Funding for nursing home

[Hittapotamus]

MIL has ever worsening dementia. She's currently in hospital and after the conversations we've had with her it's becoming increasingly obvious she is unlikely to be able to be discharged home.

She has some funds and I wondered what funding might be available for her nursing home care? What are the thresholds for self funding vs social care vs NHS care? What might she be entitled to? She also has diabetes which isn't under control. She has a district nurse once a day but her afternoon levels are very high so realistically needs 2 injections a day. Presumably that will be funded by a district nurse going into the nursing home twice a day?

I would really appreciate your advice on this as we add her to the waiting list for a place in a dementia care nursing home.

You dm may be eligible for funding- contact age uk for advice'. Does she have an admiral( Alzheimer’s nurse)
yiur local authority adult social care team can help and advise. She may get a funded place on discharge- make sure you are really clear about what she can and can’t do and what support she has….. “ unsafe discharge “ is a useful phrase. There should be a discharge coordinator at the hospital. Make sure your dm doesn’t say family will look after her…….

She’ll need a financial assessment by social services.
I think the cut off for savings is about £23k and if she has more than that she’ll definitely need to pay
if her diabetes is very unstable and unpredictable there is a chance that she may qualify for nhs continuing care in which case the nhs pays for her care (up to a certain amount - you can top
it up if the chosen care home is more expensive)
this is a handy webpage www.ageuk.org.uk/information-advice/care/paying-for-care/paying-for-a-care-home/

Both really useful posts thank you. I'll follow up with those avenues.

No dementia nurse yet. The last week she's gone significantly downhill in that area.

They were talking of discharging her so someone needed to be with her 24/7. There is no someone who can do that so unsafe discharge will be used.

My mum doesn't have Continuing Healthcare. She was assessed by Social Services and is "fully funded" however she still pays the bulk of her income as her contribution. Basically they take everything above £ 32.00 a week. As her wardrobe is full, all toiletries are provided all she needs to pay for is the visit from the chiropodist every couple of months and the hairdresser if she wants it done. I have tried to persuade her to have her hair done but apparently at £15K a time it costs too much!

If she does have some savings above £23k, it might be worth prepaying for her funeral now as this may take her savings down towards the £23k cut off?

Don't worry. You don't have to do anything yourselves just now other than inform yourself about processes.

The hospital will have a discharge team who will arrange assessment and funding required before she's discharged. She will not be assessed for CHC funding until she is out of the hospital, usually.

She won't be medically fit for discharge yet otherwise they will have told you already. Ask the ward staff if you can have the tel number to speak to, or be referred to the discharge team when she's ready and they'll take it from there.

Bit late to reply, but does your mum own her own home? If she does then that will be included in any assessment which will take you over the £23k, so it will need to be sold in order to fund her care. I've just been through this with my own DM. She had no savings at all...literally just lived off her state pension...and her tiny northern terraced house just sold for £118,000 so hardly a fortune. Poor sod worked all her life in a factory (as did my dear old dad!) and this is where we are now. Breaks my heart really 😢

Yes she does. We're having to self fund private carers at the moment because the OT keeps trying to sign her off. But then calls DH to say she has concerns. Yes! So do we! And we need that help now! He's found a home for her but he's trying to eek out her independence as long as possible (she goes out and eats sugary foods which makes her blood sugar levels rocket, she has a 'funny turn', ends up in hospital, back to square one). I'm looking at increasing her carer hours so she can be accompanied to these cafés and advised about better diabetic friendly choices. I think it's going to go down like a lead balloon but I can't do nothing!

Still haven't got anywhere with CHC.

Yes, definitely do this. We did the same for my parents when it became apparent that residential care was needed.
The assessment for continuing healthcare is arduous and you're very unlikely to get it.
My mother was bedbound, needed significant nursing care, unable to feed herself and suffering from dementia and severe depression. Frankly it was a joke.
She was going to be discharged from hospital back home. She only went to a rehab unit when my brother asked "Can she actually walk?"

Look at nursing care now rather than a move from a residential home which will eventually be unable to meet her needs. It was quite distressing for my mother.

She's gone significantly downhill since I posted and will be moving into a nursing home next week.

Can she still receive CHC funding whilst in a nursing home? It's phenomenally expensive and she couldn't afford to live there more than 5 years without additional funding. (it's the going rate in our area. We haven't deliberately picked an expensive one!)

