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continuing care for my elderly father?


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Some more news... The residential home have agreed that my father's needs are greater than they can provide and his room will only be held to the end of this week. I've spoken to the hospital care manager and they are waiting on a decision as to which level of nursing care my father needs as well as a decision on the funding. I've also received a copy of the care home's notes. They've listed 9 accidents/falls in the 6 months he's been there, most of which were in the final month or so.

My father has stabilised as much as he's able to I feel. At least he's getting the assessment he so obviously needed.

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Thats good news that your father has stabilised and he is getting the assessment. i dont think its a case of you being fobbed off, i think its more of a case of join the queue in their eyes, however I would have hoped they would have been in contact with you speedier than they have been. The sooner an assessment is done you at least know what to start looking for and where to look for the best for your father. Let us know the outcome of the assessment when it is done, bear with it, it shouldnt take too long now.

 

Trix x

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The hospital care manager has phoned today to say they have assessed my father as needing nursing home care (not EMI). She also said my father doesn't meet the criteria for continuing care. I'm having a meeting with her tomorrow to discuss it more fully.

Any tips on the questions I should ask would be gratefully received.

 

Dee

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It's no surprise that they have said your father is not eligible. It seems to be a standard tactic, especially if they know there is money to be had from a persons assets. Have they supplied you with a full copy of the assessment? And it would be worth asking who sat on the assessment panel that decided he was not eligible, in terms of their professional capabilities.

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I had a frustrating meeting with the care manger today, although she was as helpful as she could be - it's just the system that's at fault. It now turns out that my father hasn't had a full assessment for continuing care (as I'd previously requested in writing). It seems the hospital have a form with a checklist where a nurse ticks a few boxes on a list of criteria and if the patient doesn't have enough ticks a full assessment is not carried out. In other words they are assessed to be put forward for the assessment (or not) and my father was turned down at this stage. I said I would still like the full assessment to be carried out as I'd previously requested. She said they would do it but it would mean my father remaining in hospital until a decision was reached on funding. I feel caught between a rock and a hard place. I want him to be settled into a comfortable home as soon as possible obviously, but going ahead with the CHC means delaying this. I feel awful.

 

On a positive note she has recommended a short list of suitable nursing homes (not EMI) which I can now go and look at. I still don't have any paperwork but she will make that available tomorrow (regarding the assessment for nursing care).

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I have insisted on a full continuing care assessment. I've had a phone call from yet another person and she wants to meet with me tomorrow to discuss it. If I still disagree with them (they don't feel my father meets the criteria so don't even want to put him forward for an assessment) then they will go ahead with it. It seems you have to jump through hoops to even get as far as a proper assessment.

 

I have insisted on a full continuing care assessment. I've had a phone call from yet another person and she wants to meet with me tomorrow to discuss it. If I still disagree with them (they don't feel my father meets the criteria so don't even want to put him forward for an assessment) then they will go ahead with it. it seems you have to jump through hoops to even get as far as a proper assessment.

 

I have seen a copy of his needs assessment and there is an awful lot missing, particularly under the section on mental health. When I enquired about this with the ward manager she said they have to be careful not to 'label' him and remarked I wouldn't want him to end up in an EMI home would I? I replied I wanted an accurate reflection of the facts, I didn't see that as 'labelling'. He had been aggressive on the ward on at least one occasion (and previously in the residential home) and yet they stated there were no instances of this on their assessment! She just kept saying he was a very pleasant man. I 'm not saying he isn't, just that when his mental health is disturbed he says and does things he wouldn't do normally. I feel as though they are trying to minimise his needs.

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Thanks. I will have a look at that site.

 

I'm just wondering if I should pursue a different angle in addition to the continuing care. I believe I mentioned before that my father was in the secure mental health unit at the hospital for a period of months last year. He received ECT treatment etc. I'm currently requesting to see his notes from the mental health team as there is a possibility that IF he was in hospital under s117 of the mental health act he should be provided with free aftercare. I now have a letter to say that my father was on enhanced CPA (Care programme approach) when he was discharged last year and that was why he didn't have to pay for services then.

 

I'll await the notes and take it from there.

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As someone who has fought the NHS and won regarding Continuing Care funding for my mother, I know how difficult it can be. By gathering every last scrap of information regarding your father's health, you are off to a great start.

 

Unfortunately I don't have much computer access time at the moment (building work on my house at the moment and a half broken computer which won't work half the time).

 

But when I'm back, I'll try to help if I can.

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I'm very pleased you won continuing care for your mother. Do tell me more when you have time.

 

Thanks for your input.

 

I have a meeting next week with the continuing care assessor and the care manager to try to sort out the inadequacies in my father's joint assessment.

 

Dee

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To be honest I don't know. There are so many people involved. My father has a care manager at the hospital - they come under social services don't they? There is a CPN involved, a consultant psychiatrist, the care manager, the ward manager, a consultant dermatologist and so on.

