Continuing Health Care – the grim reality – Part one

Spoiler alert – applying for Continuing Health Care is not an easy process.

We believe it’s a national scandal that many thousands of elderly people who worked hard all their lives and paid their taxes, are not looked after in later life in their hour of need.

Instead of automatically being looked after, free of charge, by our NHS – they are expected to jump through hoops to prove that they are ‘sufficiently sick’ to deserve free nursing care.

In the first of this two-part blog we examine why a diagnosis of dementia does not automatically qualify your relative for free Continuing Health Care funding and more importantly how you can “tip the scales” in your favour.

Continuing Health Care – the grim reality part one

We often receive distressing phone calls, along the lines of: “Mum has fallen over, fractured her hip and we’ve now been told that she needs to go from hospital into residential care.

The reason mum needs to go into residential care is because, in addition to becoming quite frail, her ‘forgetful memory’ has now been diagnosed as dementia.

During the conversation, we also hear the familiar story that the family have ‘helpfully’ been made aware that they are entitled to ask for an assessment for eligibility for the NHS Funded Continuing Health Care.

This, they are told, is to assess whether their mother has a “Primary Health Need”.

But they are then shocked to discover that dementia and other illnesses associated with getting old such as arthritis and macular degeneration do not, in themselves, qualify for the NHS to pay for care.

When mum was in hospital, the NHS paid for her operation because she paid her taxes and, as everyone knows, health care is free at the point of need.

But because dementia is unfairly not deemed a ‘disease’ by the NHS, mum only qualifies for ‘social care’ in a residential care home. This means helping mum get up, get washed and dressed and helping with meals.

Families tell us: “We can’t quite believe that, despite our parents paying tax all their lives, we are going to have to sell mum’s home to pay for this care”.

At a time when families are having to deal with the physical and emotional effects of a family member who has gone from being independent to now needing to give up their own life and move into communal living, it is overwhelming to have to deal with all the practical consequences of who pays for this care.

But wait … it gets worse!

Because this is not ‘healthcare’ but ‘social care’, your relative will be subjected to a financial assessment – otherwise known as a means test.

Anyone who has capital in excess of £23,250 – and if your relative needs to go into residential care this includes the value of their home – is referred to as a ‘self-funder’.

Self-funders not only have to pay for the cost of their own care but have to pay a higher rate than fellow care residents who are being funded by the Local Authority!

If you think that’s unfair – we agree with you.

To add insult to injury, during the means test process, any gifts or transfers of assets made by your relative will be put under the spotlight.  If your local authority suspects the gift or transfer was made in order to avoid care fees, this is considered to be a deliberate deprivation of assets and they will take legal action to recover the missing funds.

The nightmare never seems to end!

Next week …. we take a look at the CHC application process and we tell you how you can increase your chances of a successful claim.