Author: Claire Edwards
As 2020 draws to a close I, like so many others, am reflecting on the experience of older people and their families during the Coronavirus pandemic.
Public services for older people have long been in crisis, with funding at the very heart of it.
Way back in January we were waiting expectantly for the outcome of yet another green paper seeking once more to address the question – how should long term care for older people be funded?
And then Coronavirus hit ! Inevitably the green paper has been kicked into the long grass whilst all efforts have focused on survival.
The Coronavirus Act directed NHS, Local Authorities and The Care Quality Commission to reconfigure services to save lives and protect the most vulnerable.
We have seen:
- Thousands of lives saved.
- The nation come together to clap for carers
- Captain Sir Tom Moore inspire the nation to get walking
But sadly we have also seen:
- Families unable to visit their loved ones as care homes strive to protect their residents from infection.
- Older people isolated in their own homes.
- Essential support services for older people and their carers in the community close.
- Interruption to non coronavirus virus healthcare services.
- The impact this has had on the nation’s physical and mental health.
I feel privileged to have been able to:
- Give clarity where there was doubt about hospital discharge process
- Find the right care solutions when this was uncertain
- Successfully challenge funding decisions by the NHS
- Listen and reassure when anxiety and doubt took hold
- Educate and inform via professional webinars
Thankfully the light is now at the end of the tunnel with the roll out of the much awaited vaccine and there is optimism that life might just start returning to normal during 2021.
The focus can then return to ensuring that older people receive quality care in an environment of their own choosing and are fairly assessed for the financial support that they may be entitled to.
Never before has independent care advice been more valuable and I thank my clients and professional contacts for putting their faith in me.
Happy Christmas to you all and, this year in particular, don’t let’s forget to focus on what we are blessed to have rather than what might have been.
During the Coronavirus crisis the NHS has and continues to save lives whilst the Local Authorities have and continue to provide an essential safety net to the most vulnerable.
Claire Edwards Eldercare Consultant provides an extra layer of support for older people and their families:
- Who have needed to accept essential short term care, funded and arranged for them by the NHS and Adult Social Care Teams, that they do not see as being the longer term solution.
- Who have lost one parent only to discover the extent to which that parent was supporting the other.
- Who prior to this crisis had recognised the vulnerabilities of an older relative but have put plans to find the right care solution on hold.
- Who are concerned about the cost of care for an older relative, either because the temporary public funding will soon come to an end and /or because their own ability to step in has been affected by the dramatic and unexpected changed in their own financial circumstances.
Claire Edwards Eldercare Consultant can help by:
- Conducting independent consultations and assessments to provide an opportunity to identify health and care needs, discuss a range of care options, to provide clarity during these uncertain times and to help inform decision making about next steps
- By individually researching the most suitable and sustainable long term care solution taking into account the most up to date government guidance and current practice around the provision of care during the Coronavirus crisis and beyond.
- Supporting older people and their families with their contact with NHS, Local Authorities and the Department of Work and Pensions to ensure they are aware of all available financial support and how it can be accessed.
Call me, Claire Edwards RN Eldercare Consultant on 07415387129.
Never before has independent care advice been more important, for both privately funded individuals and those dependent on the Local Authority for the funding of their care.
Exceptional demands are being made on our NHS and Adult Social Care Teams who, as always, are on the frontline when it comes to supporting older people and their families, often at a time of crisis. As an NHS trained nurse with many years hospital based experience, I applaud them unreservedly.
Inevitably it has become necessary for essential changes to be made to how services are delivered by both sectors and I give a brief summary of my understanding of these, together with their likely impact on older people and their families, below:
Adult Social Care
The Coronavirus Act 2020 became law last week and all main stream duties of Local Authorities as set out in the Care Act 2014 have been downgraded to powers, with the exception of ; where meeting needs is necessary to avoid a breach of the Human Rights Act.
This means that:
Many individuals may struggle to access care needs assessments and carer’s assessments, eligibility decisions and reviews for the foreseeable future leaving large numbers with unassessed and therefore unmet needs.
Family, other advocates and care providers may not necessarily be involved in new assessments.
There will be no requirement for Local Authorities to provide a written report following a care needs or carer’s assessment so accountability will be removed.
The principles of person centred care may be lost.
