CHC application

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Experience Level: Intermediate
Hi, My 86 year old mum is in hospital after suffering a fall down the stairs at home on 20th Jan

She sustained multiple injuries, broken and cracked ribs, broken shoulder bone, cracked vertebrae in the neck. (she is still wearing a collar) and she sustained head injuries to the front and back of her head with bleeding on the brain. A CT scan was done but no surgery as no swelling was seen.

Prior to the fall she had some short term memory problems but since then she has severe impairment and often fails to finish a sentence. she fails to recognise people or remember their names. on bad days she will just ramble off at a tangent when engaged in conversation. she was quite depressed too but now they are giving her Mirtazapine which is lifting her mood.

I attended a DST meeting on 19.02.2010 where after some argument, the Nurse assessor said that she was going to recommend my mum to panel for CHC. She also said mum needed an EMI nursing home and I visited several. some of which were not very nice.

She scored 2 severes (cognition and drug therapy)
4 highs with a disputed 5th and 2 Moderates

At The DST meeting I was asked several times by a social worker to sign a 'single assessment' form which as having power of attorney ,I refused to do and wrote on the DST that I had refused consent for Social Services to share information etc. (They didnt seem to be best pleased at this, But I dont need the SS on my back)

Mum was mobile on a zimmer at this time and was being dressed each day and sitting around a table for meals with other patients.
I have had cause to write to the hospital twice about her weight situation and the fact that she didn't appear to be eating much. They put her on drink supplements and recorded her intake for a while, but have now written on the
notes. \"Now taking all meals\" and no longer record the info. I was happy until one of her regular visitors informed me that she still wasn't eating properly and thought that she wasn't being helped to fill in meal forms so for example, \"the roll arrived without the soup\" she said.

Exactly 7 days after the DST meeting, the Nurse assessor rang to say that there was new evidence to suggest that the DST no longer represented an accurate picture of my mothers needs and they wanted to re-assess her. and update the DST. she asked for my consent to do this without my presence (I live a long way from the hospital) which I refused.

I spoke to the Mental health nurse who had been trying to get my mother to agree to a MMSE test. to my knowledge that is the only thing they did in that week following the DST. She scored 15/30 on that and 0/5 on repeated cogs tests. They only managed to do the MMSE because my G/F who works with dementia patients told them how to get her top co-operate (which may have been a bad idea) She also said that Mum now only needed an EMD home which has no nurses on site and is supposed to cater for Dementia patients,. I only found one in the area and I asked the person in charge what the difference was between EMD and EMI and she said \"well, in here, they are not ill, they've just got dementia\"! I decided that this place was not suitable for mum.

I also believe that my mother should be in a nursing home by now but they seem to be hanging on to her until the next meeting at least.

I demanded a letter explaining what the clinical changes were that requires a new DST meeting just 7 days after the first one for a 86yr old patient who doesn't know what day it is. There is another DST meeting now scheduled for next week which I have said I will attend.

I am in receipt of that letter now and wondered if you could provide me with a quote for:

A/ Some initial guidance on how you think I could best handle that next meeting, poss a telephone chat to go over the above and the letter and:

B/ Guidance on handling the appeals process effectively.

I intend to dig my heels in and refuse to comply with any requests to pay nursing home fees but obviously need to keep my mums best interests at heart at all times.

Do you think that you can help with this?

I look forward to hearing from you


PS You can quote a cost per hour or call for telephone support if you wish

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