Alternatives to going to live in a care home

I will keep adding to this- contributions most welcome from all regions or countries. I will have  a look at all UK regions eg Scotland.

Scotland

Nursing and personal care is free in Scotland for those over 65 years of age (paid for by the Government—!) (http://www.gov.scot/Topics/Health/Support-Social-Care/Support/Older-People/Free-Personal-Nursing-Care). Need to check if  a person has to have lived in Scotland for so many years prior in order to receive this . Be interesting to analyses the possible effect on this? Do people have more of an option to remin in their own home than they do in England? Assessment is done by the Local Authority. Some care at home must be paid for such as shopping, but some services are free (ibid).

Northern Ireland

As it stands now (2015) – similar to England http://www.nidirect.gov.uk/your-home-your-assets-and-your-care-home-fees

Wales

Similar to England http://www.ageuk.org.uk/cymru/home-and-care/care-homes/

Alternatives to going in a care home;

Before 7 years make a gift of home to offspring. Many solicitors will not do this- they regard it as fraud.
Go in a granny annex at your offspring’s house if social services allow it.
Find an agency and invite a student to live with you- in return he or she cares for you so many hours a day.Murphy (2012) http://www.theguardian.com/money/2012/jan/06/homeshare-scheme-tackle-housing-crisis
Advertise for a live in carer , or visitor or carer but check their credentials !
Some agencies do offer live-in carers for a fee!!
Age UK will provide carers for an hourly fee
Age UK will provide round the clock care- if you bequest them your property.

Charities will advise besides Age UK- there are others. They may even offer grants (see below- Help the Heroes).
Ask people in the community to shop for you.
Refuse to go- they may label you as “lacking mental capacity”.

Relatives- if you support their “fight” to remain in their own home or at your home, you may be banned from being involved or even visiting them.
Go to cheaper care overseas (Dimon 2014 Hasta La Vista Gran ). .
Live with a friend.
Join a commune.
Become a nun or charity body member.
Live in a hotel- one couple did this Will regulations eventually prohibit this? http://www.telegraph.co.uk/news/uknews/1562763/Pensioners-lived-in-a-Travelodge-for-22-years.html (2007)

A positive example- a war veteran , petition signed, has a grant from Help the Heroes for a live in carer –
http://www.itv.com/news/london/update/2015-04-04/96-year-old-war-veteran-given-emergency-grant-after-public-outrage/
This is short term so the council have offered to pay for care with payment being taken from the eventual sale of his house http://www.bbc.co.uk/news/uk-england-london-32471877

A charity in Ireland called ALONE has undertaken a report regarding this issue “The charity Alone, which provides services for older people in need, has said that a third of people currently in nursing homes could live at home if they were supported to do so” (rte.ie) .”Instead of spending €1,600 a week on a nursing home, maybe some of that money could be drawn down to purchase services in your own home for €500 or €600, he said” (ibid), http://www.rte.ie/news/2015/0622/709653-nursing-homes/   EINnews

Has been focus on retirement villages for some time but here it is again http://www.telegraph.co.uk/news/health/elder/11803577/End-of-the-care-home.html (ack Strength in Numbers). Consider eg Joseph Rowntree UK.

Also sheltered housing such as Anchor.

Yes we will always need care homes but please, only when absolutely essential.

LA/politicians remember- community care is far cheaper than care in care homes. Are we simply supporting businesses?
Yes- many love living in care homes but it does not suit the majority.

Some people it does suit http://www.ageuk.org.uk/home-and-care/care-homes/inside-a-care-home/

This is not all about being able to leave your property to your family- technically you do not own it yourself  anyway- the Government do. It is about quality of life- you should be cared for where you want to be cared for and in the manner in which you wish to be cared for.

NMC – FIT TO PRACTISE?

Offices of The Nursing and Midwifery Council ¿ NMC at 23 Portland Place London W1B 1PZ. UK.NMC, 23 PORTLAND PLACE, LONDON

Dear NMC,

Thank you for describing your function so very clearly, it is a comfort to nurses to know what their registration fees are paying for, rather like a supermarket shopper examining the contents of a packet to ensure they are not eating horse meat.

