Care Home Costs
Discussion
A friend of mine had to have his elderly mother moved to a care home, where she had a couple of small strokes and became more and more confused. Eventually she was diagnosed as having developed Vascular Dementia and moved to a home that specialises in looking after patients with dementia.
When she was first assessed, in a regular nursing home, he was told that her care would qualify under Continuing Care and as much her pension would be hers to keep. Unfortunately, once she had moved, he received a letter saying that she did not qualify and as such, nearly all of her income would go to the local authority. She has also been presented with a bill for some arrears, which he is now being held liable for.
I just wondered if anyone here might have been through the same thing, or could advise about who is and isn't eligible for car through NHS Continuing Care if they develop dementia?
Thank you.
When she was first assessed, in a regular nursing home, he was told that her care would qualify under Continuing Care and as much her pension would be hers to keep. Unfortunately, once she had moved, he received a letter saying that she did not qualify and as such, nearly all of her income would go to the local authority. She has also been presented with a bill for some arrears, which he is now being held liable for.
I just wondered if anyone here might have been through the same thing, or could advise about who is and isn't eligible for car through NHS Continuing Care if they develop dementia?
Thank you.
People who are in genuine need of nursing care should receive funding. There is a national framework which becomes interpreted in different ways by different authorities and quite often, patients can be led to believe they don't qualify when they do. The authorities have to give their reasons for refusal.
At the moment, because there is a so called 'dementia time-bomb' it is not in the government's interest to officially recognise dementia as a qualifying illness, although there is a campaign to get this changed.
Unfortunately, unless a patient is bedridden or has substantial nursing needs (i.e: more than feeding, getting dressed, washing, help with moving around), they will not qualify.
In my experience, the authorities will do their utmost to wriggle out of paying, especially when the patient has assets.
At the moment, because there is a so called 'dementia time-bomb' it is not in the government's interest to officially recognise dementia as a qualifying illness, although there is a campaign to get this changed.
Unfortunately, unless a patient is bedridden or has substantial nursing needs (i.e: more than feeding, getting dressed, washing, help with moving around), they will not qualify.
In my experience, the authorities will do their utmost to wriggle out of paying, especially when the patient has assets.
The first thing you need to do is to get a copy of her assessment. They tend to do an initial assessment but it's important for her to request a full assessment. This will involve different people who might have conflicting views on her needs. My experience is that medical staff, hospital and council social workers will try to pass the buck depending on whether it's NHS or local council who will most likely be funding.
Once she has the full assessment, the decision can be appealed if there is a good argument. You can ask for the assessment to be fast tracked if her health is deteriorating.
Unfortunately, these things take time, and more time is spent fighting out the financial side of things than enjoying their final days. The ambiguity and misinterpretation of the system is an absolute minefield. Even the professionals can't interpret the process properly.
Once she has the full assessment, the decision can be appealed if there is a good argument. You can ask for the assessment to be fast tracked if her health is deteriorating.
Unfortunately, these things take time, and more time is spent fighting out the financial side of things than enjoying their final days. The ambiguity and misinterpretation of the system is an absolute minefield. Even the professionals can't interpret the process properly.
Yes, I'm discovering just how convoluted and complicated the whole process is. The initial assessment was done by a lad at the most recent home, while I was there. I didn't actually realise just what it was he was filling in and with hindsight, it would seem neither did he. As it was, I had to pull him up on a couple of points, but I am going to go through the whole thing again. I have written and asked for an appeal against the decision and it seems that this is more common that I'd imagined. I know funding is limited but it's as if applications are automatically declined in the hope no-one will say anything.
e21Mark said:
I know funding is limited but it's as if applications are automatically declined in the hope no-one will say anything.
I tend to agree.I've found that the most frustrating thing is that you can't get independent advice - everyone seems to have their own agenda. Our local council give a list of independent financial advisors who specialise in healthcare but they are more interested in lining their own pockets. The charity websites such as AgeUk, are a useful source of information, as are the forums. My advice is: don't get fobbed off.
