DM going into care - what happens at an Assessment?

[WhoisitnowRalph]

My DM has had Alzheimer's Dementia for 3 years, and over the last 4 months she has lost about 80% of her mobility - she can just about shuffle with a walking frame, but she's falling over repeatedly now and paramedics have been out to her on about 6 occasions since October - 3 of those in the last 7 days.

I managed to double her private care visits to 4 per day over Christmas, right up to the earliest date I can get her into respite care which is new years eve - she obviously isn't safe and can't go on like this, I'm on tenterhooks all night wondering if she'll fall getting up for a wee, and although daytime is easier most of her falls have happened after lunch when she tries to "rush" to the loo but there's no carer there.

The care home (which is fabulous, costs a small fortune but it's worth it) is coming to do a needs assessment on Monday but haven't told me what it entails. What do they do, will they ask her questions and try and get her to demonstrate how poor her mobility is? Am I able to be with her? She finds interactions exhausting and I don't want her to feel humiliated or as though she's failed a test.

I have so much going around my head. I have cameras set up in her flat (mainly for her front door, as she sometimes wanders) and one has just alerted me that she's got up to go to the bathroom. I'll be in a state of anxiety until it picks her up coming back. I'm 30 minutes drive from her.

I'll be so relieved when she's safe in care (3 days and 3 nights to get through without caving in to a hospital admission), yet so sad that it's come to this.

I need to get into bed so haven’t read the full thread but your lo May qualify for Chc

If you do nothing over the weekend, study the prof Luke Clements video on YouTube on social care

It’s brilliant...
You also should be offered a dst meeting
If you need any help please let me know tomorrow

Remember a week met need is still a need..don’t be fobbed off
My aunt paid £125k into the system when she should’ve had chc ..she had a cursory meeting while she was in hospital ...was told she didn’t meet the requirements..with Alzheimer’s and cancer, the poor women didn’t know where she was , couldn’t feed herself, was doubly in continent and was turned down
She never made it out of hospitality died 5 weeks later.

Will do, thanks Dowser!

I've submitted the online assessment form for CHC. I doubt she is poorly enough and she isn't being discharged from hospital but it's worth a go! I have to reapply for AA as well, she got turned down when I applied just prior to her first fall.

Just realised I didn't put type II diabetes or hyperparathyroidism on the form, only the alzheimers and poor mobility.

i believe the assessment tool used almost internationally is called the MDS RAI (home and once in facility residential).
it's a series of questions that really need to be answered by the family (as the clients generally are not able or not fully aware ) starts off with demographics then moves on section by section it even includes religion. even an experienced long term care assessor will take a good 2+ hours time to complete the questions (and more if family not present).
most of the questions are "in the last 3 days", some are "in the last 90 days". how many times has the client fallen in the last 90 days, how many hospital admissions etc.
it's actually good if the past 3 day or 90 have been particularly dreadful as it gives a better picture of what the client and family have been dealing with.
one of the final questions is a full list of all medications/prescribed and non prescribed as well as herbal remedies (yes even camomille tea)taken.
it's a computer generated questionnaire but there is room to add in additional information.
it really allows a good picture of the client to develop.
don't be shy (and if you don't want to mention something in front of your mom, use your body language to indicate inaccuracies; such as raising your hand or shaking your head) then meet in private to allow the information to be updated.

Dysphagia (the difficulty swallowing) is a symptom of various forms of dementia, it's something that a good care unit will assess regularly. They can prepare her food to different consistency, and add thickener to food/drinks too - they will be very aware of it. It's hard to hear, but chances are she won't throw up, it does sound much worse than it is, try not to worry, and just watch out for things like big chunks of meat and such that need a lot of chewing. Soft and easy, little and often...