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What was the length of your Fathers assessment period when first admitted to hospital.Your father should have a primary nurse who should be able to explain treatment,nursing care and future management/nursing care.The assessment period is normally six weeks and is an ongoing process the primary nurse should be able to keep you informed and should be able to discuss/answer some of your questions/concerns.Your best approach is to demand a family meeting with all those individuals who are involved with your Fathers care.Also I note that your Father was in a secure unit,was he detained under the Mental Act.If so how often was he seen by the consultant.I am unsure about the Mental Health act in England,I am from N Ireland so would be more up to speed with The Mental Health Order (NI) 1986.One more question,has the care manager asked you to complete a financel assessment,this is done in order to determine if your Father is self funding.

 

Whizzy

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I've wrriten requesting access to my father's health records (with his permission) so that I can ascertain what section of the mental health act he was under when he was admitted to hospital last year. He was in a secure ward for a period of 3-4 months and had ECT treatment. However, I'm not sure if he was 'sectioned' as he was admitted voluntarily on the recommendation of the consultant. She saw him regularly then and continues to do so. I know that if he was under section 3 he should have free aftercare but so far the information hasn't been forthcoming. A financial assessment was done when he was admitted to a residential home in February and it was deemed he should pay for his care (after the initial respite period) as he has a property and some savings. We have asked for deferred payments. That was before I discovered all this information on the web. His place at the residential home is now closed as he has been assessed as needing a nursing home.

 

I'm having a further meeting with the continuing care assessor and the care manager this week to correct his multi-agency assessment as it was very inaccurate in places. My father has been in hospital for a month now. As far as I understand it's only the decision on funding that's keeping him in hospital and finding a correct home for him. They say they can do no more as far as rehabilitation.

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From experience its unusal for the financial assessment to be completed in the residential setting.The financial assessment is normally completed prior to discharge,or during the assessment process.Be sure that the nursing care plan/nursing notes are included in your Fathers health care records.Was your Father sectioned/detained under the Mental Health act while in the secure unit,you need to find this out.

 

Bigdess

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I have written to the consultant to ask what section of the mental health act my father was under while he was in hospital. I'll let you know of the response.

 

A further complication. A family member has been using my father's bank account inappropriately. He has joint power of attorney along with myself but only one POA could be named on the account. I've only discovered this abuse of trust after seeing some statements. I know I need to approach him and sort this out immediately but it is so hard. I feel it is such a huge betrayal. My father would be horrified. I feel swamped by the situation.

 

Dee

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  • 3 weeks later...

I have at last received a copy of the decision made by the panel not to award my father continuing care. All it is is a brief letter and a summary of the assessed care needs. It wasn't sent to me directly but a copy was addressed to my father and left on the ward. I received it yesterday evening when I went to visit . This morning I had two phone calls pressuring me to find him a nursing home placement as he is 'blocking' a bed on an acute care ward! They are saying he must be moved to a home even though the dispute over funding is ongoing. I will appeal against their decision not to award my father continuing care but I don't hold out much hope. I also feel I haven't been given enough information as to why he was turned down.

 

The battle goes on....

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You should have received a copy of the full assessment, not just a few summarys.

 

I know it's hard, but stick to your guns on this one. The law is on your side. If your fathers condition is comparable or worse than that of Pam Coughlan then his care should be fully funded by the NHS. They are using the pressure tactics very early, but be firm with them and state that you are not prepared to look for a home at this stage while the appeal process is ongoing.

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Thanks for your input Rob. I have sent off a letter of appeal. The continuing care assessor tried to arrange another meeting in order to dissuade me from continuing, but I refused.

 

 

A further development - I went to visit my father this afternoon and was told by the ward manager they will be moving him tomorrow - to a 'cottage hosptial' in a nearby town (about 12-15 miles away). She said she'd been trying to get hold of me all morning - funny that - neither my mobile nor my home phone rang...

 

It's still an NHS hospital, so I beleive, but it seems they place people there who are continuing care appeal cases.

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Yet another twist in this sorry tale - my father was taken by hospital transport to the 'cottage hospital' only to arrive and be told there was no bed available after all! He was promptly returned back to the ward he came from. What a fiasco! It's not going to help my father's depression in the least. Needless to say I made my feelings known regarding the matter.

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hi , l think the way you have been treated, and your father is disgraceful. My father is in a home for demensia, the social services are a law to themselves this is my tale.. This is a letter to social services l could not get a answer as my brother brrr veto any communication between social services and dad, this is by everyone only he can deal with it, whom we do know and not trust at all even if he got power of attornty with mum..

The letter is now a over year old.

 

I am writing this letter to say how shocking that my mother is being treated by the way social services choice to involve me in their questioning over financing my fathers care.

It started when, my father who has senile dementia were encouraged to go to day- care Mayfield centre .

 

I got a telephone called by the social services in relation to paying for this day-care place..

