Take the SAGE test to spot early signs of dementia or Alzheimer’s
September 8, 2016
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Take the SAGE test to spot early signs of dementia or Alzheimer’s

. Photo: Ohio State University

A 15-minute test conducted at home can indicate early signs of mental decline that might be the first glimmer of Alzheimer’s disease or dementia.

US researchers who asked more than 1,000 people aged 50 and older to take the self-adminstered Sage test found that 28% had cognitive impairment, a mild loss of mental functioning.

The results closely matched those from detailed diagnostic tests carried out by experts.

While the Self-Administered Gerocognitive Exam (SAGE) test cannot diagnose patients’ problems, it gives doctors a “baseline” of mental function so that progressive changes can be tracked over time.

Try the test yourself – you’ll need a pen and to print out this page:

1. From memory, what is today’s date?

Date_________ Month________ Year____________

2. Name the following pictures (spelling is not important):

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. Credit: Ohio State University

3. How are a bicycle and a train similar? Write down how they are both alike. They are…. what?


4. How many 5p coins would it take to pay 35p?


5. You are buying £1.95 of groceries. How much change should you receive from a £5 note?


6. Memory test – remember these instructions. Do later only after completing the test.

At the bottom of the last page write “I am finished” on the blank line provided.

7. Copy this picture

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. Credit: Ohio State University

8. Drawing test

  • Draw the face of a clock and write in the numbers
  • Position the hands for 5 minutes past 11
  • On the clock, label ‘L’ for the long hand and ‘S’ for the short hand

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Draw the clock in the space above.

9. Write down the name of 12 different animals (spelling is not important)

1 _______________________

2 _______________________

3 _______________________

4 _______________________

5 _______________________

6 _______________________

7 _______________________

8 _______________________

9 _______________________

10 _______________________

11 _______________________

12 _______________________

Look at this example, then go to question 10

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. Credit: Ohio State University

10. Do the following

Draw a line from one circle to another starting at 1 and alternating numbers and letters in order before anding at F (1 to A to 2 to B and so on).

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. Credit: Ohio State University

Look at this example, then go to question 11**

  • Beginning with 6 squares
  • Cross out 1 line (marked with an X)
  • Leaving 5 squares
  • Each line must be part of a complete square (no extra lines)

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. Credit: Ohio State University

11. Solve the following problem

  • Beginning with 5 squares
  • Cross out 3 lines (mark with an X)
  • Leaving 4 squares
  • Each line must be part of a complete square (no extra lines)

article_update_img.jpg
. Credit: Ohio State University

12. Have you finished?


If you struggled with the test, take the paper to your GP.

Remember that SAGE (test) does not diagnose any specific condition.

The results of SAGE will not tell you if you have Alzheimer’s disease, mini-strokes or any number of other disorders.

But the results can help your doctor know if further evaluation is necessary.

– Ohio State University

Other examples of the SAGE test can be downloaded here, here, here and here.

September is World Alzheimer’s Awareness Month; Alzheimer’s Action Day is September 21
September 4, 2016
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During World Alzheimer’s Awarenss Month in September, you can help fight the stigma surrounding Alzheimer’s disease, educate others about the disease, and begin to change the way we look at Alzheimer’s.

Help us to create a conversation within the African and Caribbean community

  • Speak up about the facts: Alzheimer’s is NOT normal aging or “a little memory loss,” it is a progressive and fatal disease.
  • Share your story about overcoming stigma around Alzheimer’s disease at  https://pearlsupportnetwork.org.uk/forum/

  •  Visit pearlsupportnetwork.org.uk/  to learn more about dementia and for tips on how to handle stigma surrounding Alzheimer’s disease.
  • End ALZ on Facebook. Turn Facebook purple by using our graphic as your profile picture. Tell your friends why you’re supporting the promotion of Alzheimer’s awareness and ask them to join you.
Direct payments
September 3, 2016
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If you, or the person you are looking after, are assessed by the local council/trust as needing support, then you or they have a right to ask for a direct payment instead of having the support arranged by the local council/trust.