THE NMC IS THE INDEPENDENT REGULATOR FOR NURSES AND MIDWIVES IN THE UK. OUR PRIMARY PURPOSE IS TO PROTECT PATIENTS AND THE PUBLIC THROUGH EFFECTIVE AND PROPORTIONATE REGULATION OF NURSES & MIDWIVES. WE SET AND PROMOTE STANDARDS OF EDUCATION AND PRACTICE, MAINTAIN A REGISTER OF THOSE WHO MEET THESE STANDARDS, AND TAKE ACTION WHEN A NURSE’S OR MIDWIFE’S FITNESS TO PRACTISE IS CALLED INTO QUESTION.

It is also helpful for nurses to know that registrations fees support 5 areas of NMC acivity:

1. Advancement of Health or Saving of Lives
2. Education/Training
3. General Public/Mankind
4. Other Charitable Activities
5. Provides Advocacy/Advice/Information

Several questions arise from your published accounts:
Income  and Spending
31 Mar 2014   £65.19m     £70.59m
31 Mar 2013   £73.36m     £63.27m – Employees 441
31 Mar 2012   £52.78m     £61.19m
31 Mar 2011   £52.47m     £44.72m
31 Mar 2010   £51.71m     £36.74m

The 2013 accounts include a government grant of £20 million: ‘The Government expects that this grant will provide the extra financial support required for the NMC to properly tackle a backlog of fitness to practise cases, as well as to allow it to reduce the effect of a fee rise for hard-working nurses and midwives’ (www.gov.uk/government, October 15, 2012).

These questions are:
1. How many staff did you employ as of 31 March 2015? Has this number increased from its 2013 level?
2. How many of these staff are directly involved in the operation of fitness to practise cases?
3. How many staff are currently employed in each specific area of your activity? Or do staff multi-task, and combine different roles?
4. Under your Education/Training remit, do you have specific links with any UK university or business school?
5. Will you define ‘Other Charitable Activities’, and provide full details?
6. What was your total wage bill for the year ending 31 March 2015?
7. What was the total amount of ‘out of pocket’ expenses for council members in the year ending 31 March 2015?, i.e. monies spent on hotel bills, etc.
8. Are fitness to practise cases being more speedily dealt with, or is the NMC finding it difficult to keep up with the number of cases referred by employers?, i.e those who you wish to give the power of nurse revalidation to, who, of course, do not refer ‘manufactured’ cases to you because they want to get rid of a ‘troublemaker’, perhaps someone with standards that are not compatible with their business objectives.
9. Concerning linking employment appraisal and revalidation, did you consider Lenin Nightingale’s alternative suggestion of annual update courses at local education establishments?, which was sent to you via Twitter. Lenin did not receive a reply, and, to be frank, considered this rude, and not befitting an organisation involved in setting standards.
9. Have you recovered from your trading loss of 2014? Are you in surplus again? If not, and most nurses would not welcome another hike in registration fees, have you considered reducing your number of staff? As you know, these are times of austerity, so we are repeatedly told, and those with spare rooms are being subject to a ‘bedroom tax’. Is it not time the NMC ‘downsized’? Perhaps you could relocate away from the bright and expensive lights of london. May I make a suggestion of somewhere more central?, which would certainly cut costs? Grimsby. Since its fishing industry has collapsed, there are plenty of very large buildings available in the old dock areas, and you wouldn’t have to pay your staff as much, for there are plenty of cut-price ex-council houses for sale, and staff could shop at the local £1 shops. Those involved in fitness to practise hearings could stay in local hostels, alongside homeless families. This would save so much money, and would stop anyone being a fitness to practise panel member for the wrong reasons – £260 a day expenses. This amount would not be needed in Gimsby, for Lenin is reliably informed that sausage, chips, and gravy can be bought for £3, less if you ask for a childs’ portion.
10. Do you think you are fit to practise? Lenin does not intend this to be a cruel question, he only asks it in the same vein as an old nursing sister asked of him, peering over her spectacles: “Do you think you possess the necessary attributes to be a nurse?” She only intended to be kind, and point Lenin toward another career.