Ask social services or heallth visitors about over night care. There are usually tw o types - Marie Curie offr some free overnight but its not regular its when they have availability and often this works hand in hand with a service called Hospice at home. Which offers something similar on the NHS again they ring on the day if they have availability

The Assessments are pretty straight forward and it should be social services arranging this not the home itself - they should be doing a physical and mental Health assessment and seperately a financial assessment

This is the video..it’s very informative
It’s an hour but broken down into bite sized chunks
Make notes on each section

If you can take someone along with you who can prompt you
There were three words we needed to remember I’ll see if my husband can remember them. I think they are discussed in the video.
One may be challenging needs. My lovely mum had become aggressive and would kick and bite
The care home she was in wanted her out After 4 years so they were actually quite supportive
After she was moved to a nursing home, there was another chc meeting
It was supposedly at 3 months but due to a hiccup we had it at 6 months
I just felt the SS officer wanted to take the funding away..however my husband didn’t quite chant a well met need is still a need but he did pipe in, yes that’s cos her needs are met.

I hope you got the information and it went well

It went OK in the sense that they are happy they can accommodate her needs - yet, he took just 20 minutes to ask questions, didn't seem to think her dementia was particularly apparent, and asked in front of her "does she know?"

I thought it could take up to 2 hours!

DM was quite confused by it all and now I have to tackle tomorrow. What if she gets upset or has a meltdown, I really don't know what to say or do.

With regards to being turned down for AA
Reapply. - and ask for it to be backdated to your original application as well

The fact that she now has carers 4 times a day to assist her would generally mean at the minimum she would get low rate care
But if you add that she needs night help - ie even by you watching her assisting her she would get high rate
If she is on any medication get a copy of the prescription
If she is diabetic or has any long term illnesses that may not be on her prescription tell them
about that
If she has a blue badge photocopy it and send that as well

State that your mum needs help taking her medicine
That she is not capable of dressing or undressing herself without assistance - hence the carers that come in 4!times a day

Get a doctors note confirming she has Dementia/Alzheimer’s and send that off as well

Also apply for a blue badge as they are available for people with dementia now
You would just need a doctors letter confirming that she has dementia and to mention her problems with her mobility

On the AA form Use words like. My mother needs assistance to take her pills otherwise she won’t know which ones to take due to her Dementia
She is not able to take her pills without assistance

Words to use would be my mother needs Assistance to do XYZ This could be all of these things ,bathing, toilet needs, cooking food preparing , getting dressed

Getting ready for bed, getting up in the morning

So words like My mother is not capable to do XYZ in a Safe manner without assistance from another person
You could also have the care company that you use to write a quick letter confirming that they visit 4 times a day now

With a lot of DWP forms it’s all about the keywords that highlight what’s wrong
Keep copies of everything and photo copy the AS form

I need to reapply but the rejection is dated July - do I have to do the entire application again?

Going into a care home is a massive move but the right one from what you said.

What I am concerned about it you are doing this all alone without any input from adult social care. The issue here is you said your mum is only just over the financial threshold. That means when your mum funds run low, she will be entitled to help from the council with money.

Now, if the care home do not accept local authority rates then you will have a problem. I have seen residents be moved from care homes by local authorities due to the high rates. This can be distressing for the client.

Care home 20 minute assesment is not surprising. They want the money and custom. I would advise you to contact adult social care and ask for an urgent assesment, they can help you through this process.

I would worry about the financial implications in the future if I was you.

In queue for assessment from adult social care, I have spoken to them. Also discussed implications with home if mum outlives funds - all state funded homes are full anyway, so they usually renegotiate lower fees with council so people can stay.

With sale of property mum has about 3 years of fees. I've done nothing but worry about financial implications.

Yes you would need to do the AA form again
I can’t remember if it’s PIP or AA but you need to have needed the help for at least 3 months and that’s it’s not expected to get better within a further 6 - 9months I think both AA & PIP are the same requirement
But the fact that you applied in July means that your mother needed help then but because it had only just started with her falling she wouldn’t qualify as she hadn’t hadn't been like that for 3 months ( technically )
So when you reapply make sure you mention that how long ago she started falling.

And also how long she has been diagnosed with dementia.

Definitely get a doctors letter confirming this and send a copy of your mums prescription
And also apply for a blue badge
If your mum has been diagnosed with dementia a few years ago and you mentioned that in the form then she should have really at a minimum got low rate care which is help during the day time

In case you aren't aware of it there is a very helpful elderly parents board on Mumsnet, full of people who are going through similar and understand the difficulties and emotions.