Ask the Expert – COMPLETE: Between 1pm - 2pm... - Care Community

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Ask the Expert – COMPLETE

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Between 1pm - 2pm, David-James- from Clarity Care Consulting will be here on the community to answer your questions about social care.

Thanks to everyone who has submitted a question already, we will be posting these throughout the hour so keep your eyes peeled.

For those who haven’t it’s not too late – feel free to post during the hour

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46 Replies
jaykay777 profile image
jaykay777

Does your program take place in Great Britain? Here in the U.S. in a half hour, it will be 8:00 a.m.

in reply to jaykay777

Hi jaykay777 ,

Yes, our expert is in the UK. Feel free to ask any general questions but unfortunately, he won't be able to help with any specific US social care system details.

Thanks for asking and I hope you get some useful info from this hour!

David-James- profile image
David-James-

Good afternoon everyone :-)

klr31 I had to put my father in a Home at Christmas where he has settled quite well. Unfortunately, I live over 100 miles away. I haven't had any help from a social worker and my father is self-funding. I would like to know if we move him to a Home nearer to me who picks up the funding once his savings are gone?

David-James- profile image
David-James- in reply to

If your father was receiving financial assistance towards his care home in his own area, and then chose to move to be close to you his funding would go with him. However he sounds like he is funding his own care? So it would be the local authority he is living within when his money runs out that would be responsible for funding support- subject to their eligibility criteria and funding levels.

klr31 I also wonder if I should move him as, apart from me seeing him more often and being near him, everything else points to me leaving him where he is. I have no-one to talk to about this dilemma. He has every medical facility near him whereas very little around where I live; the Home near me is more expensive hence his savings will disappear more quickly; he has settled where he is and, although is dementia isn't terrible at present, I don't want his health to suffer if I move him. It took from December to March to get his health on an even keel and keep him out of hospital.

David-James- profile image
David-James- in reply to

The questions you are asking yourself are perfectly right and I’m encouraged that you are considering your fathers needs first. So, I would question is a second move for your father within his best interest? What are the pro’s and con’s? What does he feel? and does he have capacity to make this decision for himself with or without support? The home he is living in may also be able to help you get this information right. Ask the opinion of as a many people who know him best. This will share the responsibility and help inform your decision either way.

Jennymary My mum had a minor fall the day after Boxing day last year, my sister rang the non emergency number and was advised to take mum to A&E, mum aged 85, partially sighted, diabetic, angina, pacemaker uses pain patches on her knees, was kept in despite A&E not finding anything but it was more to give her some rehab - which never happened and she was transferred, against our wishes, to another hospital, again for rehab but again it's never happened.

Last September a meeting was held at the family home and mum's GP at the time agreed that her sugar levels be kept mid teens as she functions better like that.

At the second hospital, my sister, who despite working full-time, has been mum's main carer, advised the nursing staff of this, but time and time mum's sugar was in single figures, I remember one day my sister ringing me and telling me the nurses were happy as her sugar had gone up, when asked what level it was she was told , it's 6, earlier it was 3, more than once my sister rang me in tears over the way mum was being looked after and she said she'd be happy to walk out the hospital with mum just to get her away from the place. The hospital didn't liaise with GP about her sugar levels as mum had been in hospital for so long.

Mid April a meeting was held and it was decided that mum no longer needed hospital care and we got her moved into a care home which is close to me.

The GP visits on a Tuesday morning and a few weeks ago I decided to visit mum at that time so that I could try and have word with GP, they didn't arrive while I was there, so my question is how do I go about seeing the GP regarding mum's care.

Finally, during her stay in hospital she was really unhappy and it showed, since being in the home she has flourished, she does have dementia now as well, but she's happy and when I went in last week the activity was making chocolate brownies, we took mum along and she really enjoyed it, it was a pleasure to see her stirring the mixture and saying how long they'd need in the oven, she even licked the spoon!!!!

David-James- profile image
David-James-

Clear communication is essential in supporting both long and short term medical care needs. In the first instance, I would suggest requesting a telephone consultation with a GP where possible at a minimum. GP’s are not always able to share information, but welcome additional information to aid any diagnosis or to form their professional opinions and decisions. However, there could be other methods to gain medical support, for example specialists community nursing services like district nursing, community Matrons, over 75’s nurses, or Nurse Practitioners. These will vary according to what service provision there is within your area. I would suggest speaking to the practice nurse or the GP, as to how you can link with these services.

In respect to the difficulties experienced whilst in hospital, I would always suggest discussing any concerns with the Patient Advisory Liaison Service(PALS), They act as advocates for Patients and their families and will challenge medial practice where required whether the patient is in hospital or even once they have been discharge. Independent advocate services are also often able to support and challenge where necessary.

Jennymary Mum can put her feet on a hoist for transferring to/from bed/wheelchair, does this mean she is mobile despite the fact she has been unable to walk on her own for many months?