Somehow it was to believe that l was the best one to answer questions about my father’s financial affairs. I was asked questions did they have x number of pounds in savings etc… which l said they pay full council tax so they would at least £16000, in the bank…

Far as l know l was asked if they had any other money coming to them etc.. as far as l know l may been asked if they was in private housing l said no they moved to a council house, then they asked the previous house their own Yes! they would be selling it then l said l do not know at the time...

It was then l was told that by law that his portion of capital, if it is over £21000, he has to fund care himself. Also this would be in his own right he would have this amount before social services would fund part of his care..

When my mother realised that when she deducted her portion of savings, at the start of the day-care payments, my father could have been entitled to part payment or paid for free towards this service

 

Now few months later on my mother has been paying for his day-care and support for few months, sadly my dad had to go into care at P/Manor, because mum not fit to look after dad.. At home..

Then when the question of money raised to pay for this care, my mother did not know when the house sale has gone through. It was held up by legal matters due to my father has court of protection, l thought my brother was going to buy the house of his parents etc.. He was unable to do so in his name , because he has power of attorney over my father affairs and my mother also has this right too… My brother’s wife is to be the purchaser of the house..

 

My mother has signed papers only when l spoke to the lady on the telephone that my brother who was dad’s carer, he had right to his portion of the sale of the house… l did not realise or forgot that my brother had rights to his portion as his name is on the title deeds… so l had to explain this fact… to the lady on the telephone…I am sure that she did not believe me etc. … I did not know how much the house is being sold it is none of my business.

My mother had a telephone call 19th October 2006, she felt that they did not believe her when she said she has not had the money from sale of their house.. In saying this l am sure that my father was and is entitled to have his care payment for by the social service under the ceiling limit of £21000 before this day would arrive..

As his saving fell below this amount … eg saving book, far as l know my mother can prove this..

Also as my father has this court of protection my mother would ensure that he got his finances that is due to him . My mother would show she is telling the truth when she has the date of paying the sale of the house money to her husbands saving account. She will have the receipt to show…

It also has come to my notice after my mother had told me off for discussing their financial arrangements with social services at all… Again it was assumed it would be ok to do so it is awful that l was asked to discuss my parents business which l found very hard to do so..

 

Again, Social services should gone to those who have legal power to discuss the finances of my father’s care eg: my mother and my brother who has power of attorney Mr R … also his carer should be also involved person to person so all facts can be discussed..

In my eyes l was helping my mother who is not a fit lady, to realise that the questions would be raised who pays for what towards his care… but social services have told my mother l have told them about their finances , l spoke the truth to whom asked me questions.. Please ask those who have legal rights to answer all payments to his care from now on…

It is a strain to know your father is not getting any better, it was l who had to take him to the nursing home and leave him there…

My Parents never owed any money they hate debt, they are of a generation that they believed care is from cradle to grave.. Its is a very sad affair, l hope this letter will show that change is needed to approach this sensitive subject of financing care… ended

 

As it was mom's health dicated the move, there for the question of not selling the house soon as they left, but soon as social service got that they own property, Social services expect people who move out of their home to sell it straight away, no matter how the housing market is viewed or any family choices. Age concerned states those who move out of the home to residance or nursing care can appy 12 week grace of care and also deferred payments, social services said they never heard of it therefore it was denied to them .. in a pigseye. .. due to the inhuman practice of social services.. if it not for a carers group whom l am a member off. l gone out of my mind, l am not the only one keep on recompense, also find the law to the social service get the name of the mp, if your not happy.also if you know someone abused the power of attorny l would report them to the courts of protection.. it is abuse of their powers .. l have the feeling l may have to do this myself as l do not trust my brother at all, over another legal matter which l need a lawyer to understand the housing buying and selling business arrangements .. far as l know cab say we do not owe him any money and a lawyer accused him of being not honest.. another story

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Hi skydancing

 

Thanks for sharing your experience. The more I learn about social services and the NHS the more I am dismayed by their actions.

 

I went to visit my father tonight to discover he had a nasty cut on his head. When I enquired I was told it happened yesterday and next of kin were supposedly informed. My brother hasn't said anything and I certainly wasn't informed. My father seemed more confused than ever. Very sad.

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Thanks for sharing your experience. The more I learn about social services and the NHS the more I am dismayed by their actions.

 

 

Same here Dee. Their actions across the country are criminal.

 

Skydancings story is dreadful. Social Services and NHS know full well that in situations where both spouses are still alive, and one has to go into a care home, that they can not touch the property while the other person is still living there, but they try and pull the wool over peoples eyes and convince them otherwise.

 

It is forums like CAG, NHS funded Continuing Care and the Coughlan case and Free nursing care information that are spreading the word about the disgraceful behaviour of the authorities in plundering the assets of the elderly when they know full well their care is for medical reasons and should be funded by the NHS in full.

 

Just like the issue of bank charges, the more that know about this scandal the better. It has to be challenged.

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