MEDizzy - An 84-year-old woman with dementia was to be discharged from

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Geriatric Medicine 2

An 84-year-old woman with dementia was to be discharged from hospital to a dementia registered care home. Her family asked for a needs assessment of eligibility for NHS Continuing Health Care prior to her discharge. Which of the following is not directly included in this assessment?

ExplanationAny individual whose health care needs change is eligible to be assessed as to the complexity of their health needs in order to determine whether they are eligible for continuing health care funding. This is especially true, if they are changing residence (i.e. moving in to a care home). This assessment takes in to account the following domains: • Behaviour. • Cognition. • Communication. • Psychological/emotional needs. • Mobility. • Nutrition. • Continence. • Skin (including wounds and ulcers). • Breathing. • Symptom control through drug therapies and medication (includes a need for supervision of complex medication regimes). • Altered states of consciousness. • Other significant care needs. Each item is assessed according to its nature, intensity, complexity, and unpredictability. Vision is not directly taken in to consideration, but may influence behaviour, communication, emotional needs, ability to maintain nutrition and continence. Where a person’s primary need is a health need, they are eligible for NHS continuing health care. Deciding whether this is the case involves looking at the totality of the relevant needs. Where an individual has a primary health need and is therefore eligible for NHS continuing health care, the NHS is responsible for providing all of that individual’s assessed needs, including accommodation, if that is part of the overall need. If the person does not qualify for NHS continuing health care, their local authority will be responsible for assessing their care needs and providing services if they are eligible. However, if they don’t qualify for NHS continuing health care, but are assessed as having health care or nursing needs, they may still receive some care from the NHS. For someone who lives in their own home, this could be provided as part of a joint package of care, where some services come from the NHS and some from social services. If the person moves into a nursing home, the NHS may contribute towards their nursing care costs.