On behalf of many nurses, a reply would be most welcome.

Yours in expectation,

lenin nightingale 2015

AMERICAN LESSONS – THE FUTURE OF CARE IN THE UK

A report in December, 2014 (bigstory.ap.org), stated that ‘New Mexico’s attorney general … sued one of the nation’s largest nursing home chains over inadequate resident care … The novel approach in the lawsuit filed by outgoing Democratic Attorney General Gary King could be applied in other states if it succeeds. It targets seven nursing homes run by Preferred Care Partners Management Group L.P. of Plano, Texas, a privately held company with operations in at least 10 states: Nevada, Arizona, Colorado, Florida, Iowa, Kansas, Oklahoma, Louisiana, Mississippi and Texas … Traditionally, nursing home allegations have identified lapses in care — such as avoidable deaths, hygiene issues or a pattern of resident injuries from falls … Cited as Confidential Witness 2, the daughter of one patient at a Santa Fe facility … said she repeatedly found her father unattended, dirty and complaining he was hungry. With the facility’s staff saying they didn’t have enough time, the woman took over the daily bathing and feeding that the nursing home was being paid by the government to do … She would come in every day just after she left work around 5:00 p.m.,” the complaint said. “She could not stand to see her father neglected, so providing his basic care became her life’.

There you have it, the solution to ‘some unacceptable staff behaviours were not challenged effectively’ – ‘staff hitting, pushing, shoving, dragging, kicking, secluding, belittling, mocking and goading people … withholding food, giving cold showers, over-zealous or premature use of restraint’ (quotes concerning the ‘Cornwall abuse scandal’) – is to prosecute at an executive and commissioning level. Send the ruling clique to prison for 5 years. Things would soon improve. Cameras in all care facilities could be made compulsory, of course, as an alternative, but that would be like filming spot-the-staff, an equivalent of a David Attenborough documentary about the rareness of snow leopards! The cameras might even show what goes on a resident’s dinner plate, and, in that case, some film footage might have to be given an x-certificate, not something to be seen at a vicar’s tea party, or the RCN Conference. Can you imagine the outrage? “Oh Cecilia, this awful film is putting me off of my cream bun and coffee!” – referring to a vicar’s tea party, of course.

Can’t afford care home top up fees for your mum or dad? Think that’s the end of the matter? Wrong!, as a report in ‘Forbes’ shockingly explained: ‘A Pennsylvania state appeals court has ruled that the adult son of a nursing home resident is responsible for her unpaid $93,000 bill. And the decision has some elder care lawyers wondering if this is just the beginning of a trend’. You better believe it. ‘Pennsylvania is one of 30 states that have filial responsibility statutes—laws that impose a duty on adult children to care for their indigent parents. About two-thirds of those states, including Pennsylvania, allow long-term care providers to sue family members to recover unpaid costs. The rest, including states such as Massachusetts, have no recovery provisions. However, failing to care for a parent is a criminal offense. In the Bay State, the penalty is a $200 fine or up to one year in jail. The court also ruled that the facility could arbitrarily go after any family member it wanted, as long as it could prove that relative had the resources to pay’. Is this writing on the wall plain enough – God help the granddaughter with a well paid job! – the pack of capitalist hyenas running the no-care business will be on your trail. A thought occurs, though, could a relative claim a discount on the debt if their relative had been subject to ‘hitting, pushing, shoving, dragging, kicking, secluding, belittling, mocking and goading’? It might pay to send your loved one to Cornwall, and sod your conscience.

