Benefits you can claim when you have care needs
Uncategorised
September 25, 2016
0

If you have care needs or a disability there are benefits to help you manage with the extra costs. Most of these benefits aren’t affected by income or savings and you may be able to keep them if you have to go into a care home.

  • Why it’s important to claim all the benefits you’re entitled to
  • What benefits are you entitled to?
  • Personal Independence Payment
  • Disability Living Allowance
  • Attendance Allowance
  • Council Tax discounts and exemptions
  • Other benefits
  • State Pension and Pension Credit
  • Benefits for carers

Why it’s important to claim all the benefits you’re entitled to

The amount you pay towards your long-term care is worked out as if you’re already receiving all the benefits you’re entitled to.

So it’s important to claim everything you can, otherwise you’ll end up paying more than you need to.

What benefits are you entitled to?

Financial support is available whether you need help to live safely and comfortably in your own home, or you need to move into a care home.

What’s more, not all benefits are means-tested. Disability benefits that help with personal care needs or the extra costs of getting around don’t take your income or savings into account.

Personal Independence Payment

If you live in England, Scotland or Wales and have difficulty getting around or everyday tasks you can make a claim for Personal Independence Payment (PIP).

This benefit is replacing Disability Living Allowance for people aged 16 to 64.

PIP is tax free, paid weekly and not usually affected by your income or savings.

There are two parts to PIP:

  • a daily living component which is paid if you need personal care
  • a mobility component if you need help getting around

There are two rates for each payment. Which one you get will depend on how severe your needs are.

Personal Independence Payment rates 2015/16

Daily living component Mobility component
Standard rate £55.10 Standard rate £21.80
Enhanced rate £82.30 Enhanced rate £57.45

If you’re in England, Wales or Scotland, find out more about PIP, including how to claim, on the GOV.UK website.

If you’re in Northern Ireland, find out more about PIP on the nidirect website.

Disability Living Allowance

If you live in England, Scotland or Wales, you can only now make a new claim for Disability Living Allowance (DLA) if you’re claiming for a child under 16.

DLA is tax free, paid weekly and not usually affected by your income or savings.

There are two parts to DLA called components:

  • the DLA care component helps with the extra costs of personal care – it is paid at one of three rates
  • the DLA mobility component helps with the extra costs of getting around – it is paid at one of two rates

It is possible to get either or both components.

Disability Living Allowance rates for 2015/16

Care component Mobility component
Higher rate £82.30 Higher rate £57.45
Middle rate £55.10 n/a
Lower rate £21.80 Lower rate £21.80

If you are aged between 16 and 64 and are currently getting DLA, you will be invited to be reassessed for Personal Independence Payment a few months before your current DLA award is due to end or if your condition changes.

If you’re in England, Wales or Scotland, find out more about DLA on the GOV.UK website.

If you’re in Northern Ireland find out more about DLA on the nidirect website.

Attendance Allowance

Attendance Allowance is tax free and is not usually affected by any savings or income you may have. You may be entitled if:

  • you’re aged 65 or over and need help with personal care because of illness or disability (this could be a physical, mental disability or learning difficulty)
  • your disability means you need supervision to avoid putting yourself in danger (for example you need someone to make sure you keep to a strict diet or help you take certain medications)

Attendance Allowance is based on the care you need, not the level of care you’re currently receiving.

So even if you don’t receive support from a carer at the moment, you may still be entitled to this benefit.

You can get a lower rate if you need help in the day or night and a higher rate if you need help day and night.

Attendance Allowance rates for 2015/16

Higher rate Lower rate
£82.30 £55.10

If you’re in England, Wales or Scotland, find out more about Attendance Allowance, including how to claim, on the GOV.UK website.

If you’re in Northern Ireland, find out more about Attendance Allowance, including how to claim, on the nidirect website.

Council Tax discounts and exemptions

You may receive a reduction on your Council Tax bill if you’re getting certain benefits.

If your home has been specially extended to help you stay there, you should not have to pay any extra Council Tax.

To find out more, find the details on the GOV.UK website.

Council Tax only applies to people living in England, Wales and Scotland.

If you live in Northern Ireland, you might get a reduction in your Rates through the Rate Relief Scheme. Find out more on the nidirect website.