Apparently, to qualify for continued funding the patient needs to be in a nursing bed with qualified nurses on call; not a residential dementia home or rest home but this seems to conflict with some of the information in the government guidelines.
Remember that assessments can be requested every six months.
Qcarchoo said:
I've found that the most frustrating thing is that you can't get independent advice - everyone seems to have their own agenda.
There are firms of solicitors that operate in this area. I've no idea whether they'd operate on a no-win no-fee basis or if you'd have to pay up front, or whether what they do is reasonable or if it's a form of ambulance chasing.Short version.
Mum got confused, doc said vascular dementia, mum needed to be in a home, no one was doing anything so we put her in a Bupa home after seeing 4 others.
Once in home and we were paying we were passed from pillar to post and gave up it cost £45k a year but mum was in a great place.
Again we asked for help especially as we found out of 14 residents only 2 paid full wack! But this was a closely guarded secret.
Sadly mum died last year after 5 years in the home, I approached a specialist lawyer who work on a 25% cut of the win (claim is £235k ) we did the paperwork and stuff 7 months ago, they have 3 years to respond! That's our situation it stinks! But mum got the best care and that was the then priority.
Mum got confused, doc said vascular dementia, mum needed to be in a home, no one was doing anything so we put her in a Bupa home after seeing 4 others.
Once in home and we were paying we were passed from pillar to post and gave up it cost £45k a year but mum was in a great place.
Again we asked for help especially as we found out of 14 residents only 2 paid full wack! But this was a closely guarded secret.
Sadly mum died last year after 5 years in the home, I approached a specialist lawyer who work on a 25% cut of the win (claim is £235k ) we did the paperwork and stuff 7 months ago, they have 3 years to respond! That's our situation it stinks! But mum got the best care and that was the then priority.
3 months ago I sent a letter requesting an appeal be lodged, regarding the claim for Continuing Care Funding. I was told the relevant medical records etc would be sought and an appeal meeting would take place mid February. I called 3 times and wrote 3 times but no reply.
Today, I get a letter with a one line apology for the delay and asking me to submit a Continuing Care Appeal form! There's no mention of the previous promise to deal with this matter back in February. I'm just amazed at how poorly they've dealt with this whole matter. I'm just off to the Care Home, to see if they've heard anything, before I complete and submit this latest form.
Today, I get a letter with a one line apology for the delay and asking me to submit a Continuing Care Appeal form! There's no mention of the previous promise to deal with this matter back in February. I'm just amazed at how poorly they've dealt with this whole matter. I'm just off to the Care Home, to see if they've heard anything, before I complete and submit this latest form.
e21Mark said:
She has become very dependent (needing 2 nurses to be moved), can't mobilise, needs feeding and persuasion to take medications. Sadly she has been pretty much bedridden for the past 3 months, after getting a pressure sore on her back from sitting.
eligible for NHS funded Nursing Care in a care home but no where near complex enough for CHC - CHC funding is for Stephen Hawking level care needs, i doubt Frank Williams would qualify for CHC despote being a tetraplegic ( unless he's got really bad sleep apoena as well). 
Bump, as we're going through this ourselves. Wanted to share this for interested parties http://www.caretobedifferent.co.uk/paying-care-hom...
You may have to pay it and put a claim in, they are shocking in that we claimed over 15 months ago and they have taken so long to do anything the letter of consent expired we had to do a new one - our solicitor saus it typically takes 3 years for a judgement on a payment. We spent over 1/4 mil and whilst I dont expect it all paid I expect a basic level of care to be provided that we can top up.
My problem is that I simply don't have it. What little money there was paid funeral costs. As a result they are threatening County Court action and have even said they would chase any other family members for the money.
If they do take this to the County Court, will I be afforded an opportunity to put my case?
If they do take this to the County Court, will I be afforded an opportunity to put my case?
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