Temporary eligibility criteria for services may be set in such a way that makes them incredibly difficult to meet resulting in a huge level of unmet need amongst older people.
Unpaid carers will feel even more pressured to provide more support than they already are, alongside concerns about breaching guidance on social distancing and self-isolation.
Financial assessment, a pre-condition to a charge being agreed or paid may be delayed until after the crisis is over, though I should add that this will not in itself be an obstacle to services being provided.
The postponement of financial assessments whilst services continue to be delivered means that individuals may be put in a position where they have to accept a service that they will later be charged for without knowing what that charge will be, causing some individuals to decline services altogether.
This may cause conflict for the representatives of individuals who lack mental capacity, in particular concerned sons and daughters who are themselves under huge financial strain due to the crisis.
Patients are understandably being discharged from much needed hospital beds earlier than ever, using the “discharge to assess” protocol.
Guidance to NHS staff states that patients must leave their acute hospital bed within an hour of the decision to discharge and the discharge lounge within two hours. It is the intention that “a leading healthcare professional” will visit patients who return to their own homes, on the same day as their discharge from hospital to arrange on going support services.
This means that :
A huge strain is being placed on local care agencies and community health staff
Pre-existing problems with the availability of care staff and the distribution of equipment to maintain independent and safety at home will be exacerbated.
There will be a rise in anxiety amongst older people and their families about accessing essential services.
Patients in need of residential care are likely to be denied choice in the rush to arrange “placement” at the earliest opportunity.
NHS Continuing Healthcare Assessments
CHC assessments, with the exception of Fast Track applications, are not currently being conducted until after the Covid 19 crisis, though 3 and 12 month reviews of funding already in place, and which can result in funds being withdrawn, may continue in some instances.
Requests to appeal a previous decision can be made but will not be acted on until after the crisis.
This means that:
There is going to be a massive backlog of NHS CHC Checklist and Decision Support Tool Assessments.
Where 3 and 12 month reviews of existing CHC arrangements are conducted, these are likely to take place without the option of genuine representation and may result in funding being withdrawn unfairly.
How Claire Edwards Eldercare Consultant can help
Continued provision of consultations and assessments by Telephone, Facetime, Skype or Zoom, so that independent, accurate and personalised advice and support can be given.
Liaison with Hospital, Adult Social Care Staff and Care Providers as required to support families and carers whilst suitable care arrangements are put in place.
Use of my expertise, knowledge and time to research and report on the most suitable care providers of home care and residential care to support informed choice and decision making.
Support understanding all aspects of care fees funding, for now and at the end of this crisis, for both clients dependent on Local Authority and those who are able to fund their own care, including assistance making successful applications for statutory funding where appropriate and accessing regulated financial advice where this is required.
Provision of emotional support to older people and their families through what has become a frightening time for so many.
Signposting to ancillary services and relevant helplines.
Older people continue to live with multiple health conditions that impact on their quality of life, with or without coronavirus.
All the difficulties within our healthcare systems remain but with the added pressures of this far reaching infection.
Older people are more vulnerable than ever ( of both social isolation and the potentially serious consequence of infection ), huge demands are being made on our NHS staff and there is an inevitable knock on effect on Adult Social Care Services in the community.
Families need help navigating the new guidance set down by the Government, finding the right care solutions and accessing all available funding.
Care homes and care agencies continue to accept new clients and care still needs to be paid for.
If you are supporting an older person professionally or personally, this is the time to take individually tailored and flexibly delivered independent care advice.
Don’t let’s forget that older people continue to live with multiple health conditions that impact on their ability and quality of life, with or without coronavirus.
All the difficulties within our health and social care systems remain but with the added pressures of this far reaching infection.
Older people are more vulnerable than ever (of both social isolation and the potentially serious consequences of infection), huge demands will be made on our NHS staff and there will be an inevitable knock on effect on Adult Social Care Services in the community.
Essentially families will still need help navigating the NHS and Adult Social Care Services, finding the right care solutions and accessing all available financial support.
If you are supporting an older person professionally or personally, this is the time to take individually tailored and flexibly delivered, independent care advice.
Do get in touch on 07415387129. I would welcome the opportunity to assist you.