This information applies to people living in England, Wales, Scotland & Northern Ireland.


How do I get a direct payment?

To get a direct payment you firstly need to have an assessment from the local council/trust. The assessment and the process will differ depending on if you are a carer or the person being looked after.

For further information on assessments please click the relevant link below.

 

If you, or the person you are looking after, are assessed by the local council/trust as needing support, then the local council/trust will work out how much it would cost to provide such support (generally called a personal budget). This is then broken down into any amount you or the person you are looking after might have to pay (if any – further information on charging is available in our assessments factsheets – see below) and any amount the local council/trust has to pay.

You can then choose to ask the local council/trust to arrange the support themselves or you can ask for a direct payment. A direct payment is the amount of money that the local council/trust has to pay to meet the needs of you or the person you are looking after, and which is given to enable you/them to purchase services that will meet your/their needs (as assessed by the local council/trust).

It is sometimes possible for the person you are looking after to pay you or another family member or friend to meet their needs (see “If the person I am looking after gets a direct payment can they use this to employ a family member?” for further information on employing family members).

Although most people will be given a direct payment if they ask for one there are some categories of people who cannot get a direct payment, for example those under various orders or treatments for drug or alcohol dependence.

If the person being assessed does not have mental capacity, or does have mental capacity but would be unable to manage a direct payment, then someone can be appointed to manage the direct payment on their behalf.

Note: If you or the person you are looking after already receive support from the local council/trust but would like to receive a direct payment instead, you can ask the local council/trust to make this change.

Note: Direct payments are not compulsory and if you would rather the local council/trust arrange the support they should do so. It can also be possible to have a combination of support from the local council/trust and direct payments.

 


How much will the direct payment be?

The direct payment must be an amount sufficient to meet the needs the local council/trust have assessed you or the person you are looking after as having.

However, you/they might have to make a contribution towards the cost of meeting your needs (further information on charging is available in our assessments factsheets – see above).

If the person you are looking after uses the direct payment to pay for a care worker then there might be additional costs involved in this (ie recruitment costs, auto enrolment pension costs, national insurance and income tax cost etc.). If so then the direct payment amount must be sufficient to cover these costs.

 


What can I spend the direct payment on?

The direct payment must be used to meet the needs the local council/trust assessed you or the person you are looking after as having.

The local council/trust has to agree that what you/they spend the direct payment on will meet these needs.

Example: If you are a carer and one of the needs the local council/trust assessed you as having was ‘help with the cost of driving lessons to help you continue in your caring role’ you could ask for a direct payment to meet this need and could use the direct payment to purchase driving lessons.

Example: If the person you are looking after is assessed as needing ‘a care worker for an hour a day’ they could ask for a direct payment to meet this need and could use the direct payment to employ someone of their choice to care for them for one hour a day (if the local council/trust agree that this person would meet this need). It is sometimes possible for the person you are looking after to pay you or another family member or friend to meet their care and support needs (see “If the person I am looking after gets a direct payment can they use this to employ a family member?” for further information on employing family members).

 


Will getting a direct payment affect any benefits that I or the person I am looking after receives?

Direct payments that you are given as a carer to purchase services to meet your needs as a carer are not counted as ‘income’ for any benefits you receive, and so would not affect any of your benefits.

Direct payments that the person you are looking after is given to purchase services to meet their needs are not counted as ‘income’ for any benefits they receive, and so would not affect any of their benefits.

However, if the person you are looking after pays you or anyone else with their direct payments, then this would count as ‘earnings’ and might affect any benefits you, or anyone else being paid, gets.

 


If I or the person I am looking after gets a direct payment would I or they have any responsibilities?

If you get a direct payment there will be various responsibilities.

Everyone receiving a direct payment must keep records and submit accounts to the local council/trust showing how the money was spent. The local council/trust should discuss with you what the monitoring process is.

In addition, if the person you are looking after has been assessed as needing a care worker, and if they have been given a direct payment to purchase this service, then depending on how they purchase this service, they (or someone managing the direct payment on their behalf) might be taking on the responsibilities of an employer – see section below.

