Family told by NHS: Alzheimer's is not a 'health condition'

This is from The Telegraph in the UK. It is precisely why I am so adamant against a government run health care in the US.

By Nick Britten
Published: 4:28PM BST 18 Aug 2009

NHS Worcestershire ruled that Judith Roe, 74, did not qualify for NHS funding because her condition was a "social" rather than "health" problem, even though she was so ill she could not make a cup of tea and regularly left the stove on.

She was forced to sell her £200,000 home to pay her £600-a-week nursing home fees, which would have been funded if she had been categorised correctly.

Mrs Roe's family appealed to the Health Service Ombudsman, which ruled that Mrs Roe's assessment had been incorrect and her treatment should have been funded by the NHS. NHS Worcestershire has now reimbursed them for six years of care.

Her son, Richard, 40, urged other families in a similar situation to fight for the care they are entitled to.

He said: "The way the health trust behaved was scandalous. It has been very stressful.

"All the time we were told we were wrong while believing we were right.

"They told me I should count myself lucky because there are people that are more ill than my mother, which was an outrageous thing to say.

"I want anyone else going through a similar experience to know they may be entitled to care. Even if they're being told they're not entitled, they should fight for it.

"With us, they made a mistake. They did not carry out their duties properly."

Mrs Roe, a retired church warden and school teacher, was diagnosed in 2002 with severe Alzheimer's and Parkinsons.

Under English law, elderly people must pay for their own residential care unless their needs are deemed health-related.

She was assessed but her needs were regarded to be social rather than health, meaning she did not qualify for funding.

In August 2003 her family paid for a social worker to visit her twice a day and in 2004 she moved into a nursing home because she was too ill to stay at home.

In 2007 she was moved into another home because her condition had deteriorated.

Despite being bedridden and requiring round-the-clock care, NHS Worcestershire PCT refused to pay a penny towards her fees.

Throughout this time Mr Roe wrote dozens of letters to the PCT asking them to re-assess his mother.

He said: "I wanted to know just how ill my mother had to be before her condition was deemed a health issue.

"The NHS doesn't want to admit elderly people have health issues because then it falls to them to pay for their care."

He added: "We made the difficult decision to sell her home because we were under the assumption that older people sell their houses to pay for care.

"It was only when we started to look at funding and ask the PCT what funding was available that we realised that she shouldn't have had to self-fund."

Finally, in May 2008, on the recommendation of the Ombudsman, two social workers from the PCT assessed Judith and agreed she qualified for continuing care and paid for her fees at the home until she died in October.

However, the Health Services Ombudsman said she should have had continuing care from 2002 and NHS Worcestershire agreed to pay.

He said: "It should never have got to the point where I had to write to the Ombudsman.

"The PCT did not follow the correct procedures and as a result we had to sell the family home and use her savings for care which should have been funded by the NHS.

"We became very angry because the primary care trust was very arrogant and unhelpful."

Paul Bates, chief executive of NHS Worcestershire, said: "Decisions around eligibility for continuing NHS care are extremely complex and difficult even though we have national guidance to assist us.

"The line between the need for healthcare and social care is a very thin one indeed, but the impact for the individual is the difference between free care and care which is means tested.

"We would not wish to see Mr Roe's experience repeated and there are clearly lessons for us to learn."

Each NHS trust has its own criteria for interpreting the Government's guidelines on who qualifies for free nursing care.

Andrew Harrop, Head of Policy for Age Concern and Help the Aged, said: "The system for deciding where the line is drawn between free NHS Continuing Care, and paid for social care has been a mess for years.

"We are still very concerned that older people may wrongly be forced to pay for their care when it should be free.

"We strongly encourage anyone who believes they are unfairly missing out on NHS support to fight for their rights."

The Health Service Ombudsman concluded 53 cases of continuing care last year having investigated them. 75 per cent of cases were either fully upheld or partly upheld.

A spokesman refused to comment on the case, other than to say its role is to assess whether the strategic health authority's decision was based on following correct procedure, rather than the need of the patient.

In 2006, a government review revealed that one in five elderly people were being wrongfully denied free care.

http://www.telegraph.co.uk/health/healthnews/6049942/Family-told-by-NHS-Alzheimers-is-not-a-health-condition.html

Adult Hockey Clinic

Dave, Brian and I spent the last three days attending an adult skills seminar with the Pittsburgh Penguins. Well, Dave and I watched while Brian participated. There were several guys in attendance from the Penguins organization, but the two most seen before the camera are Mike Yeo and Phil Borque. Phil Borque played for the Penguins during their run for the cup in the 1990's. He's a really nice guy who reaches his students quite well.

Mike Yeo is an assistant coach with the current team. He is extremely knowledgeable about stick handling and skating. He taught a great deal to Brian. We attended the same seminar last year, but unfortunately coach Yeo taught from the bench and couldn't be on the ice due to an injury. This year we got to see him in full glory - wow can this guy skate!

The seminar was held at the Penguins practice facility in Washington County, about an hour's drive from home and about a 30 minute drive from downtown Pittsburgh. The facility is beautiful. There is a restaurant above the ice with huge glass windows to view the on-ice activities. Dave and I had dinner while watching Brian take part in the seminar.

The first night of the seminar, Dave and I were seated in the observation area of the restaurant pretty much at center ice. Shortly after we sat down, two women with three children were seated two tables away. The ladies were chit-chatting away while their three children turned the restaurant on its ear.

The kids looked to be about 8, 6 and 4 - all certainly old enough in my mind to have some basic table manners. The youngest, a boy, yelled when he spoke. He was obviously looking to be the center of attention and when he didn't get his way, he turned the volume up even higher. The middle child, a girl, tossed her straw paper at the oldest and they then proceeded to slap each other across the table.

In all fairness, I don't know if the three kids were siblings and if so, which of the women was their mother. But, neither said a word to correct the behavior. It was very distracting to the rest of the diners.

After the children were finished eating, the youngest got up from his chair and ran up and down the aisle between the tables. At one point, he stretched his arms out to block the way for the waiter to pass. I looked at the women - again, not a word.

Dave and I began to talk about the years when our own children were young. We often had sibling issues at the table - Nikki would blow her straw paper at Brian or Brian would chew with his mouth open to make Nikki crazy. They were always given one warning with a stern look; stop it now or be removed from this restaurant. Nikki usually yielded the warning, but Brian would push just a little further!

And Brian was frequently removed from the restaurant by his dad or I.

The conclusion we came to is that the women were more interested in having dinner and chatting to each other than to see the situation for what it was. Not only were the children rude and distracting to the rest of us in the restaurant, but it became a hazard when the youngest was blocking the way for the waiter. If that same waiter had spilled something on the boy, he could have been seriously injured.

And let's face it - the restaurant could have been liable. In today's litigious society, they could have been sued.

Where is the common sense with these parents? What was so important that they ignore the rude behavior and grant the kids free reign in a restaurant? Where is the consideration for others?

I am beginning to wonder if we as a society have all but abandoned common sense...