All posts tagged Attendance Allowance

A Family Carers' Tale – Caring For Someone With Dementia

Here is a story about how my elderly care consultancy, Relative Matters, helped two sisters care for their elderly mother who was living with dementia, at home.

Emma and Ruth’s Story

Emma had been concerned about her mother Martha for a while, because she had been showing signs of dementia, such as repeating questions to Emma and becoming confused when she carried out basic tasks like preparing scrambled eggs or heating a pizza. Eventually Martha was diagnosed with Alzheimer’s disease, the most common form of dementia.

At first Emma and her sister Ruth, took turns to stay with their mother but soon found they could not keep it up. We found a small day centre not far away, which specialised in looking after people with dementia, so Emma arranged for her mother to attend, five days a week. This enabled Emma to continue her career as a physiotherapist and her sister to spend more time looking after her husband, who recently had a stroke. We pointed out to Emma and Ruth that when Martha attended the day centre, she would be kept safe, socially stimulated, receive nourishing food and regular drinks.

As their mother’s disease progressed, we helped Emma and her sister to claim the higher rate Attendance Allowance and arrange for regular carers from an agency to provide care and support for their mother before and after she attended the day centre.sisters

To help provide consistency, we advised Emma and Ruth to set up a Care Journal for their mother. Whoever was with Martha, would record the important details of their shift, such as food eaten, fluids consumed, bowel and bladder movements, activities accomplished and other relevant information.

Emma, Ruth and the care workers became proficient at using the hospital bed and hoist provided by the district nurse, a wheelchair, wheelchair ramps and a food processor to prepare easy to chew, soft food as Martha had chosen not to wear her dentures. We suggested Emma and Ruth arrange for Meals on Wheels to be delivered on a Saturday to give them a break from preparing food and free up time to take their mother out.

When their mother became ill with pneumonia, Emma took special leave from work and moved in to look after her. During Martha’s last forty-eight hours of life, she was loved and comforted by Emma and Ruth, attended by the district nurse and heard her son’s voice over the phone, all the way from Australia.

Myth-busting Care for the Older People

When your elderly parents need care it can feel daunting as you have probably not had experience of the elderly care system before. Let me try and help you understand more about it by dispelling some of the myths that surround care for the elderly.

The state will fund my parents care and provide support to arrange it won’t they?

Older people will not receive any financial help or practical support  from Social Services if they;

  • Have savings, investments or assets (including their property) above the current limit of £23,250. ▪ Are considered to have enough income to pay for their own care.
  • Do not have high enough care needs to meet their tightened eligibility criteria.
  • Are able to arrange care and support  themselves or have a relative who is willing or able to do so on their behalf.

For those people who are eligible for social care funding, only their basic needs will be met and they may have to contribute towards the cost, in some cases quite significantly. If your parent is funding themselves in a residential home and their money runs out, Social Services has to take over funding their care fees. However, they may have to move into a smaller room in their care home or move to another home altogether if the home refuses to lower their fees to the maximum that Social Services are willing to pay.

While the eligibility for NHS Continuing Healthcare funding has always been restricted to those with the highest, most complex, unpredictable, and unstable health needs, the interpretation of the eligibility criteria has become tighter and the same applies to the Registered Nurse Care Contribution (RNCC).

Social Services will provide care at home for my parents if they need it

Social Services will only provide in-house care or commission agency care if your parent meets the criteria outlined above. Even if  they meet the criteria, most Local authority Social Services Departments will only fund personal care and will not help with daily living tasks such as housework, shopping and preparing food. Some authorities are stricter than others and it’s always worth checking first. It is also important to check whether your parent may be entitled to welfare benefits such as the Attendance Allowance which can be used to help pay for their care and support.

Social Services will take your parents home away to pay for their care?

This is not necessarily true. Property will not be taken into account for home care support or if the person going into care has a spouse or dependent relative living in the home.

Care provided by charities and not for profit organisations costs less than commercial ones?

This is not true. Businesses and not for profit organisations have to operate a business model and make a profit. The only difference is that that they use their profits to develop their services. In my experience some so called not for profit organisations can actually cost more, especially if they have a bureaucratic infrastructure.

If my parent’s are eligible for NHS Continuing Healthcare (CHC) funding they will not have to pay for their care.

Also untrue. If your parent is awarded CHC funding they will be reviewed each year to see whether they have improved in any way and no longer meet the funding criteria. With painful funding cuts ongoing, sometimes NHS assessors interpret the national assessment tool differently so the person is no longer eligible for funding. If this ever happens to your elderly parent, there is an appeals process. While not for the faint hearted, because it is time consuming and log winded, it is usually worth doing as thousands of pounds can be reimbursed and saved if you eventually win.

The care landscape is changing rapidly and new legislation is on the way. As Social Services and the NHS seek new ways to meet the demands of the ageing population, having to do more with less will be their mantra and we will be expected to play an even bigger role in caring for our elderly loved ones. It is therefore vital that you understand and anticipate realistic funding entitlements to enable you to help your elderly parent plan their care. Check to see whether Social Services or the NHS might contribute towards the costs. Without this information you might make misguided decisions about your parents’ care and support and how to fund it. You can find out more at http://www.patient.co.uk/showdoc/3

Checklist of Benefits and Other Payments (2016/17)

From April 2016 there will be no increase for most benefits for older people with the exception of pension benefits

Read more

You don’t have to put mum into a care home

Soon after I set up the Hospital to Home service at Relative Matters, I received a call from my friend Jan. She was in quite a state because she had been told that her mother, who had a stroke a few weeks before, was ready for discharge from hospital and needed to find a care home. While needing a lot of support, her mother did not meet eligibility criteria for CHC funding, or funding from Social Services, as she had savings that put her above the financial threshold. Jan had been given a list of care and nursing homes and asked to arrange her mother’s move as soon as possible as the hospital needed her bed. People who do not qualify for funding from Social Services do not usually receive support from a social worker.

Jan’s mother is a widow and felt strongly that she did not want to live in a care home. I told Jan this was not the time to make a rushed life changing decision and advised that her mother was entitled to 6 weeks intermediate care free of charge, regardless of her means, so we could find a suitable care home for her to convalesce for a few weeks, while we planned her long term care.

I worked with the Hospital Discharge Team and manager of the home to design a care plan that had a rehab element built into it and Jan’s mother moved to the care home a few days latter. The care home was great and played a positive part in building her confidence.

While her mother was in the care home we began recruiting a small team of personal carers. After her mother had been in the home for 4 weeks, and in consultation with Jan and her mother, I arranged an OT and care agency assessments so agency carers could continue with an updated care plan at home, while waiting for the personal assistants to start. (Recruitment of a personal assistant can take around12 weeks, including reference and CRB checks) 

Today a small team of 3 part time carers look after Jan’s mother and she is living happily at home. The carers work less, and therefore cost less, because Jan covers some care at weekends and we use the following pieces of equipment.

  • A community alarm and personal response service
  • A fall detector
  • A bed and chair sensor
  • A computer for shopping etc.

We also arranged for her mother to attend a local Stroke Club where she has made new friends.

As well as respecting her mother’s choice to live in her own home and giving her the best quality of life possible, I saved money by finding the right placement (home support as opposed to living in a care home), maximising her income by applying for higher rate Attendance Allowance , using equipment to improve independence and her mother’s existing support network.