 


If the person I am looking after gets a direct payment to purchase a care worker does this mean they become an employer?

Using a care agency

If the person you are looking after uses a care agency to purchase this service, then the care agency would be the employers, and the person you are looking after would not be taking on the responsibilities of an employer.

If the person you are looking after wants to find care agencies in their area they could ask their local council/trust if they have a list of local care agencies and they could use one of the following:

  • In England the Care Quality Commission is the health and social care regulator and has an online directory of registered independence care services.
  • In Wales the Care and Social Services Inspectorate Wales is responsible for inspecting social care and social services and has an online directory of registered care services.
  • In Scotland the Care Inspectorate regulates and inspects care services and has an online directory of registered care services.
  • In Northern Ireland the Regulation and Quality Improvement Authority is the independent health and social care regulator and has an online directory of registered care services.

Employing a care worker directly

If the person you are looking after employers a care worker directly (even if this is a family member or friend), then they will be taking on the responsibilities of an employer.

This can seem daunting, however, in many areas of the country there are organisations which can help with these responsibilities. You can ask your local council/trust about organisations in your area, and you can also have a look on the Resource Directory from Disability Rights UK which is a tool to help you find regional and local services that may be able to offer different types of support and advice, including support with direct payments.

Some examples of employment responsibilities:

  • check the references of the intended employee and find out if they have had an up to date Disclosure and Barring Service (DBS) check
  • make sure the intended employee has the right to work in the UK
  • set up a system for paying wages, deducting tax and national insurance and keeping records for the Inland Revenue
  • ensure that the employee has the annual leave they are entitled to under ‘Working Time Regulations’, any maternity/paternity/sick pay they are entitled to and ensure you comply with auto enrolment duties
  • do a check to ensure that there are no potential health and safety risks to the employee because of the care they will be providing, as well as removing any potential dangers in your home that could put them at risk
  • ensure that you have suitable insurance cover (ie employer’s liability insurance and public liability insurance)

This is not a definitive list and if the person you are looking after is considering becoming an employer they should seek advice on their full responsibilities.

If the person you are looking after does want to employ a care worker and wants to know how to find care workers in their area, then they could ask their local council/trust if they hold any information on care workers in the area and they could place a job advert on websites like Gumtree and the government website Universal Jobmatch.

There are some useful websites which have helpful information about employing care workers:

  • ACAS provides advice and information to employers and employees and have some information on employing personal care workers and a guide for new employers.
  • Being the Boss is a peer support website run by people with disabilities who aim to share knowledge, support and information around employing personal assistants.
  • Wales only – Dewis Cymru provides advice and information on direct payments and on employing personal assistants.
  • Scotland only – The Scottish Personal Assistant Employers Network (SPAEN) is a membership organisation which supports people with disabilities and/or long-term conditions or impairments to use a direct payment to employ personal assistants. They offer a range of supports and services to enable people to engage their own staff.
  • Scotland only – Self-Directed Support Scotland is a one one-stop-shop for information about self-directed support (including direct payments) for people who use social care services. It provides information about direct payments and links to local support organisations that can help you decide about employing care workers and to set up and manage your direct payment.
  • Northern Ireland only – The Centre for Independent Living provides advice and information on getting direct payments, using personal budgets and employing carers and personal assistants.

 


If the person I am looking after gets a direct payment can they use this to employ a family member?

If the person you are looking after gets a direct payment to purchase a care worker they might want to employ someone they already know to provide the care, such as a family member. However, there are rules around employing family members which vary depending on whether the person you are looking after lives in England, Wales, Scotland or Northern Ireland.

In England the rules are that:

  • The person you are looking after cannot normally use the direct payment to pay a family member they live with to provide them with care. However, if the local council agree that this is the most effective way of meeting their needs then it is sometimes possible. For example, it might be necessary if there are religious reasons or communication reasons (other reasons may also count as necessary).
  • The person you are looking after can use the direct payment to pay a family member who does not live with them to provide them with care (as long as the local council agree that this family member will meet their needs).
  • The person you are looking after can use the direct payment to pay a family member (regardless as to whether or not they live with them) to provide the management and administration of the direct payments, where the local council think that this is necessary.

