Adult Social Care

margaretclare

weanie wrote: »

I really feel for you. My mother has slid down a slippery slope of Dementia with amazing speed since Dad died. Mum was no Einstein but she was capable of intelligent conversation, worked extremely hard an lived a good, honest and thrifty life. She brought up her family well and was a good friend to others and helped many people in her lifetime. No amount of 'Brain Gym' could have avoided her form of dementia. She was an excellent cook and studied recipes well and used a vast knowledge of food to improve her health and that of my father.

There have been some highly-intelligent people who fell victim to this disease. Iris Murdoch. Charlton Heston. As well as those who've been mentioned, Reagan, Terry Pratchett etc.

I've recently learned that a guy who was in my form at school died of this disease about 3 years ago. He must only have been about 70 when he died and he'd been in a home - I don't know how long. As regards intelligence, he and I were both Grammar School pupils, the upper end of the intelligence scale. So again, having a high IQ doesn't appear to be a safeguard.

Gavin83

Trebor16 wrote: »

Because if their primary needs are health needs then the NHS is obliged to pay for their care costs in full. It's the basic principle of how the NHS was set and should work. This care should be provided regardless of means. In return for thisn promise that the government made we pay a heck of a lot of our hard earned in income tax and national insurance (not forgetting VAT, duty on petrol and all the other stealth taxes).

So why should someone have to sell their home when they have genuine health needs?

I suggest you take a look at the following websites so that you get a better understanding of the system, as you are lacking knowledge of this issue.

http://freenursingcare.findtalk.net/forum.htm

http://gpss.npl.com/nhscare/

Thank you for the links but I have a very stong understanding of NHS CC, residential and nursing care funding, so I'd appreciate it if you dropped the arrogance.

If someone has genuine health needs that requires 24 nursing care then they should be fully funded by the NHS under continuing care on the existing rules, therefore it really isn't relevant to this topic. I was referring to the care that isn't covered under the NHS and the resident is currently required to pay for.

This topic is after all suggesting that all placements should be funded by the Government.

Trebor16

Gavin83 wrote: »

Thank you for the links but I have a very stong understanding of NHS CC, residential and nursing care funding, so I'd appreciate it if you dropped the arrogance.

It was hard to tell given the rubbish you were spouting:rolleyes: And there was no arrogance there, just correcting someone who didn't know what they were talking about.

_Gavin wrote:

If someone has genuine health needs that requires 24 nursing care then they should be fully funded by the NHS under continuing care on the existing rules, therefore it really isn't relevant to this topic. I was referring to the care that isn't covered under the NHS and the resident is currently required to pay for.

You didn't make that very clear in your posts at all. The fact is that the NHS and social services work very hard to muddy the waters on this issue and to try and convince people that their needs are only social. You only have to look at their treatment of those with Alzheimers or dementia, both illnesses, but they end up being told their primary needs are not health needs.

Gavin wrote:

This topic is after all suggesting that all placements should be funded by the Government.

The thread was started to tell us about a Green paper being published soon by the Government. Talking about continuing care is a natural progression to the original subject.

EdInvestor

margaretclare wrote: »

In addition, there were what were called 'geriatric hospitals'. These were what had been workhouse infirmaries only painted magnolia instead of dark green. They would care for people who were simply infirm as opposed to demented. These did come under the NHS and there was a different, shorter and simpler, nursing qualification which was considered adequate - more basic, more practical, less academic. But there was no question - it was still 'nursing' as opposed to 'care'.

This is the nub of the whole care funding issue.Dementia victims - by far the majority of the entire care population - are not regarded as ill.Therefore they do not come under the NHS funding umbrella.

How did this puzzling dichotomy develop? It seems perfectly obvious to the man in the street (not least to the victim's families) that these people are ill, and formerly they were housed in psychiatric hospitals ( presumably state-run and funded?) Were these hospitals run by the NHS?

If so, how (and when) did the NHS manage to get rid of its responsibility in this area?

Errata

EdInvestor wrote: »

This is the nub of the whole care funding issue.Dementia victims - by far the majority of the entire care population - are not regarded as ill.Therefore they do not come under the NHS funding umbrella.

How did this puzzling dichotomy develop? It seems perfectly obvious to the man in the street (not least to the victim's families) that these people are ill, and formerly they were housed in psychiatric hospitals ( presumably state-run and funded?) Were these hospitals run by the NHS?

If so, how (and when) did the NHS manage to get rid of its responsibility in this area?

Yes, the psychiatric hospitals were NHS from 1946 onwards and trust me - you don't want to know the details of what happened to people with dementia in the old lunatic asylums which they were before that date.