Other benefits

If you’re on a low income, you may also be entitled to other benefits and help with health costs.

Check out Turn2Us, a charity that helps people access welfare benefits, grants and other support.

Find out more about help with health costs on the NHS website.

If you’re in Northern Ireland, find out more about other benefits on the nidirect website.

Memory Boosting Superfoods That Fight Alzheimer’s
Uncategorised
September 22, 2016
0

 

infographic2

Code to copy and paste to put this image on your site:

In order to get enough of these brain boosters, you’ll want to make sure your loved one stocks up on these foods:

Vegetables, especially leafy greens like spinach, kale, turnip greens and cruciferous vegetables like broccoli, which have been strongly linked to lower levels of cognitive decline in older age, according to a study in the Annals of Neurology.

Salmon and other cold-water fish, such as halibut, tuna, mackerel and sardines, which are rich in omega-3 fatty acids. Other omega-3 sources include beans, some nuts, flax seeds and healthy oils, like olive oil.

Berries and dark-skinned fruits which are rich in antioxidants. According to the Alzheimer’s Association, some of the fruits that pack the most punch are blueberries, blackberries, strawberries, raspberries, plums, oranges, red grapes and cherries.

Coffee and chocolate are surprisingly good for you. Recent studies have shown that caffeine and coffee can be used as therapeutics against Alzheimer’s disease. The caffeine and antioxidants in these two tasty treats may help ward off age-related memory impairment, along with cinnamon, olive oil and curry.

Extra virgin olive oil contains a substance called oleocanthal that helps boost the production of key proteins and enzymes that help break down the amyloid plaques associated with Alzheimer’s disease.

Cold-pressed virgin coconut oil is a heart-healthy oil that is free of cholesterol and trans-fats, and boosts ketones. Coconut oil has been shown to improve the body’s use of insulin, increase HDL (good cholesterol), boost thyroid function and acting as an antioxidant and natural antibiotic.

Sources:

Clarke R, et al. Folate, vitamin B12, and serum total homocysteine levels in confirmed Alzheimer disease. Arch Neurol. 1998 Nov;55(11):1449-55.

Desilets AR, et al. Role of huperzine a in the treatment of Alzheimer’s disease. Ann Pharmacother. 2009 Mar;43(3):514-8.

Gu Y, et al. Food combination and Alzheimer disease risk: a protective diet. Arch Neurol. 2010 Jun;67(6):699-706.

Lourida I, et al. Mediterranean diet, cognitive function, and dementia: a systematic review. Epidemiology. 2013 Jul;24(4):479-89.

Mandel SA, et al. Understanding the Broad-Spectrum Neuroprotective Action Profile of Green Tea Polyphenols in Aging and Neurodegenerative Diseases. J Alzheimers Dis. 2011;25(2):187-208.

Mangialasche F, et al. High plasma levels of vitamin E forms and reduced Alzheimer’s disease risk in advanced age. J Alzheimers Dis. 2010;20(4):1029-37.

Pettegrew JW, et al. Clinical and neurochemical effects of acetyl-L-carnitine in Alzheimer’s disease. Neurobiol Aging. 1995 Jan-Feb;16(1):1-4.

Scarmeas N, et al. Physical activity, diet, and risk of Alzheimer disease. JAMA. 2009 Aug 12;302(6):627-37.6. Unlisted. Citicoline. Alt Med Rev. 2008;13(1):50-7.

Baum L, et al. Six-month randomized, placebo-controlled, double-blind, pilot clinical trial of curcumin in patients with Alzheimer disease. J Clin Psychopharmacol. 2008 Feb;28(1):110-3

Cardoso BR. Importance and management of micronutrient deficiencies in patients with Alzheimer’s disease. Clin Interv Aging. 2013;8:531-42.

101 Activities
Uncategorised
September 22, 2016
0

 

1

Listen to music

 

2

Toss a ball

 

3

Color pictures

 

4

Make homemade lemonade

 

5

Count trading cards

 

6

Clip coupons

 

7

Sort poker chips

 

8

Read out loud chapters from Harry Potter books or other favorite stories

 

9

Rake leaves

 

10

String beads

 

11

Bake cookies

 

12

Take photos of the person and you and create a collage

 

13

Brush or comb one another’s hair

 

14

Participate in the Alzheimer’s Association Walk to End Alzheimer’s.
To learn more about Walk, please click here.