In Wales the rules are that:

  • The person you are looking after can use the direct payment to pay a family member who lives with them to provide them with care and/or management support, but only if the local council is satisfied that this is the best way of promoting and delivering their outcomes.
  • The person you are looking after can use the direct payment to pay a family member who does not live with them to provide them with care and/or management support (as long as the local council agree that this family member will meet their needs).

In Scotland the rules are that:

  • The person you are looking after can use the direct payment to pay a family member (regardless as to whether or not they live with them) to provide them with care if the local council think that this is appropriate and/or the best way of meeting the person’s needs. For example, it might be necessary if there are religious reasons or communication reasons (other reasons may also count as necessary) or because the right support is not available (ie in a rural or remote area). However, this is not the case if the local council believes that the family member is under undue pressure to agree to the arrangement, or if the family member is a guardian or has financial or welfare power of attorney for the person being looked after (in which case the family member cannot be paid via the direct payment of the person you are looking after).

In Northern Ireland the rules are that:

  • The person you are looking after cannot usually use the direct payment to pay their spouse or partner, or anyone who lives with them (unless that person is someone who has been specifically recruited to be a live in employee) to provide them with care, unless it is an exceptional circumstance. For example, it might be an exceptional circumstance if there are religious reasons or communication reasons (other reasons may also count as exceptional circumstances).
  • The person you are looking after can use the direct payment to pay a family member who does not live with them to provide them with care (as long as the local trust agrees that this family member will meet their needs).

Note: For England, Wales, Scotland and Northern Ireland, if the person you are looking after does want to employ a family member, try to think of an many reasons as you can as to why that family member would be the best person to provide the care (unless the family member is an exempt person in Scotland).

