withdrawal of continuing healthcare funding

[talli]

Hi
I'm hoping for some advice. My Mum was finally awarded chc funding 6 months ago after 4 years in a care home. This was solely after I read about it on this forum- no one had even told me such funding existed. It was a battle to get it and she was awarded it on condition that she moved to nursing EMI. Mum moved to her new home 4 weeks ago and I have now received an appointment to attend a review of the funding. The assessor has advised me that Mum received the funding because of her behaviour and they would assess if she still qualifies. As her condition has now deteriorated to such an extent that she is barely awake I feel sure that they will now say that she no longer qualifies for funding because she is managable. Can you only receive funding if the condition makes you aggressive? Mum is worse than ever -she cannot communicate at all, she cannot walk or even prop herself up if she slips to one side, she is doubly incontinent and barely opens her eyes for more than a few minutes at a time. Surely she should qualify for funding more than ever. I would welcome any advice so that I can fight her corner .

 

[milly123]

hi Talli 2years ago i was awarded cc because of my husbands aggression at that time he could walk talk and feed himself i was told it would be reviewed in 3month and then every 12month now my husband is just like your mum and cannot do anything for himself last week i got a phone call to say they where arranging another assesment in the next week this is the first one i have been asked to attend im like you i feel i could loose it .i have very strong feelings about having to pay so much for care everyone should qualify for cc my husband like all others worked hard all his life paid in the system good luck milly

 

[talli]

hi Talli 2years ago i was awarded cc because of my husbands aggression at that time he could walk talk and feed himself i was told it would be reviewed in 3month and then every 12month now my husband is just like your mum and cannot do anything for himself last week i got a phone call to say they where arranging another assesment in the next week this is the first one i have been asked to attend im like you i feel i could loose it .i have very strong feelings about having to pay so much for care everyone should qualify for cc my husband like all others worked hard all his life paid in the system good luck milly

Thanks milly. Once Mum was awarded the funding I breathed a sigh of relief - I wasn't expecting to go through it all again so quickly. I feel that these professionals are being paid to make sure hard working, honest people cough up for every penny possible. If it were any other illness the nhs would be paying for care. Good luck with your husbands assessment.

 

[2jays]

No experience myself - yet - but from reading posts on here...

I would argue the case that just because the need for continuing care is being managed it doesnt mean there isnt a need...

"They" make up the rules about CHC to suit the purse...

Another unnecessay fight but worth it if you can fight their decision... I am guessing "They" are going to say no need to continue funding....

 

[geum123]

Hi Talli,
My dad was awarded CHC also for challenging behaviour, and like you I expect they will try and take it away from him if his behaviour becomes compliant. Time will tell.

However I would ask what medication your Mum is on at the moment.
You could perhaps ask to see your Mums care notes.
It could be that she is asleep most of the time because of medication?
or it could of course be a natural progression for your Mum.

Sometimes when it is unavoidable my Dad is sedated,
but a fine balance has to be struck because if he is sedated too much they are then unable to get him to take food or liquid.

As 2jays says, a managed need must still be treated as a need.
Make sure it is recorded if you don't agree with the criteria,
and appeal the decision if you don't agree.

 

[talli]

Thanks for your thoughts. I am ready for another fight! I am just unsure from which angle to fight. I will check Mums medication but I think it is just the progression of her illness that has lost her challenging behaviour. Since she has moved to nursing EMI and the staff have only known her a few weeks I feel that I don't have an ally to help fight any arguments. The nurse at her previous home could really stand her ground when challenged. These assessors seem to be able to bamboozle you with jargon about complexity, intensity and whether things are health needs or not. It certainly helps reading about other peoples experiences.