Another game coming our way via Uncle Sam-Old-Lies: ‘Nursing-home residents call in a panic: First they are sent to a hospital for a medical or mental health condition. Then, when the hospital discharges them, the nursing homes won’t take them back. It’s called ‘hospital dumping’, said Marilyn McCormick, regional coordinator for St. Louis Long-Term Care Ombudsman Office, which is funded under the federal Older Americans Act. The dumping of mostly low-income nursing-home patients—including a growing number of African-American elders, such as those in North St. Louis, is a nationwide problem, one involving a complicated dance between nursing homes that complain of low Medicaid payments, hospitals put on the spot to find another facility that will take the person, and frail elders and their families’ (St. Louis New America Media, Rebecca S. Rivas). What visions await! Skint Granny fighting not to get in the ambulance! – she knows her fate is to be sent to the equivalent of a nursing home knackers’ yard in the UK, or to be whisked off to an economy flight to a cheap nursing home in Botswana.

The UK is generally 10-20 years behind what America does, but, as sure as their capitalism is our capitalims, and their corporations are our corporations, it spreads here eventually, like an illness that develops so slowly the patient doesn’t realise they are sick, and, by the time the realisation sets in, so has rigor mortis.

lenin nightingale 2015

“Me, myself and I”

I will now ramble–

They who rule- prefer to “divide to rule” less chance of anybody fighting back.

The germ is within us- propogated by politicians- compete and reign as an INDIVIDUAL. We know what that means- kick others out of the way. Hence attacks against the vulnerable or so- called “non-contributors”.  Today we have ideas shared by many- perspectives shared by many- stop chasing the ball alone and allow others to catch it. The more the merrier.

See twitter galaxies at the end of here- it explains  a lot http://www.bbc.co.uk/programmes/b05s7pgs  Are galaxies in essence so different?

Many who campaign are at risk of reflecting they who they campaign about—. George Orwell – When man looked from pig to man- they were one and the same  Goodreads “The creatures outside looked from pig to man, and from man to pig, and from pig to man again; but already it was impossible to say which was which.”

DEFAMATION LAWSUITS AND THE NURSE

Nurses are increasingly being accused by employers of conduct that is against the NMC’s Code of Professional Conduct. This is likely to increasingly occur, in that the RCN support a system of nurse revalidation made by employers. Some of these claims are a matter of opinion, and are unlikely to be the subject of a claim of defamation. In what follows, I give examples of advice given to nurses (in an American context), who believe that they have been wrongly accused. American law on this subject differs only by nuance from that of the UK and other jurisdictions. My advice to all potential claimants is to proceed in a defamation case only if you have evidence of the falseness of the claim against you; can you prove that the accuser had not investigated the claim against you thoroughly (did not go through a process of due dilligence – acted with reckless disregard), and, thus, has repeated a damaging and unsubstantiated rumour?

If, after considering this, you may consider taking your case to a no-win-no-fee solicitor for a free consultation as to whether your claim is persuable, and, if so, to request them to inform the NMC that the claim against you is sub judice – awaiting judicial determination.
PROVING DEFAMATION
State rules differ on what an employee must prove to win a defamation case. Generally speaking, however, the employee must persuade the judge or jury of these five things:
•The employer made a false statement of fact about the employee. Statements of opinion (“I think Joe had a negative attitude”) can’t be the basis of a defamation claim. Nor can true statements, no matter how hurtful.
•The employer “published” the statement. In other words, the employer must actually make the statement to someone. (i.e. The NMC). Some states recognize “self-publication” as a way of meeting this requirement. Self-publication happens when the employer makes the false statement directly to the employee, who is forced to repeat it to others (for example, when asked by a prospective employer why she was fired from her last job).
•The employer knew or should have known that the statement was false. If the employer believes, in good faith, that its statement was true, there’s no defamation claim. However, if the employer acts with reckless disregard for the truth – by repeating a damaging and unsubstantiated rumor without checking into it, for example – that might support a defamation claim.
•The statement was not privileged. Many states recognize that candor and open communication are vital in certain relationships. Statements made in these contexts are privileged, which means that the speaker is protected from liability for making the statement. Many states recognize a qualified privilege – which protects the speaker as long as he or she acted without malice – for statements made in the context of giving an employment reference to a prospective employer.
•The employee suffered harm because of the statement. Certain statements are considered defamatory “per se,” which means that the law presumes the statement causes harm (and so the employee doesn’t have to prove it). For example, many states consider statements that someone committed a crime or lacks the necessary skills for his or her chosen trade or profession to be defamatory per se. If the employee has to prove damage, the harm usually involves another company’s refusal to hire the employee because of the statement.