15

Plant seeds indoors or outdoors

 

16

Look at family photographs

 

17

Wipe off the kitchen table

 

18

Weed the flowerbed or tend to the garden

 

19

Fold laundry

 

20

Have a friend visit with a well-behaved pet

 

21

Cut pictures out of greeting cards or magazines

 

22

Play dominoes

 

23

Ask the person about his or her favorite childhood books or cartoon characters (you can share yours too)

 

24

Bake homemade bread

 

25

Sort objects by shape or color

 

26

Sing old songs

 

27

Invite the person to tell you more when he or she talks about a memory

 

28

Put silverware away

 

29

Make a Valentine card

 

30

Play favorite songs and sing

 

31

Ask the person about his or her brothers or sisters

 

32

Make a cherry pie

 

33

Play with tops or jacks

 

34

Make a scrapbook

 

35

Take a walk around the yard

 

36

Write a poem together

 

37

Reminisce about the first day of school

 

38

String Cheerios® to hang outside for birds

 

39

Make a fresh fruit salad

 

40

Sweep the patio

 

41

Color paper shamrocks green

 

42

Fold towels

 

43

Have an afternoon tea party

 

44

Talk about great inventions

 

45

Look through the pages of a clothes catalog

 

46

Look at a map of the United States and identify states and capitals

 

47

Make a family tree poster

 

48

Color a picture of our flag

 

49

Eat a picnic lunch outside

 

50

Water house plants

 

51

Play horseshoes

 

52

Dance

 

53

Watch Sesame Street together

 

54

Make homemade ice cream

 

55

Make holiday cards

 

56

Reminisce about favorite sports activities the person enjoyed while growing up

 

57

Write a letter to a friend or family member

 

58

Dress in your favorite football or soccer team’s color

 

59

Pop popcorn

 

60

Name the presidents

 

61

Give a manicure

 

62

Make paper butterflies

 

63

Plant a tree

 

64

Finish famous sayings

 

65

Feed the ducks

 

66

Model with play dough

 

67

Look at pictures in a comic book

 

68

Put a puzzle together

 

69

Sand wood

 

70

Rub in hand lotion

 

71

Arrange fresh flowers

 

72

Remember famous people

 

73

Recite nursery rhymes

 

74

Make peanut butter sandwiches

 

75

Cut up used paper for scratch paper

 

76

Blow bubbles

 

77

Take care of a fish tank

 

78

Bake cupcakes and decorate them

 

79

Interview the person about his or her life using either a video camera or cassette recorder

 

80

Play Hangman

 

81

Finger paint

 

82

Cut out pictures from magazines

 

83

Put coins in a jar

 

84

Put bird seed out for the birds

 

85

Decorate a pumpkin

 

86

Reminisce about a favorite summer

 

87

Roll yarn into a ball

 

88

Trace and cut out autumn leaves

 

89

Cook a favorite family recipe together

 

90

Gather a yellow sponge, crayons, paper and tape and make a SpongeBob SquarePants

 

91

Wash silverware

 

92

Give him or her a hug

 

93

Ask the person to show you how to knit or sew (or another favorite hobby)

 

94

Make a picture frame our of popsicle sticks and glitter

 

95

Play a musical instrument

 

96

Keep a journal together

 

97

Ask the person to talk about his or her favorite sports hero

 

98

Sort playing cards

 

99

Ask the person about his or her favorite pet

 

100

Wash windows together

 

101

Ask the person about his or her first car
10 Stimulating Activities for Alzheimer’s Patients
Uncategorised
September 22, 2016
0

Dementia can cause seniors to withdraw from activities, family and friends. But maintaining those relationships and interests reduces the effects of severe cognitive impairment, leading to a better quality of life.images

The most common form of dementia, Alzheimer’s disease impairs behavior, memory and thought. According to the Alzheimer’s Association, Alzheimer’s accounts for 50-80% of dementia cases. While memory loss may start out mild in early stages, the disease worsens over time. Eventually, it can restrict a person’s ability to carry on a conversation or even respond to people or surroundings.

