weak and we are left to wrestle with 'judgements' - and you only have to look at the current state of our politics to see how well that works!
Blancr