SUING FOR DEFAMATION
If you think your former employer may have committed defamation, you should talk to an employment lawyer to find out whether your case is worth pursuing. These claims can be tough to win. The actual misconduct generally takes place in a private conversation that you aren’t privy to, so it can be hard to prove a defamatory statement was made. You’ll also have to show that the false statement was the reason you were turned down for a new job. And, in states that allow employers to claim a privilege for statements made as part of a reference, you’ll have to prove malice on the employer’s part.

Before you meet with a lawyer to assess your claims, gather any evidence you have. For example, had you gotten an offer letter or other indication that you would get the new position before your prospective employer pulled the plug? Do you have anything in writing about your former employer’s reference policy – or the actual statements that were made? (The NMC receive a statement detailing alleged misconduct) Did you hear anything from the prospective employer that made you suspicious? There are legal tools a lawyer can use to gather evidence of what was said to whom, but you should be prepared to explain what led you to believe that your former employer defamed you (and to hand over any relevant evidence).

CASE STUDIES
Can I sue my former employer for defamation of character for being fired due to being accused of being rude to those I supervise

I was falsely accused of being rude to those I supervised and I was fired because of their false accusations. I am a Registered Nurse and the job I was fired from was my first Nursing job and this has left me very distraught and upset and uncertain how this will affect me getting a nursing job in the future. I feel my character has been majorly assasinated and drug through the mud by the certified Nursing assistants who falsely accused me.

Christine C McCall, Administrative Law Lawyer Pasadena, CA.
‘Based on your factual summary, this is not a circumstance of potentially meritorious defamation claims. The reasons for your termination are by definition your employer’s opinion of you, and opinions are not subject to defamation law. Moreover, for there to occur defamation, there must be publication to a 3rd party of false statement of fact, not just publication to you. Then, there must be damages — actual losses — to you caused by the publication of the false … ‘.

Jeffrey Ira Schwimmer, Personal Injury Lawyer, New York.
As has been pointed out, you are referring to claims made against you by co-workers which can be characterized as opinion, as much as fact; and it appears that your employer chose to believe the others and not you. Essentially, you are referring to what is often referred to as a question of credibility, based on a “he said/she said” scenario. A war of credibility without any strong independent proof is not the kind of evidence that a defamation claim can be won on.

What the NMC needs to legally do (in my opinion), to successfully prove negligence, is to consider as factual that elements of liability are present:

Duty. Every person has a duty to act reasonably. Nurses, because of their specialized training, have a duty to care for their patients with the highest degree of skill and ability they can offer. Once a nurse assumes care for a patient for the shift, he or she has a duty to that patient for the entire shift.
Breach of duty. This is failure to exercise the degree of care that an average nurse would have used in similar circumstances. The plaintiff will compare your conduct with what another nurse would or should have done in a similar situation.
Causation. Was the breach of duty a substantial factor in causing the patient’s injuries/poor care?

I suggest that all nurses accused of negligence, who attend an NMC hearing, are represented by their Union’s solicitor, or by one paid for by private indemnity insurance.

lenin nightingale

Think Tank

We have several ideas- as we are sure others do- if anybody wishes to establish them? Please inform us if you have additional ideas for others to adopt or know of some already in progress. . We are not now in  a position to do them ourselves and wish only to improve care.

Care homes

Relatives within care homes / others should be able to pay for  a  vistior of the resident who may take him or her out , simple shopping, etc. This could be done by the relative paying minimum wage for an hour to  a person. It could be done privately or via an agency. Of course additional expenses include petrol for example. If the resident is in somebody’s car- personal insurance is needed plus CRB’s . We know this but it is not out of reach.