Activities Bring Pleasure to People with Alzheimer’s

Keeping aging loved ones active in hobbies and interests that gave them pleasure in the past is important after a disease diagnosis. These stimulating activities for Alzheimer’s help:

  • Stir memories
  • Foster emotional connections with others
  • Encourage self-expression
  • Lessen the anxiety and irritability that Alzheimer’s may bring
  • Make people with Alzheimer’s feel more engaged with life

What activities best suit people with Alzheimer’s? That depends on the individual. As AARP.org describes, it is important to create meaningful activities, not just ones that fill time. Consider interests they had in the past, knowing that some activities may need to be modified for safety or practicality. Keep in mind that Alzheimer’s affects behavior and senses in addition to memory. So, activities that a person once enjoyed may become overwhelming or even frustrating now.

Suggested Activities for Seniors With Alzheimer’s

Here are 10 activities to try with your loved one. Certain activities may work better at different times of day. Understand that the person’s level of interest or involvement may decline as Alzheimer’s progresses.

  1. Sing songs or play music.
  2. Do arts and crafts, such as painting or knitting. Keep tools and patterns simple.
  3. Organize household or office items, particularly if the person used to take pleasure in organizational tasks.
  4. Clean around the house. Sweep the patio, wipe the table, fold towels or try other household tasks that help the person feel a sense of accomplishment.
  5. Tend the garden or visit a botanical garden.
  6. Read the newspaper.
  7. Look at books the person used to enjoy.
  8. Cook or bake simple recipes together.
  9. Work on puzzles.
  10. Watch family videos.

Take a Flexible, Supportive Approach

If your loved one resists an activity, take a break. You can try again later, or ask your loved one how the activity can be changed to make it more enjoyable for them.

Remember to concentrate on the process of an activity and not the results. It does not matter if you never get the puzzle put together. What matters is that your loved one enjoyed the time spent on it and felt useful.

What activities does your loved one with Alzheimer’s enjoy? Please share your insights below.

Take the SAGE test to spot early signs of dementia or Alzheimer’s
September 8, 2016
0

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):

article_update_img.jpg
. 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

article_update_img.jpg
. 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

article_update_img.jpg
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

article_update_img.jpg
. 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).

article_update_img.jpg
. 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)

article_update_img.jpg
. 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
0

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
0

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
0
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
A Helpless Voice
September 2, 2016
0

Today I shall remain nameless, but my emotions shall not. If you are like me, a caregiver of someone diagnosed with probable Alzheimer’s Disease, these emotions will seem very familiar. Today, I am speaking on behalf of all husbands, wives, daughters, sons, relatives and friends of someone suffering from Alzheimer’s Disease. Today I am speaking on behalf of all members of an often secret fraternity/sorority called Alzheimer’s Caregivers.

Members of this secret club are not medical practitioners – not psychologists or psychiatrists – not professionally trained to deal with the effects of watching someone say the last “The Long Goodbye”. Members have been dealt an unfair card in this great poker game called life – and are forced do their best with the cards left in their hands.

Life of a Member becomes split into two parts – before diagnosis and after.

Before diagnosis there is confusion, resentment, frustration and worry.

  • Resentful of the unexplained change in personality and perceived irrational decisions or actions that were taken by our loved one in previous times. Our reaction, which is natural, is to avoid contact with them – to limit interaction with the individual who we perceive to be miserable or fussy. The change in the relationship may be subtle, and start as early as 10 years prior to diagnosis – 10 years before you realise that the personality changed because of the disease. It is only closer to diagnosis that you become more and more convinced that something is not right.
  • Confused by an increased level of forgetfulness; bewildered by some apparent instances of getting lost on roads they were once very familiar with; confused by the fact that they repeat the same thing multiple times in the same conversation; confused by the fact that they do not seem to recall some recent event(s).
  • Frustrated by inappropriate behaviour (even though those outside of the family sometimes are oblivious to it); and closer to diagnosis frustrated by their stubborn insistence that there is nothing wrong and it is a normal part aging.
  • Worried about the future and the increasing number of strange events that you can no longer explain away – worried and scared enough to go straight into the doctor’s office to ask for help for your loved one.

Depending on how “early” they are in the disease, your loved one may be first diagnosed with Mild Cognitive Impairment (MCI). Technically, though, as a caregiver you still feel as though you are in “no man’s land”… at least for a while….Then the paranoia steps in and the frequency of accusations (which were initially sporadic) become an everyday affair. Out of desperation you reach out to your doctor once again and your loved one is eventually diagnosed with probable Alzheimer’s Disease.