There has always been a disconnect between physical health and mental health, with even today nurses in general hospitals not having proper training to nurse people with dementia who've been admitted for physical health reasons. Medics and nurses like to 'cure' people and dementias are not amenable to that, which makes medics and nurses pretty uninterested.

Matters are not helped by psychiatry being a relatively new specialism which historically attracted many poorer calibre doctors. Not much success in acheiving cures in the same way as the heroic specialisms also puts psychiatry low on the funding totem pole and sadly old age psychiatry comes bottom within psychiatry.

seven-day-weekend

Trebor16 wrote: »

I don't disagree with you at all on that one Monkeyspanner. Sign me up to your campaign!!!:D

I also agree

margaretclare

Errata wrote: »

Yes, the psychiatric hospitals were NHS from 1946 onwards and trust me - you don't want to know the details of what happened to people with dementia in the old lunatic asylums which they were before that date.

There has always been a disconnect between physical health and mental health, with even today nurses in general hospitals not having proper training to nurse people with dementia who've been admitted for physical health reasons. Medics and nurses like to 'cure' people and dementias are not amenable to that, which makes medics and nurses pretty uninterested.

Matters are not helped by psychiatry being a relatively new specialism which historically attracted many poorer calibre doctors. Not much success in achieving cures in the same way as the heroic specialisms also puts psychiatry low on the funding totem pole and sadly old age psychiatry comes bottom within psychiatry.

Errata is correct. As a student nurse 1957-60 I don't recall ever hearing the word 'dementia'.We did have older people on the wards who were there because of physical illnesses and some of these were said to be 'confused'. The word 'confused' was bandied about quite a lot. We were young then (God forgive us!) and we assumed that this 'confusion' was something that happened to all the older people. But, at that time, there were still the big psychiatric hospitals and there were the geriatric hospitals.

Where I qualified was called an 'acute' hospital. I went into midwifery after that and that was most of my career.

EdInvestor

Thanks for the historical perspectives, I think it's clear how the system grew up.Pre war, the poor with dementia would be warehoused at Govt,later NHS hospitals and then later in council run care homes, and the well-off demented would be looked after by servants, and then later in fee-paying privately-run care homes.

Councils (having failed to avoid this burden in the first place) are now trying to offload the cost onto the patients and families, while the NHS, delighted to have got shot of these tiresome incurables, constantly fights all efforts to get it to take legal responsibility.

This has coincided with an increased ability to pay for care by the large numbers of formerly poor people who have joined the middle class home owner group over the years and are now being targeted by the councils..

But at the same time we have had substantial social change: middle class women are increasingly unwilling or unable to be the put- upon carer who looks after the ailing parent and has no life of her own: and aspirational families are very unwilling to lose assets they have built up, from very modest beginnings, in paying for a relative's care which in recent memory would have been free.

This problem does not look like it will go away: especially as the media is so keen on medical matters these days - as the coverage of the late Jade Goody showed so well.

margaretclare

Ed, I don't think there used to be 'council run care homes' pre-WWII. There were, as previously mentioned, acute hospitals, geriatric hospitals, psychiatric or 'mental' hospitals and there were also convalescent homes. In addition there were private nursing homes but these could be used for maternity or for convalescence if people wanted to pay.

I do not know when care of the elderly, whether dementia patients or not, was offloaded on to local authorities.

But at the same time we have had substantial social change: middle class women are increasingly unwilling or unable to be the put- upon carer who looks after the ailing parent and has no life of her own.

The first time I started to hear the term 'dementia' was in relation to my MIL in the mid-to-late 1970s. She insisted on selling up and moving in with us and we really didn't know at that time what the basic problem was. We just thought she was a 'bit peculiar' a bit lonely, although with hindsight there were clues. We all went on holiday together and in one of the hotels we stayed at, she went round telling everyone that I was 'the woman her son lived with, his first wife ran off and left him, you know, my dear...'

There was always a grain of truth in her most embarrassing statements!! In fact I had left within weeks of my first marriage and she was part of the reason. We did get back together again a couple of years later though.

It only became clear to us when she went into hospital for acute surgery and she didn't know where she was. I clearly remember an interview I had with a hospital social worker who said she was 'glad to talk to you rather than your husband'. I pointed out that it was not my mother but my MIL, and the response was 'oh yes dear, but you'll be the one who'll have to cope, it always is the woman, isn't it?'

I'd just started on a full-time degree course and I could not contemplate 'having to cope' with a woman who didn't even know who I was, who her granddaughters were...we used the value of her property, which she'd sold to move in with us, to pay for her residential care.

EdInvestor

margaretclare wrote: »

Ed, I don't think there used to be 'council run care homes' pre-WWII.

Sorry my post was unclear, have amended it.

I do not know when care of the elderly, whether dementia patients or not, was offloaded on to local authorities.

Anybody else know?