New Year; same old social care news stories. This one from the Daily Mail tells the story of Phyllis Knight, a lady so badly affected by Alzheimer’s disease that she spent 4 days living with the dead body of her husband before neighbours discovered what had happened, yet has been turned down for NHS Continuing Care funding, which would ensure she gets her care home fees paid for.
Her local PCT decided that Phyllis’ needs are social care related, rather than health care, which means that the local authority assess her eligibility for services. And because Phyllis has assets of more than £23,500, she doesn’t get any state help.
It is a story that has been told many times before and sadly, dementia represents a big grey area in health and social care; the crux is whether people with dementia primarily have social care needs – such as help dressing, washing or cooking – or health care needs, like nursing care.
And it can be tricky to decide this, as people from the NHS have admitted to me. With a physical disability, it can be easier to tell what needs someone has on a day-to-day basis because their condition is (relatively) stable, but someone with dementia often has needs that can vary markedly, depending on what sort of day they are having.
Indeed, in the earlier stages of dementia, it may be social care that the person needs, and only as the condition advances, they need nursing care.
Making a decision to award continuing care or not is also difficult because it is down to a human judgement. No matter how clearly the guidelines are framed, no 2 judgements can be the same.
This issue may get addressed when (if?) the government reforms adult care funding – a White Paper is awaited with baited breath after the consultation closed late last year – with some talk of some health and social care monies being merged together. But this is only conjecture.
But what won’t happen is the government paying for the care of all people with dementia. With about 700,000 estimated to have some form of dementia in the UK, that bill would be too much for the NHS to take.
So, for the time being, again, the newspapers will have an easy story to file every few months when the next disgruntled family decide to go to the media to complain.