Sounds familiar, doesn’t it?

I told you, I am speaking on your behalf. You will admit however that I have grocely oversimplified this process. The diagnostic process is far more involved. Also, at the time, you don’t naturally identify the emotions that you feel. There are weeks, months and even years between events. Many times you believe yourself to be imagining things until you sit down and compare notes with other family members or family friends. Then….reality hits like a sledgehammer.

After diagnosis, you are faced very much with the same emotions but for different reasons.

  • Confusion remains. Confusion over the diagnosis and what it means. Confusion over the plethora of theories circulating and terms like PiB, ameloydes, plaque, tangles… For members of this secret club, those terms are foreign, complicated and scary.
  • Frustration remains. Frustration that all the medicine in the world will not bring back the lost memories. Frustration that there is no cure and no play – by – play guide book. Frustration that there is still so little known about the disease in general and moreso, in the Caribbean.
  • Worry remains. Worry over what the future will hold at the various stages. Worry about the financial toll that it is and will continue to take. Worry over whether insurance will cover it. Worry about whether you can get Alzheimer’s – or pass it on to your children. Worry about the little things that they no longer do – read, watch television, run, swim, do crossword puzzles, garden, play golf,…use the telephone. Worry over whether or not to keep it a secret.

But new emotion – the one that replaces resentment is – GUILT. Guilt over the many years lost. Over the arguments, over the silent resentment of you loved one, only to later learn that they were unwilling victims of a disease that many still don’t know exists. Guilt over the inner-voice you ignored when you first sensed that something was wrong. And eventually, guilt over making the decision to seek the help of a daycare environment and guilt over feeling inadequate – that you couldn’t do it alone.

If you are lucky, there is another emotion to come – ACCEPTANCE. Acceptance of the fact your loved one is simply not the same person. They are now a new version of themselves, and you are greedily cherishing whatever is left…fighting desperately with time – which as you know – takes no prisoners.

Many caregivers take a while to master this emotion….sadly, some never do. Some try not to think of the disease too often and avoid remembering (in those quiet moments). They try to forget that overnight, precious memories get erased – like the hard-drive of a computer being wiped clean. But caregivers, you should celebrate and cherish every remaining day that your loved one is with you. Take lots of pictures!!! Even if they do not remember the moment, try to focus on the fact that at least they were happy in it.

So for us caregivers, it is in short an emotional roll coaster and later on more emotions will present as your loved one approaches the need for palliative care. The “Long Goodbye” is a delicate balancing act between pharmacologist and non-pharmacologist treatments. At any given time you are filled with one or more of the following: confusion, resentment, frustration, worry and guilt…. as well as the feeling of being overwhelmed and helplessness….

…but if you are lucky, also ….ACCEPTANCE.

Type 1 Diabetes Linked to Increased Dementia Risk
August 30, 2016
0
Woman using glucometer for diabetes

Older patients with type 1 diabetes (T1D) have more than an 80% increased risk for dementia compared with those without diabetes, a new study suggests.

Previous research showed that older people with type 2 diabetes (T2D) have about a two-fold greater risk for dementia compared with people without diabetes, but the current study is the first to look at dementia risk in elderly adults with T1D.

“There has been a paucity of work in type 1 diabetes because only recently have they been living longer, and living long enough to be at risk for an age-related neurocognitive dysfunction,” Rachel Whitmer, PhD, senior scientist, Division of Research, Kaiser Permanente, Oakland, California, told Medscape Medical News.

Dr Whitmer presented the results here at the Alzheimer’s Association International Conference (AAIC) 2015.

Living Longer

The study included 490,344 persons aged 60 years and older who were members of Kaiser Permanente Northern California, none of whom had dementia. Of these, 334 had T1D.

Over a 12-year period, 16% of the patients with T1D were diagnosed with dementia compared with 12% of those without T1D.

Compared with participants without T1D, those with T1D were 83% more likely to get dementia (hazard ratio


, 1.83; 95% confidence interval [CI], 1.3 – 2.5) after adjustment for differences in age, sex, race, and vascular risk factors. After adjustments for stroke, peripheral artery disease, and hypertension, the HR was 1.61.

