Three weeks ago my father had a bleed on the brain. The bleed was found after he was taken into hospital for a suspected chest infection.
My parents are ordinary folk who both worked for government services during their working lives.
To begin, for the last few years my father has struggled with walking, requiring support and equipment as an aid, so he is prone to the occasional fall. He has COPD, and follows 10 years ago when he was admitted into the same hospital with a suspected heart-attack, though never confirmed, at that time he lost a lot of body weight and muscle tone. Since, as above, he has struggled to walk unaided, wasn’t helped when he broke his hip 2-years ago over the Christmas period, and now has a natural forward stoop. Moreover, my father is not the man he was, showing signs of memory loss and at times social disengagement. What a transformation for a man spending many years supporting my mother who had developed a rare migraine condition, which is now under control.
So now, his life has become quite static, if not stagnant. He follows a set routine, says little, struggles to walk to and from the bathroom, seldom wanting to venture outside and use his swanky EPV. Mum who has, as I said, her own problems tries her best, along with selfless support from my sister and family.
My parents sold their primary home a number of years ago (alarm bells!), be cautious, and they now live with my sister in a converted downstairs layout. To that end, to date, my parents have not qualified for any Social Care benefit because of their invested savings and they have been recently self-funding private morning and evening care for my father. My mother could no longer fully manage my father and his when no one else was in the house to help with my father’s needs. They do qualify for the Gov.UK weekly Attendance Allowance.
However, since his latest episode in hospital, my father now requires an increased care package as determined by the NHS hospital staff – a consultant Neurologist, a physiotherapist and an Occupation Therapist plus the Ward nursing team. None of this care will be funded, as the local authority social care team say my parents do not qualify for any assistance as they have above the threshold in savings (£23,250 or £46,500) etc see articles on Social Care Means Tests. To reiterate, they decided to sell their home a few years ago, beware of the pitfalls when making this considered decision; and my father has been assessed of not requiring sufficient medical /nursing support to qualify for either NHS CHC or FNC funding. This decision is a mystery to us as in our opinion both his cognitive physical and mental state have changed, and he is double incontinent, and cannot currently walk more than two steps unaided. These are social ailments not medical it seems. However, my parents still qualify for the government ‘Attendance Allowance’ because they are older than 65 and they are self-funding at this point in time.
Explanations of NHS and Government Care Contributions:
- NHS England, Continuing Healthcare (CHC): https://www.england.nhs.uk/healthcare/
- Useful docs including the CHC Checklists: https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care
- Full or partial care costs may be funded should you fit the criteria.
- NHS England, Funded Nursing Care (FNC) – if you are not eligible for CHC: https://www.nhs.uk/common-health-questions/caring-carers-and-long-term-conditions/what-is-nhs-funded-nursing-care/
- An example you may qualify for the weekly £158.16 per week for instance.
- UK Attendance Allowance if over 65: https://www.gov.uk/attendance-allowance
- Example allowances start at £57.30 per week
Furthermore, it has been stated that sending my father to respite care will not assist him, as it is surmised that his mobility/cognitive state will not improve sufficiently in the short term. By either going home, or into a ‘care’ environment, this might enable his state of mind, and subsequently his physical condition to change with the regularity of life and a more inclusive feeling of familiar surrounds.
The proposed NHS care package for home care requires two nursing staff to support/assist his lifting and mobility and turning in bed to minimise pressure sores 5-6 times a day and night time attendance once – to turn him. The cost for the joint home delivery care package quoted by a local care company was between £8500 – £10000 GBP per month. This cost was also checked by the local authority Social Care team.
As I said, we applied on my father’s behalf for NHS CHC funding through the hospital’s internal Clinical Commissioning Group (CCG) Discharge Team, which was turned down. The completion of the CHC checklist is infamous – 2 A’s, or 5 B’s to qualify. Yet their representative said ‘Dad’ wanted to go home and be cared for by my mother. We, as a family, had already said this would not be practical on a full-time basis, and his downstairs bedroom required further adaptation, all driven by the revised 24/7 care need. We approached a local care home at the end of my parent’s road, 3 minutes from the front door – a superb facility. The cost of full-time care surprisingly would be approximately £5800 per month, so the family made arrangements to proceed into a purpose-built environment with on-hand 24/7 care (he was assessed at the hospital by two members of their nursing home management team) The CCG Discharge team then attempted to meddle and updated the local authority Social Welfare saying that we were effectively coercing my father into a move that he did not want, this was utter rubbish – this is a man who does not really know where he is, and he now becomes angry because of his disorientation apart from his physical limitations – who then attempted to block our immediate arrangement, even the hospital was pushing ahead with his discharge – they wanted his bed. After a lot of unnecessary upset, and challenge about who would pay for my father’s onward care. The social welfare representative even suggested he should go to respite care, so obviously had not bothered to read the consultant’s/doctor’s notes/recommendations. We took charge and resolved all, and Dad is now into the fifth day at the care home so we will see how all goes. He is now eating more regularly and getting used to his new surrounds which are furnished with items from home and his favourite riser chair. The care staff are wonderful. In due course, we have arranged for a private physiotherapist to attend, and we continue to assess what is best for my father.
All in all quite an experience, but in hindsight, I think I would advise anyone to avoid selling the family home first without extensive consultation and review, and look more conservatively at savings allocation.
So with my father safely ensconced in the care home with full care on hand 24/7, my mother then on day 2 tripped over a kerb on her way to visit him, gashing her forearm down to the elbow, exposing the bone, and bumping her head, ending up in hospital – oh my! In life, it is certain that we all will get older, but none of us can really plan for what might happen to us even with the best-laid plans.
But, I am left thinking what happens to those who take-up out an equity release plan for their home from one of the providers who use enticing television advertisements and then find themselves requiring care home support? Perhaps, a blog for another day.
The Grey Chameleon 