Individual and independent advocates : takes the above a step further, Pay a monthly fee to be guaranteed a weekly visit and feedback.

Relatives group- when you visit your relative- why not assess the care? Use the form from Lenin Nightingale . Somebody could coordinate the responses from this.

Nurses

Pay  a monthly fee to ? solicitor to be guaranteed legal cover if you need it.

Why not establish a totally indpendent union? ie independent of the government.

Why not establish a totally independent nurse University?

Community care

Too many people are without shopping- start  a shopping delivery service/buy a specialised van if you can.

Community cafes- we know of some. We need more. Could combine this with help with form filling and benefit advice.

See Detroitsoup- this may link to this .

Communal allotment- for anybody to grow and anybody to enjoy the produce.

Communal car boot- for all to sell

Establish  a registered charity to open youth clubs- youths also to assist the community.

Swap shop- we know some of these exist. Who wants tuition in exchange for eg a meal out/ a book? What can YOU offer?

Reading service – see RC below

Establish  a charity library full of old books . Offer to obtain books some districts will not obtain (funding). Loan books for  a small fee.

Craft exchange- see RC below. We came across this once.

Start  a “men-in sheds”—- we know there are some

Housing

(Apart from capping rents/ stopping sale of council houses —)

Many of the young face  a prospect of nowhere to live apart from with their parents. The consequence of this amongst others, may be becoming carers of their parents or becoming homeless.

Establish  a housing charity to buy cheaper properties that need renovation (could set up  a link with the LA for this).

After improving them; could use an army of volunteers , let the houses out to the young at cheap rents.

Living

Have a group of people who aim to live on £5  a week with no debt. Any spare money to be used to help the others with.

 

By doing this- we flow with the system and do not try to attack .

Nurse Registration : Unexpected Outcomes at Professional Conduct Hearings

Any contributions, with links, are welcome to this from all countries.

UK: NMC

Nurse removed from register for eating  a resident’s fish and chips (2015) http://www.liverpoolecho.co.uk/news/nurse-who-helped-herself-patients-8701997

Nurse cautioned by the NMC for hitting  a patient (2013) http://www.leicestermercury.co.uk/Nurse-kicked-struck-dementia-patient-Glenfield/story-19980525-detail/story.html

Poor care of a diabetic patient.  Who is accountable? http://www.irwinmitchell.com/newsandmedia/2014/march/nmc-hearing-sees-nurse-cautioned-for-gross-negligence-relating-to-diabetic-womans-care

“A senior midwife who went home instead of helping a heavily pregnant woman and her unborn child – who both later died – has been suspended for just three months.” (2014) http://www.dailymail.co.uk/health/article-2759456/Midwife-went-home-instead-helping-heavily-distressed-mother-unborn-baby-BOTH-later-died-struck-off.html#ixzz3XNZjxfmN  A Hodgekiss (Ack AnnDitch twitter)

http://www.dailymail.co.uk/health/article-2759456/Midwife-went-home-instead-helping-heavily-distressed-mother-unborn-baby-BOTH-later-died-struck-off.html

http://www.newsshopper.co.uk/news/dartford_swanley/13380785.Nurses_guilty_of_misconduct_after_leaving_man_lying_in_his_own_urine_will_return_to_work/?ref=twtrec  via EIN news Simpson F (2015) “A woman has been left ‘gobsmacked’ after three nurses who left her disabled partner lying in his own urine were not struck off – despite being found guilty of professional misconduct”- cautions were given.

http://www.crawleynews.co.uk/Manager-notorious-Copthorne-care-home/story-26928194-detail/story.html  ack YVM and End ElderAbuse twitter-

“A MANAGER who was in charge of a notorious care home where institutional abuse contributed to the deaths of residents is being allowed back into the profession six months after being suspended from nursing.” (ibid). Charges included orders to staff to destroy medical records, ineffective medication procedures, ignored and labelled residents.

Yes- we know there are mitigating circumstances to consider, and different people on different committees.