Over the last few weeks I have had reason to reflect on what it is like to be dependent on others for care and support and what an eye opener it has been. I believe I have always shown empathy to my clients in need of support but there is nothing like losing your own independence (albeit for a short period in my case) to bring home the reality of what this means to the individual, particularly when long term care is required.
Don’t get me wrong, my family have been amazing in their endeavours to look after me and I suspect I haven’t been the easiest of patients to look after. However I now realise how easy it is for those providing care and support to “take over” with the very best of intentions to do as much as possible to help. On more than one occasion I have found myself saying “I have had a hip replacement not a brain injury” in order to re assert my right to make decisions about the support I receive.
A timely reminder that it is frustrating enough being dependent on others for practical tasks without adding to it by inadvertently assuming the role of decision maker too !
A year ago I was privileged to be invited to the launch of Stay Safe Support, a great online resource for older people and their families, providing advice and information about scams, home safety and first aid.
Stay Safe for Older People was launched by Emma Hammett ( First Aid for Life ) and Carolyn Cripps OBE ( Fit for Life ) in partnership with ROSPA, Age UK and the Trading Standards Scams and Fraud Team.
Yesterday I returned to the launch venue, the Royal Hospital Chelsea, for another really informative event with presentations from a variety of organisations dedicated to keeping older people safe.
Visit www.staysafe.support for further information.
Thank you to Emma and Carolyn for this great initiative and for inviting me to contribute.
Return visitors to my website may have noticed that all has been quiet on this page for a while, however the opposite can be said in terms of my supporting clients to navigate the care maze.
I am only now coming up for air from an exceptionally busy period dating from early January. This is clearly good news as it demonstrates the genuine need for accurate, timely and well presented advice and information when families are seeking to find the right care solutions for an older relative. What is also clear is the appreciation of a face to face meeting and an open door to ongoing contact. It is frankly difficult to separate the emotional from the practical concerns which so often present them selves in equal measure and establishing a relationship (albeit briefly in many cases ) does make a big difference.
It is also my experience that resources within the NHS and Local Authorities continue to be under enormous pressure and for this reason an extra layer of support from an independent care adviser such as myself is highly recommended. I am able to either bridge the gap in services or work alongside other health and social professionals for the benefit of my clients.
And so I would like to summarise the services available to you and the benefits they provide if you decide to give me a call:
➢ A consultation visit to properly understand all aspects of the situation so that independent, accurate and personalised advice can be given and to ensure that important and previously unconsidered points are not missed.
➢ Bespoke and evidence based research and reporting of the most suitable care options to support informed decision making.
➢ Accompanied care home visits to take some of the stress and worry out of identifying the right care home.
➢ Detailed independent health and care needs assessment of health and care needs to facilitate optimum care provision and effective later life planning.
➢ Assistance with the completion of Attendance Allowance forms to improve the likelihood of a successful application.
➢ Mediation and advocacy services to support individuals or families during difficult conversations or meetings.
➢ Care monitoring to ensure that care needs continue to be met and to provide an opportunity to discuss any changes or concerns.
Essentially I am able to provide as little or as much support as you require. I am in your hands!
I was listening to a radio talk show recently and the presenter was inviting listeners to call in about the “loss of the high street”. An interesting debate developed about the pros and cons of being able to shop on line for speed and convenience versus shopping on the high street where individuals can satisfy themselves they are buying the product or service that meets their expectations.
Perhaps not surprisingly there were many calls from owners of small individual shops providing a niche service reporting that they are not only surviving the high street cull but thriving.
This made me think about the difference between relying solely on an on line search engine to find the right care and using a personal and professional service from an independent care adviser who can meet with families, take the time to understand their concerns, answer their questions, many of which will be personal to them rather than those listed in a Q&A column, and guide them to the right care solution.
You may have found me through the net but why not take the next step and call me direct ? If you like what you hear you may just choose to buy that personal and professional service that not only meets your expectations but exceeds them.
To all visitors to my website over the festive season I wish you all a peaceful Christmas.
I am mindful that if you, younger or older, have found me you may well have concerns about health and independence for yourself or someone dear to you.
Rest assured that there is support available to you from a number of different sources, you simply need to know what you don’t know.
If you are struggling to cope or need accurate advice and information which will help you to make informed choices in the New Year please do give me a call. It would be a privilege to assist you.