Continuing Healthcare

[lookingforward]

Hi Everyone,

My Mum is now 87 and lives in her own home with my sister but her health is deteriorating since having a stroke a couple of years ago and in particular these last couple of months. She needs help to walk whereas before she could do it with her walker, she has frequent bouts of dioreah and needs her legs dressed due to ulcers everyday. All these issues are being dealt with via hospital visits etc but we know she's not going to get any better.

My sister also now has her own health issues after Mums last hospital stays re-enablement free care ran out we decided we needed to keep carers coming in to help. Now at this point it should be pointed out that my parents are old school and Mum and Dad (sadly gone) never had anything without saving for it, so they never went abroad, etc etc and Mum does have some savings so when it came to the assessment it's been decided that she has to pay for everything.

Mums had to stay in a care home this week as my sister had a minor op, luckily my nephew works there so go a discount down to £600 odd for a weeks stay, and he mentioned to me have we looked at NHS continuing healthcare. The short answer is no because not one person, doctor, nurse, council official etc has mentioned it. Looking into it you have to have a short assessment to see if there's a possibility of getting it, then a more detailed assessment to kick it into action.

My sister is due another operation later in the year that will see Mum in respite for 4 to 5 weeks so we'd like to see if we can get this sorted ASAP so my question is has anyone succesfully claimed this from the NHS ?

They seem very vague about what the actually criteria are

http://www.nhs.uk/chq/Pages/2392.aspx?CategoryID=68

This document http://www.ageuk.org.uk/Documents/EN....pdf?dtrk=true from age uk says "Note: It is important to check that you have been properly assessed for fully funded NHS care, if you may be entitled to it, before the local authority carries out its means test for service provision. "

In which case are we too late because as stated that's been done ?

I feel she/we (it's mine and my brothers/sisters inheritance after all) are being punished because they had the cheek to have savings, my Dad who's been dead for over 20 years is still paying tax via Mum's widows private pension, it's just so unfair. A nurse actually told me it's best to spend or hide everything then you'll get everything free.

[SA Gold]

Re: Continuing Healthcare

I feel she/we (it's mine and my brothers/sisters inheritance after all) are being punished because they had the cheek to have savings, my Dad who's been dead for over 20 years is still paying tax via Mum's widows private pension, it's just so unfair. A nurse actually told me it's best to spend or hide everything then you'll get everything free.

It does seem very unfair. I've heard a few stories whereby some people are paying for everything, and others nothing. I think the trick (easier said than done of course) is to retire penny-less.

[cymruambyth]

Re: Continuing Healthcare

Hi we had it for my father. Luckily although he owned a nice house he enjoyed spending his money so had very little savings. He was assessed as needing the care by his GP, then social services came out and went through the finances. Dad was assessed as needing to pay some money towards his care but this was much less than care home fees etc. Once the care was in place he had a lovely group coming in who would adapt as was necessary. Unfortunately it appears that the level of service and care are dependent on where you live.

i think you should speak to her GP about moving forward with this.

[nightwatch]

Re: Continuing Healthcare

what is nursing care and what is social care? where do you draw the line?
I had a row with a Dr on this issue.
I was a Home Carer for the local council on a training course,He (Dr) stated Carers, care, Nurses, Nurse.
so I asked " if some one is at home and they are dying, cannot get out of bed to use the loo, so have to be cleaned up where they lie, have pressure sores that need cleaning and dressing, who's job is it?"
Reply" a nurse should always be doing that" It's Nursing!
my reply" Sorry but NHS won't pay the nurses and some nurses are refusing to do it as shit wiping is below them"
"My dear, I think you are wrong.
Ok, you phone up your contacts and IF I am wrong I will apologise,
That afternoon He informed us all that I was correct. It is up to the GP to state that it is medical care and then NHS will decide if they will pay or not. but if they can get away with it they won't pay.
only one of the reasons I quit the CARING profession.

I hope you get the help your Mum and sister need xxx

[Undercover Elsa]

Re: Continuing Healthcare

I'll come back to you again on this as I'm on holiday at the minute and just about to go out, but didn't want to read and run.
I'm in the process of having my late Mum retrospectively assessed for NHS Continuing care. In a nutshell, if she needs qualified nursing interventions as opposed to basic hygiene needs as provided in home/residential care then she will probably qualify.

I'll catch you later,

Elsa x

[lookingforward]

Re: Continuing Healthcare

Thanks to you all much appreciated, UE (haha Elsa just noticed the abbreviation of your name) I look forward to hearing from you later.

[Undercover Elsa]

Re: Continuing Healthcare

Hi again,
To answer your question above, the only reason they say you should check eligibility for NHS CHC prior to a local authority assessment is to avoid the "client" from being charged by the LA when they could be eligible for NHS CHC. So it's not too late to apply. You can also appeal if you don't agree with the decision.
In my Mum's case, several years ago, we weren't even told it was an option, it was only after the subject was in the news a couple of years ago that my sister and I looked into it and realised she qualified...after paying a fortune in Nursing Home fees for several years. We're still in the process of trying to claim it back.

So, you need to initiate it yourself if it's not been mentioned to you. As Cymruambyth says, I'd start with the GP.