David-James- profile image
David-James- in reply to

I would suggest from the description she is not mobile currently. An individuals ability to mobilise depends on many factors. What is causing the reduced mobility? What are the risks? Is it life limiting and changing - simple equipment could improve things and reduce risks of injury, so a physiotherapy assessment or Occupational Therapy assessment may help. However environmental changes my also need to be considered if it is believed to be more permanent. So the question to be asking is what rehabilitation potential does she have and how to maximise it.

jaykay777 profile image
jaykay777

It's nice to hear when things work out for all concerned as it has for your and your mum.

David-James- profile image
David-James- in reply to jaykay777

it is nice to hear the success' and there are always plenty, they just don't get talked about as much

pet-lamb Can I ask does the carer always get paid separately or does the money go to the person being cared for my mother needs a carer but doesn't have a bank account she wants one of my sister's to be her carer

David-James- profile image
David-James- in reply to

Carers allowance is paid to you as a care giver, but is subject to your own tax threshold, therefore could be affected by your current earnings or benefits. The person you are caring for must already be claiming selected benefits associated to their care needs and you would be needing to be providing at least 35hrs of care to the. All benefits are now generally paid directly to an account of some sort

Molliemoxie Why dont hospitals have incontinence pads for large people

Plus a hoist that is also suitable for larger ladies e.g. weight of 19 stone +

David-James- profile image
David-James- in reply to

I'm probably not best placed to be able to answer this, but it is my belief that bariatric equipment is generally available within hospitals. In respect to larger continence aids, I believe that the correct placement of pads is as important if not more so than the size itself even if more than one is required to be used. The protect skin integrity and personal dignity is the paramount importance. If it continues to be an issues as previously advised discuss with the Patient Advisory liaison Service(PALS)

Molliemoxie profile image
Molliemoxie in reply to David-James-

Thankyou

I was told they couldent bring one from another ward it would take three members of staff

They are short staffed so my mum was pulled and turned every 2 hrs except when we were visiting then it was whenever they remembered

She was catheters but it was taken out over night And was not told so and neither were we as relatives

Molliemoxie profile image
Molliemoxie in reply to Molliemoxie

Just feeling very frustrated

David-James- profile image
David-James- in reply to Molliemoxie

Hello

I would definitely make contact with the patient advisory liaison service within the hospital. Maybe also ask to speak with the ward manager. It is important that your mother's needs are not compromised by either the lack of equipment for staffing.

Molliemoxie profile image
Molliemoxie in reply to David-James-

Have done

There are other issues as well

My mother is back home now

Under her own GP

She is investigate ing

The whole situation

I am just frustrated

And impatient at the moment

Doc waiting for replys from hospital

I just know thay will have an answer for everything

David-James- profile image
David-James- in reply to Molliemoxie

I'm please to hear for your mother that she is home again now, and hope you are able to get some feedback soon.

Jules_17-B I am finding it so hard having been turned down for a second time for Continuing Health Care funding my husband had a massive bleed on the brain and had a second bleed is double incontinent. Just had catheter after a third bout of sepsis and e-coli in his urine. He continually blocked the catheter which then kept bypassing. He is paralysed down his right side is bed bound. Three seizures, Cannot speak and has lost his ability to swallow so is fed via a PEG feed. is all we have been awarded is £155.05 per week towards his nursing and we pay the rest. Now half my house comes into the equation, when I die my girls have to give half the proceeds to Social Services. How much more do you have to have wrong with you to qualify?

David-James- profile image
David-James- in reply to

Continuing Health Care has very strict criteria and it appears that your husband has been deemed to be past the initial critical care phases that require specialist medical inputs despite having high nursing needs . His needs will probably be deemed to be predictable and able to be managed within a clear care plan. Although he is continuing to have difficulty with his catheter, this would have been deemed to be manageable under standard residential or nursing practices and therefore would not qualify for additional CHC financial support. It is important to request reassessments whenever things change for him. With regard to the financial implications and request for a deferred charge agreement(DPA) being put on the property, it is my belief that a you cannot be forced into signing a DPA. There are several contributing factors to this and I feel more in depth conversation regarding specifics may be beneficial before advice could be given. Maybe some legal advice, citizens advise or even a care expert such as myself with a bit more time available

Jules_17-B profile image
Jules_17-B in reply to David-James-

Thank you for your help

wilffos481 "I am 84 years old with a Thai wife who has cared for me for the last few years.

She is currently awaiting permanent residency permit. Will she be able to claim carers allowance?"

David-James- profile image
David-James- in reply to

Your wife's ability to claim any benefits will be subject to her immigration status. I suggest seeking advise from the direct.gov website for clarity.

David-James- profile image
David-James- in reply to David-James-

I have just found this link for you that my also help from Citizens advice website

citizensadvice.org.uk/benef...

My mum took a fall a few days ago and bruised her hand and knees. Since then she is unable to bear weight on her legs nor lift herself out of bed or out of chair. Carers say we need to arrange a lifting apparatus. Where should I go for advice?