Source: Carers UK

Assessments and the Care Act (Carers)
Uncategorised
September 3, 2016
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Stage 1: Assessing your support needs
What is a carer’s assessment?
A carer’s assessment is for adult carers of adults (over 18 years) who are disabled, ill or elderly. It is an opportunity to discuss with your local council what support or services you need. The assessment will look at how caring affects your life, including for example, physical, mental and emotional needs, and whether you are able or willing to carry on caring.Who can have a carer’s assessment?
Any carer who appears to have needs for support should be offered an assessment by social services.As a carer you will be entitled to an assessment regardless of the amount or type of care you provide, your financial means or your level of need for support. You can have an assessment whether or not the person you care for has had a community care assessment/needs assessment, or if the local council have decided they are not eligible for support.
If you and the person you care for agree, a combined assessment of both your needs can be undertaken at the same time.
If you are sharing caring responsibilities with another person, or more than one person, including a child under 18, you can each have a carer’s assessment. You don’t necessarily have to live with the person you are looking after or be caring full-time to have a carer’s assessment. You may be juggling work and care and this is having a big impact on your life.
How do you get a carer’s assessment?
As a carer you should be offered an assessment by the local council adult social services department of the person you are looking after. If you have not been offered one, you should contact them by phone, in writing or on-line, and ask for a carer’s assessment or for a review of your support plan. If you want to, you can ask for an assessment before you take up your caring role.
Assessments for carers
Factsheet E1029 Assessments and the Care Act: getting help in England from April 2015
How do you prepare for a carer’s assessment?
In preparation for your assessment, it is useful to give yourself some time to think about how caring affects you. It’s also important to start thinking about any help that would make a difference to you as a carer. This will help when you discuss things that social services have to consider when doing a carer’s assessment. For a list of questions which should give you a clear idea of the
help you may need, see the appendix on page 26. Bear in mind that you might not know about all the types of help that could
be available, the assessment is to help the council understand what things you are having problems with. Social services must give you information about the assessment in advance – for example a list of the questions they will ask. They may give you a form to
write down your thoughts to these questions before the carer’s assessment. Often this is referred to as a self-assessment questionnaire. Alternatively you may find it helpful to write some notes for yourself, and talk to family or
friends to help you think about your needs. How is the carer’s assessment carried out? The law says that all assessments must be carried out in a manner which:
> is appropriate and proportionate to your needs and circumstances
> ensures that you are able to participate effectively in the assessment
> has regard to your choices, wishes and the outcomes you want to achieve
> takes account of the level and severity of your needs
If the assessment involves a meeting, it should be carried out in a convenient and private place, usually at your home or at a council office. Meetings are likely to be part of the process if the person you care for is having an assessment as well. It is your choice about whether the person you care for is present or not. If it helps, you can have a family member, a friend or a Carers Support Worker from a carers organisation with you. Assessments can be done over the phone or online, but this should only happen if you agree. If you think you can easily express your needs over the phone or online then this method may be the right one for you. Online or telephone assessments are unlikely to ever be appropriate for people who lack capacity or have difficulties with communication. Your council may carry out a supported self-assessment. This could involve you filling in a self- assessment questionnaire, and then being contacted by the council to discuss what you have written on the form.
For carers
Factsheet E1029 Assessments and the Care Act: getting help in England from April 2015
In some areas, local organisations may be asked to carry out the assessment, but arrangements should still be made through your local council and they should explain who will carry out the assessment. The assessment should be carried out by a social worker or another trained professional. The assessment will consider whether or not your caring role impacts on your health or prevents you from achieving outcomes, for example staying in work or having a social life, and what could be done to help you combine these
things with caring. It should cover:
> your caring role and how it affects your life and wellbeing
> your health – physical, mental and emotional issues
> your feelings and choices about caring
> work, study, training, leisure
> relationships, social activities and your goals
> housing
> planning for emergencies (such as a Carer Emergency Scheme) – the local council should be able to tell you more about what they can do to help you plan for an emergency You should be asked about these issues, if not you can raise them yourself. The aim of the assessment is to help you get the support that you need. So it’s best to give your honest opinion about your caring role, the care you
provide and your feelings about being a carer. Remember to look at the list of questions in the appendix on page 26 of this factsheet.
Independent advocate The council must provide you with an independent advocate to assist you in the assessment process (and after) if: without support you would have ‘substantial difficulty’ in communicating your wishes, or understanding, retaining and assessing information during the assessment and there is no other appropriate person who is able and willing to help you
For carers
Factsheet E1029 Assessments and the Care Act: getting help in England from April 2015
Stage 2 – Looking at whether your needs are eligible for support
How will the local council decide if my needs as a carer are eligible for their support?
The Care Act introduces national rules for deciding who is eligible for car and support. But it will still be for local councils to make the decision about whether or not your needs meet the rules and so whether you have what the law calls eligible needs.
You will meet the eligibility criteria if there is likely to be a significant impact on your wellbeing as a result of you caring for another person. There are three questions the council will have to consider in making their decision:
> Are your needs the result of you providing necessary care?
> Does your caring role have an effect on you?
> Is there, or is there likely to be, a significant impact on your wellbeing?
If the answer to all three questions is yes, then you will have eligible needs. These questions are explained in more detail below.