I've attached some documents you might find useful, including the "Continuum of Care Needs" that the professionals use as part of the assessment, to give you a better idea of eligibility. The left column describes needs coming under LA or residential care, the middle column can be either LA or NHS depending on severity/complexity and the right column describes needs which fall under NHS continuing care.
Hope this helps a little, and do let us know how you get on.

[Undercover Elsa]

Re: Continuing Healthcare

PS, yes it's odd, I was using the name Undercover Elsa long before I came here, must be fate where I ended up

[IF]

Re: Continuing Healthcare

PS, yes it's odd, I was using the name Undercover Elsa long before I came here, must be fate where I ended up

[lookingforward]

Re: Continuing Healthcare

Hi again,
To answer your question above, the only reason they say you should check eligibility for NHS CHC prior to a local authority assessment is to avoid the "client" from being charged by the LA when they could be eligible for NHS CHC. So it's not too late to apply. You can also appeal if you don't agree with the decision.
In my Mum's case, several years ago, we weren't even told it was an option, it was only after the subject was in the news a couple of years ago that my sister and I looked into it and realised she qualified...after paying a fortune in Nursing Home fees for several years. We're still in the process of trying to claim it back.

So, you need to initiate it yourself if it's not been mentioned to you. As Cymruambyth says, I'd start with the GP.

I've attached some documents you might find useful, including the "Continuum of Care Needs" that the professionals use as part of the assessment, to give you a better idea of eligibility. The left column describes needs coming under LA or residential care, the middle column can be either LA or NHS depending on severity/complexity and the right column describes needs which fall under NHS continuing care.
Hope this helps a little, and do let us know how you get on.

That's brilliant thank you so much.

Mums back in hospital again tonight with dehydration, she's got an on-going problem with her legs and the water comes out of them as fast as she can drink it. Hopefully picking her up tomorrow though :-)

[nightwatch]

Re: Continuing Healthcare

Hi LF hope Mums ok.
Old lady that I have known for past 25 years was in hospital a couple of months ago with that problem, they never did say what caused it, she was in a week while they tried to find out what it was, she is home now and seems to be a lot better, although a lot more confused then when she went in, I think that is just how she is though,
best of luck on the assessment of her care needs, get nagging that Dr. x

[lookingforward]

Re: Continuing Healthcare

Hi LF hope Mums ok.
Old lady that I have known for past 25 years was in hospital a couple of months ago with that problem, they never did say what caused it, she was in a week while they tried to find out what it was, she is home now and seems to be a lot better, although a lot more confused then when she went in, I think that is just how she is though,
best of luck on the assessment of her care needs, get nagging that Dr. x

They are keeping her in over the weekend, we're going to use this to ask the nurses if they can do the initial assessment to get the ball rolling.

With any luck she may also get assigned the re-enablement carers for a free 6 week period again too, that would help as we've literally just started paying for carers to come in.

[TibetanMonk]

Re: Continuing Healthcare

Hey OP

I used to work in a Nursing Home, there's two types, Nursing and Residential.

The majority of people staying there paid for themselves, however, it can be Social services funded. From what I know they're good when assessing. They look at the whole picture rather than just at what your mum is going through. The knock on affect it'll have on you and your family.

No harm in speaking to your GP.

I hope it gets sorted, when my Nan had cancer the best thing we ever did was speak to our GP when her health deteriorated.

TM

[nightwatch]

Re: Continuing Healthcare

They are keeping her in over the weekend, we're going to use this to ask the nurses if they can do the initial assessment to get the ball rolling.

With any luck she may also get assigned the re-enablement carers for a free 6 week period again too, that would help as we've literally just started paying for carers to come in.

sorry she's having to stay in, but glad it gives you the opportunity to get the ball rolling. Best Wishes NW xx

[lookingforward]

Re: Continuing Healthcare

Update,
Mums now been given the all - clear for discharge so having asked about CH several times we met with the discharge head honco who went through Mum's details with us and said she doesn't qualify. I can't remember all the details but you need something like 2 A's and 3 B's minimum to get it under the headings.
Mum's legs which have ulcers and need dressing everyday and will never get better according to the consultant were rated B for example, when I said they surely should be an A I was told that to get that her "sores" would have to be down to the bone.
You could be bed ridden but as long as you can co-operate when being washed etc you would only get a B or C
There's lots of evidence that needs to be provided by the "team" to get it as well, she said they don't hold back and if someone's entitled they will get it.

It became apparent during our chat that even this person thought the system was unfair regarding paying for care and said she wasn't leaving any money in her account when she was older.

We can ask to be assessed again via the district nurse for example should anything change with Mum's condition.

We then met with the social worker who again said that because Mum had been assessed by the council as having to pay we had to sort out the care package ourselves, they would advise if required but can't provide.

From Mum's point of view and on a purely selfish point of view this is not what she had saved the money for, it was to give her children some money when she died. Sends out the wrong message at a time when the Gov are asking people to save for retirement that if you do they will take it but if you have no money you will get the care paid for.

Not that I have any money but I wouldn't save anything even if I did, I think you've either got to have loads or nothing at all, it's not worth being anywhere in the middle