Another analysis excluded participants with T2D, which resulted in a somewhat larger dementia risk for those with T1D (HR, 1.93; 95% CI, 1.3 – 2.6). This fell to an HR of 1.73 (95% CI, 1.2 – 2.3) when fully adjusted.

Patients with T1D are now living longer, in large part because of changes in standard of care that were introduced in the 1990s. At that time, it became clear that tight glycemic control reduced complications of diabetes.

Older patients with T1D represent a unique population that has been little studied. “When these people reach old age or an age where they might be at risk of dementia, they have been living with this disease for an average of 40 years,” said Dr Whitmer.

T1D is different from other types of the disease in that it’s usually juvenile onset and requires insulin right away, so some participants in the study have been taking insulin for decades, according to Dr Whitmer. Patients with T1D tend to have more microvascular risk factors than those with T2D and have less adiposity, she said.

In contrast, patients with T2D are more likely to have macrovascular risk factors, such as end-stage renal disease or retinopathy, and a relatively high risk for stroke.

“Even though type 1 diabetes is a rare disease,” said Dr Whitmer, studying both diseases will help to understand how and why they are associated with dementia.

Another factor separating diabetes types is that even if the patients generally have taken good care of themselves, those with T1D are three times more likely to have had had hypoglycemic episodes, said Dr Whitmer.

“Part of taking good care of yourself is that you walk this tightrope between trying not to be hyperglycemic and trying not to be hypoglycemic, and we know from work we have done in type 2 diabetes that hypoglycemia, in particular very severe episodes that land you in the hospital emergency room, are strongly associated with dementia.”

Studying dementia risk in T1D may also shed new light on possible glycemic and vascular mechanisms for brain aging, she said.

Among the next steps for the researchers is to “figure out what is driving this,” said Dr Whitmer. “Is it hypoglycemia; is it microvascular risk factors; is it depression?”

Future work, she said, will “try to tease apart” dementia risk factors as well as any protective factors. Another research direction might be to determine the neuropathology — whether it’s Alzheimer’s disease or other forms of dementia that is raised in patients with T1D.

This work is becoming increasingly relevant as the incidence of both T1D (as well as other autoimmune disorders) and T2D is also increasing. For T2D, it’s likely driven by rising rates of obesity, but for T1D, it could be somehow related to lack of immune system stimulation.

According to anecdotal reports, the prevalence of a gene closely linked to T1D is the same in Finland and nearby Russia, but Finland has a much higher rate of T1D. The difference, said Dr Whitmer, could be that Russia has a higher infection rate and therefore the immune system of residents may be sufficiently stimulated.

Hypoglycemia the Culprit?

Asked to comment, Suzanne Craft, PhD, professor, Gerontology and Geriatric Medicine, Wake Forrest School of Medicine, Winston-Salem, North Carolina, and a member of the Alzheimer’s Association Medical and Scientific Advisory Council, said the connection between T1D and dementia risk may lie in the fact that this population is more likely to have hypoglycemia.

“The area of brain that supports memory — the hippocampus — is very dependent on having a constant supply of glucose and if that supply goes too low, it can cause damage to the cells in the hippocampus,” said Dr Craft. “I don’t think that the danger of low blood sugar is emphasized quite as much as it should be by physicians.”

It’s possible that younger patients with T1D today will be better managed than the participants in the current study. In that case, they may have fewer hypoglycemic episodes and possibly a better dementia risk profile.

On the other hand, hyperglycemia can cause inflammation and oxidative stress, which also negatively affect the hippocampus through a different pathway, said Dr Craft.

She also noted that T2D is increasing among children — a “scary fact,” she said — which raises the question about how this will affect their dementia risk in years to come.

Also contributing a comment was Maria Carrillo, PhD, chief science officer, Alzheimer’s Association. The study results raise the question about whether more vigilance is needed surrounding cognition in people with T1D as they age, said Dr Carrillo.

“Perhaps we should be doing more to ensure that their cognition is protected as much as possible; should they be engaging in more enrichment activities; should we be keeping an eye on their cognition from an earlier time point; should they perhaps get cognitive testing earlier, starting in their 40s and 50s in their primary care physician’s offices.”

Dr Whitmer receives funding from the National Institute on Aging.

Information source

Supported by: