Does having Alzheimer’s disease automatically qualify a person for NHS continuing healthcare funding? The experts at Compass CHC explain why it’s not quite that simple…
As a company, Compass CHC speak daily with families battling to receive continuing healthcare funding for relatives in the advanced stages of Alzheimer’s disease, in fact, our ‘charity of the year’ is the Alzheimer’s Society so today we look at Alzheimer’s and NHS continuing healthcare funding.
NHS Continuing Healthcare is a package of care arranged and funded by the NHS in England and Wales and is delivered free of charge to the person receiving the care. To be eligible for continuing healthcare funding, it must be established that your need for care is primarily health related. Additionally, these needs must be assessed as being either complex, intense and unpredictable in their nature or a combination of the same. A person’s health needs – not their diagnosis – determines whether they are eligible for funding so having a certain diagnosis, for example having been diagnosed with Dementia, Alzheimer’s Disease or Parkinson’s disease, is not in itself an automatic entitlement to free care.
The funding can be provided for care in residential homes, hospices or in a person’s own home and it is not means tested. Whilst a diagnosis of Alzheimer’s disease will not automatically mean that someone is entitled to NHS continuing healthcare the complex health needs of a person with advanced Alzheimer’s means they are more likely to meet the criteria. (The continuing healthcare assessment process can be viewed here)
What is Alzheimer’s?
Dementia is an ‘umbrella term’ used to describe a collection of progressive neurological disorders. There are several types of dementia and some people may be diagnosed with a combination of types. People with dementia may repeat themselves often or have difficulty finding the right words and may experience increasing problems with communicating. Other symptoms can include short term memory problems, experiencing confusion and disorientation in environments which are unfamiliar whilst other people may hallucinate, and some can experience depression and anxiety – however due to the progressive nature of the condition, each person’s experience of dementia is unique and they may not exhibit all these symptoms.
Around 60% of people diagnosed with dementia, will have Alzheimer’s disease which is the most common in the over 65 age group. Alzheimer’s disease affects memory (particularly in relation to time with patients becoming unable to recall recent events), cognitive ability (poor organisational skills and an inability to perform familiar, everyday tasks), insight (patient’s decision making can become affected resulting in poor judgements being made), language (difficulty naming objects and misusing words may be noticed) and spatial awareness (difficulty performing everyday tasks like dressing).
It is predicted that by 2021, 1 million people will be living with the condition whilst in the UK alone, more than 850,000 people are currently living with dementia. Alzheimer’s is a progressive disease. This means that over time, more parts of the brain are damaged. As this happens, further symptoms will develop and become more severe.
How to spot the symptoms of Alzheimer’s
Due to the progressive nature of the disease, the symptoms of Alzheimer’s are generally mild to start with, but get worse over time and eventually they will start to interfere with the individual’s ability to carry out everyday tasks. The earliest symptoms are usually memory lapses especially having trouble recalling recent events or learning new information.
As Alzheimer’s progresses, problems with communication, reasoning and orientation become more apparent meaning that the individual will need more day-to-day support from those who care for them. Patients can develop unusual behaviours that seem out of character, including aggression, disturbed sleep patterns, agitation, calling out or repeating the same question.
Eventually the person will become very frail and may have difficulties eating or walking without help; these symptoms mean that the individual will need help with all their daily activities.
Alzheimer’s and continuing healthcare
According to the Alzheimer’s Society individuals with dementia experience particular difficulties meeting the criteria of the Decision Support Tool (the document used to record evidence of an individual’s care needs to determine if they qualify for continuing healthcare funding).
“The health and social care system discriminates against people with dementia. Despite dementia being a medical condition, the needs of people with dementia are often seen as social care rather than healthcare needs. As a result, thousands of people with dementia spend substantial amounts of money on social care they need as a result of their medical condition.
Second, the design of the NHS continuing care system is not appropriate for people with dementia. The application and appeals process are difficult for people with dementia to navigate and, in many cases, assessments are conducted by health and social care professionals using generic guidance documents, without consulting professionals with experience of dementia. Alzheimer’s Society calls for independent, experienced support and advocacy to help people with dementia navigate the application process and assessments to include a health or social care professional with experience of dementia.”
Such statements only support our position at Compass CHC that it is essential that individuals are represented by an expert when tackling all matters relating to continuing healthcare funding.
How can Compass CHC help?
As we have discussed above, getting NHS continuing healthcare funding for people with Alzheimer’s disease can be particularly problematic but our team at Compass CHC comprises a combination of qualified non-practicing solicitors and medical clinicians including nurses, tissue viability specialists and pharmacists whose expertise ensures we can understand the nuances and complexities of each case.
Putting in place arrangements for ongoing continuing healthcare is a difficult process which affects people when they are stressed and at their most vulnerable. Using a firm of experts who specialise in this complex area can be helpful and removes the stress from the family at an upsetting time.
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Author: Tim Davies LLB