David-James- profile image
David-James- in reply to

Temporary injuries often cause increased needs and risks, where possible equipment can help to see you through the crisis. There are often community response services that can provide advice or guidance, these could also include GP practices, 111 or Urgent Care Centres. An alternative could even be medical equipment supply shops, as they often have highly trained staff who can offer advice also, but in the first instance professional advise is best from either Occupational therapists, Physiotherapists, nursing or medical staff. All of these will be located within the community response teams I have described

Have finished work to care for my 86 yr young mom who has moderate dementia and has just come back to her own home after 3 months in hospital. Any help and advice on anything would be appreciated.

David-James- profile image
David-James- in reply to

Try to seek some support from people who are in a similar position as yourself- Local specialist support groups. They will often be able to steer you away from the pit holes and onto meaningful support services. Local Authorities are always a good place to start and for sign posting. They will be clear about what resources they will or will not have available and if you are eligible for support. Research her particular diagnosis and prepare yourself for what may be coming in order to start making changes or seeking help as early as possible.

Are there any training courses to help become a better carer?

David-James- profile image
David-James- in reply to

I think I might need a little more information regarding specifics. There are professional training courses and qualifications to be gained, if looking for a career as a care giver. On a personal level though I am assuming you might be interested in learning about caring for specific conditions or diagnosis. Voluntary support groups are always a great way to expand knowledge share experience and develop new skills.

My mum is in a care home and they won't listen to our advice from the doctor about her diabetes. My big question is will we hit these brick walls with all care homes, or is my sister right when she says it seems now like mum's needs are too complex for this home to cope with?

David-James- profile image
David-James- in reply to

It should not be this way no and I would hope what you are highlighting is an isolated incident. Communication, the absolute paramount in supporting a loved one in a care home. Try where possible to develop your own relationship with the care providers. Visit as regularly as possible and at different times, if this is not possible maybe telephone contact or face time, skype etc. Familiarity helps greatly when you feel you need to challenge or request additional support for a loved one. In these situations communications needs to be at least 3 way between you, carers and most importantly the person themselves. If you feel you are still not being listen to you can raise those concerns to the GP or even the Care Quality Commission(CQC). This potential could have very serious outcomes for your mother health and so could possibly need to reported as a 'Safeguarding' concern that either the local authority or the Clinical Commissioning group(CCG) and or the CQC

My dad has become quite aggressive since he has been diagnosed with dementia. Has anybody else experienced similar with an elderly parent or somebody you give care to? Any ideas of how should be handling it in a way that wont make my father so aggressive?

David-James- profile image
David-James- in reply to

Aggression in certain types of dementia can be common and very difficult to deal with. I would most certainly discuss with your local older persons mental health team to gain the right treatment support plans. Again good support groups can offer advise and support. Behaviour management technics which include skills in deflection and distraction also help. This could include music therapy, dementia cafes and dementia cinema clubs etc.

My 93 year old mother is becoming very confused so much so she is a danger to herself! Who should I contact?

David-James- profile image
David-James- in reply to

Sorry I didn't realise I have missed this question!

I am presuming you are talking of a physical danger to herself. Obviously if you have serious immediate concerns you may need the support of the emergency services.

You would need to consider what the danger is and what the route cause my be i.e. environmental, physical frailty or mental capacity for example, or maybe even multiple dangers. I would urge you to seek some specialist professional support as soon as possible before a crisis presents itself. Any specialist in the areas of medical, social, or private provider of services to elderly or vulnerable adults, should be able to give you some guidance of where to start

Both my parents live at home but they are now in their late 80s and 90s so I want to make sure that they are cared for when they need to be. What are some of they key things I should think about first?

David-James- profile image
David-James- in reply to

We start to worry about parents or a loved one because we generally start to observe triggers i.e. a fall or reduced mobility etc. The best place to start is to communicate clearly with the person you're concerned for. It may be a difficult conversation but your most likely find they are concerned too, but maybe struggling to acknowledge it. Be clear about your concerns and what your think you would want to achieve. Once you have had this conversation I would seek some advice or support from individuals who have similar needs or concerns. Possibly moving onto a professional care assessment, either by the local authority or a private provider.

My mother in laws bathroom is beyond repair she has no savings and no way of paying for a new one herself . Is there any one that can help?

David-James- profile image
David-James- in reply to

There are generally various grants available from either within the private sector charities that may be able to assist. However if your mother in Law has specific care needs relating to her environment I would suggest requesting an occupational therapy assessment from your Local Authority as they may be able to access a facilities adaptations grant.

HelenHU profile image
HelenHU

The hour is now up so a huge thank you to David-James- and to everyone that submitted questions. This looks like a really informative session!

David-James- profile image
David-James-

Wow that time went very quickly!! Thank you for your questions, I hope you find my answers helpful. I have happy to pick up some other question at a later time, or even expand a little more if required

Bye for now, Dave

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