Yes she can. Ask for the home to complete a CHC Checklist. Whatever the outcome they should send it to the Integrated Care Board (or whatever they're calling it there). If she the checklist says she should continue to the next stage of assessment, they'll take it from there.

If it says that she doesn't, her finances should be assessed by the council instead to see what she pays towards it. If she doesn't meet CHC criteria, the ICB also sort out the Funded Nursing Care element if they havent already. (£209.19).

For the council financial assessment, it is only her finances and assets that are assessed, no one else's.

In the nicest possible way very few indeed will live five years in a nursing home if they are that bad going in.

If you said in February that she would be in a nursing home in September I would have thought you were talking nonsense. I cannot believe how quickly she's gone downhill 😞

Attendance allowance is also paid if she was claiming it before

She hasn't been claiming anything before because she didn't really need it (apart from the district nurse for her insulin). May I ask what an attendance allowance is please?

My mum went downhill (dementia) significantly (thanks lockdown) and we had to move her to a home, I thought should wouldn't last long.
Although she now looks very old and frail her dementia stabilised quite a bit (not better or worse) after a few months and she's now been there 2 years.
I always think she looks so frail but she still gets about independently and now the home provides her food and assistance to eat and drink and her medication she's stabilised quite a bit with regards to her physical health too.

What would you say about her quality of life @wonkylegs ?

MIL has given up golf, doing crosswords, watching TV. I'm honestly not sure how she fills her day (although her house and clothes are clean and tidy so no issues with hygiene/personal care etc).

Curious- how do you know that she requires a nursing home, rather than residential with district nurses, or home with maximum level of support, or even a dual registered, if she has not had any assessment of her needs?

I am only assuming she has not had any assessment because all of the questions you have asked would have been answered throughout?

@Hittapotamus my mum is further down the road than yours - she can't wash, dress or feed herself although she's still mobile and quite active she just doesn't know how to do those actions any more.
When she was at home still with carer support - 4 visits a day, we had a befriending visit as well a couple of days a week as she could no longer do many activities on her own but would do knitting, jigsaws, painting, pottery and baking with someone else, she also would watch tv (she wouldn't do this in her own) or have a book read to her as she forgot how to read, or play the piano but only with someone else there. We had one visit provided by social services and one we organised privately and she also went to a singing for the brain group, a day centre visit and a dementia art group. She liked to walk a lot and have company - which is still the case and the home helps with this as she has company 24/7 and is set up so she has a fairly wide safe walking access around a largish area of the building and grounds and cannot get lost .
The only thing she did completely by herself when at home was colouring which she took to with a passion.
I got her bic felt tips - they do big packs of them, that it doesn't matter if the lids get left off they don't dry up, I think they are meant for schools (Amazon) but they were great, and adult colouring books - (the works, home bargains, the range - if you don't want to spend a fortune)
It's funny because she was the least artistic person in the world but dementia unlocked a passion for colouring and painting that she never had before.
She still loves music and the care home has visiting singers and bands and also put on CDs in the lounge and her room, which she comes alive for.

The home she's moving to offers respite and post hospital rehab as well as full nursing home care. She has multiple needs at the moment which the private carers we employed said were in excess of what they could offer. The district nursing team have refused to schedule an afternoon insulin visit without 2 weeks at home regular insulin level results. However because her levels are so high in the afternoons she hasn't been out of hospital for a full 2 week period in months because she keeps falling and being admitted. We upped her carer hours to also take more readings but it was a couple of days short of the 2 weeks when she fell this time so we were back to square one with that team who were refusing to pay her an afternoon visit without 2 weeks data. And thus the cycle continued. MIL has told her friends and sisters (as well as us) she wants to be in a home. We didn't want to move her to a temporary half way place and then move her again. If she needs to stay here then she can. If she can go home then we'll need to find some new carers and hope she stays out of hospital for 2 weeks to gather the diabetes data.

@wonkylegs that sounds like she's got some joys in her life. MIL is very down at the moment. It's a uniquely personal reason why and if I was her I would be depressed (not related to her medical needs). Her friends visit her in hospital or at home when she's home but yes she doesn't do things on her own anymore. DH describes her as passive. I think company would be beneficial but she's also very private and won't talk to anyone in her gated retirement complex. I know this because her neighbour told me!