Are your needs the result of you providing necessary care? The council could decide that the care you provide is not necessary, that the cared for person could do the things you do themselves. Or they could decide that your needs or problems are the result of something other than your caring role. Does your caring role have an effect on you? The effect on you must be either:
your physical or mental health is at risk of getting worse,or you are unable to achieve at least one of the following outcomes:
• look after any children you have responsibilities for
• provide care to any other person
• maintain your home in a fit and proper state
• eat properly and maintain proper nutrition
• maintain and develop your relationships with family and friends
• take part in any education, training, work or volunteering you may wish to
• time for social activities, hobbies etc.
For carers
Factsheet E1029 Assessments and the Care Act: getting help in England from April 2015
In considering whether or not you can achieve the above outcomes, the law states that the council must take into account any difficulties you have. You will be considered unable to achieve the outcome if you:
> need assistance to achieve the outcome
> can achieve the outcome unaided but experience pain, distress or anxiety
> can achieve the outcome unaided but doing so endangers, or may endanger your or another person’s health and safety Is there, or is there likely to be, a significant impact on your wellbeing? ‘Wellbeing’ is defined in the Care Act. The definition is very broad and includes things like social and economic wellbeing, personal dignity, control over your day to day life, participation in education, work or social activities, relationships with other people, having suitable accommodation, protection from abuse and neglect. ‘Significant’ is not defined in law, and so should be given its everyday normal meaning. If you think the effect on you is noticeable or important, this could count as significant. Although the Care Act does not define what counts as a significant impact on
your wellbeing , it does list a number of things that the council must take into account when considering the issue. These are:
> you are best-placed to judge your wellbeing
> your views, wishes, feelings and beliefs should be taken in to account
> the importance of reducing existing needs, and preventing or delaying the development of needs
> decisions should be based on your circumstances, not assumptions about you
> you should be able to participate as fully as possible in decision making
> the needs of the carer and cared for person need to be balanced
> the need to protect people from abuse and neglect
> any restrictions on rights or freedoms should be kept to the minimum
possible
If your level of need varies the local council must take this into consideration
so that a full picture of your level of need is developed. The reason for the
variation is not important, it can be because the condition of the person you
care for fluctuates from day to day or week to week, or because you have
other responsibilities that can affect you from time to time.
For carers
Factsheet E1029 Assessments and the Care Act: getting help in England from April 2015
Stage 3 – What help you might get after a decision about your needs
Information and advice Everyone, including those whose needs are considered not to be eligible for
support must receive information and advice from the local council on the following:
> details of the needs that have been identified
> how to access care and support
> the care providers and services they can choose from in their locality
> how to obtain financial advice
> how to raise concerns about safeguarding, ie what to do if you are worried that a vulnerable person is at risk of harm or neglect
> how to access preventative services that could delay or prevent your needs from increasing If the decision is that you are not eligible for care and support, advice and information may be all you receive from your local council. This advice and information should be relevant to your specific circumstances and the local area you live in. It could for example include information about a local carers
support service.
Support plan
If your local council decides that your needs are eligible, then providing you want them to, they must draw up a support plan detailing how these needs will be met. If you have eligible care needs, then providing you want them to, the local council have a legal obligation to meet these needs. It may be agreed that the best way to help you as a carer is by providing services directly to you, by
providing services to the person you care for, or a combination of both. The local council can provide services themselves, or arrange services through another organisation. Alternatively, you or the person you care for can request direct payments, which are payments which enable you to buy services to meet your eligible needs. For more information on direct payments visit carersuk.org/directpayments
Your local council may or may not charge you for carers services, most councils do not. If they do, they must carry out a financial assessment to work out whether you have to make a contribution and if so, how much. If the help you are offered is free, the council do not have to carry out a financial assessment.
For carers
Factsheet E1029 Assessments and the Care Act: getting help in England from April 2015
Note:
If your local council do charge you for services and the outcome of your financial assessment is that you will have to pay the full charge, then the local council only needs to draw up a support plan and meet your needs, if you ask them too. The local council can then issue an additional charge for this. The support plan must include:
> details of the needs identified in the assessment
> which needs meet the eligibility criteria
> which needs the council is going to meet, and how
> the outcomes that you want to achieve
> information about the personal budget available (the amount of money that the local council has worked out it will cost to arrange the necessary care and support for you)
> information and advice to support you in your role as a carer and
address your needs
> information about direct payments Some examples of the kind of help that could be available to you as a carer if you are eligible for support:
> help getting around: taxi fares, driving lessons, repairs and insurance
> costs for a car where transport was crucial
> technology to support you: mobile phone, computer where it is not possible to access computer services from a local library
> help with housework or gardening
> help to relieve stress, improve health and promote wellbeing such as gym membership Some examples of the kind of help that could be available to the person you care for, in order to help you as a carer:
> changes to the disabled person’s home to make it more suitable
> equipment such as a hoist or grab rail
> a care worker to help provide personal care at home
> a temporary stay in residential care/respite care
> meals delivered to the disabled person’s home
>a place at a day centre
> assistance with travel, for example to get to a day centre
> laundry services
> replacement care so you can have a break
Supported by: