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More about Vera's care

 

Vera is 86. She lives in her own flat. Her son, Clive is 49 years old and recently divorced. He has returned to live with his mother, but he works overseas for most of the year.

Vera has moderate dementia and is also being treated for breast cancer. Vera had a previous hospital admission for breast cancer, before she came into the study.

Vera was admitted to hospital from home at the beginning of this study, after a fall. For the 6 months before she went into hospital she had regular visits from her GP, the Social worker, a Mental Health Nurse and a Breast Care Nurse. Vera needed help with washing and dressing and had help from 2 carers twice a day. She also had podiatry, which she paid for herself.

Clive arranges live-in care for his mother for part of the time when he is away for long periods.

 Costs of care for 6 months before hospitalisation:

(costed at 15 weeks at home, 11 weeks in hospital) 

Continence pads, 20@ 30p/pad for 15 weeks £90.00
Protection sheet@ 12p x 1 per week £7.44
Medications@ £89.00 per month for 6 months £534.00
1 A&E visit £97.00
Hospital admission, 75 nights @ £346/ night £25,950.00
GP visits x 3 £360.00
1 x Mental Health Nurse visits @ £56/ visit £56.00
Practice Nurse appointment £12.00
Social work visit £213.00
Breast care nurse visit x 1 £45.00
Personal care, 28 contacts/ week @ £25, for 15 weeks £10,500
Respite, 4 days @ £78/day £312.00
Podiatry x 2 @ £28.00 £26.00
Total:   £38,202.44

NHS
Social care
Self funded

Vera was admitted to hospital after a fall. She had been alone in the house and was unable to get up when she fell, so had become cold and dehydrated.

 Cost of hospital admission: 

7 days @ £346 £2,422.00
60 days @ £255 £15,300.00
Total: £17,722.00  

Vera became increasingly frail while in hospital, and was discharged to a Care Home with Nursing. The fees were £503 per week. The fes were to be divided between NHS, Vera and her family and the local authority. NHS Registered Nursing Care Contribution (RNCC) was awarded because Vera was assessed as needing a nursing care environment and was therefore eligible for an NHS contribution. RNCC, the NHS funded nursing care contribution, is currently £108.70 per week. Vera and her family will pay £113 per week, and the local authority will pay £281.30 per week.

6 months after discharge from hospital, Vera’s health score was improved, but her dementia rating and her ability with regard to activities of living had got worse.

2 of her medications were discontinued, but she had started taking iron tablets.

Vera saw her GP once during the 6 months after discharge from hospital, but had no other contact with health or social services from outside her Care Home.

 Costs of Care 0 - 6 months after leaving hospital:

Vera became increasingly frail while in hospital, and was discharged to a Care Home with Nursing.

The fees are £503 per week. The fees are to be divided between NHS, Vera and her family and the local authority. RNCC was awarded because Vera was assessed as needing a nursing care environment and was therefore eligible for an NHS contribution. RNCC, the NHS funded nursing care contribution, is currently £108.70 per week. Vera and her family will pay £113 per week, and the local authority will pay £281.30.

6 months after discharge from hospital, Vera’s health score was improved, but her dementia rating and her ability with regard to activities of living had got worse.

2 of her medications were discontinued, but she had started taking iron tablets.

Vera saw her GP once during the 6 months after discharge from hospital, but had no other contact with health or social services from outside her Care Home.

Continence pads, 21 @ 30p/pad for 26 weeks £163.80
Medications @ £82 per month £492.00
GP visit £120.00
Care Home fee (funded), 26 weeks @ £390.00 £10,140.00
Care Home fee (self paid) 26 weeks @ £113 £2,938.00
Total: £13,853.80  

NHS
Social care
Self funded

12 months after leaving hospital, Vera lived in the same Care Home with nursing, still receiving funding from RNCC and from her local authority. She continued to pay a top up of £113 per week. In the second half of the year following admission to the Home, she saw her GP 6 times but had no more hospital visits. She paid for 3 podiatry treatments arranged by the Care Home.

 Costs of Care 6 - 12 months after leaving hospital:

Continence pads, 28 @ 30p/pad for 26 weeks   £218.40
Medications @ £82.00 per month for 6 months £492.00
GP visits X 6 @ £120/visit £720.00
Care Home fee (funded), 26 weeks @ £390 £10,140.00
Care Home fee (self paid) 26 weeks @ £113 £2,938.00
Total: £14,508.40  

  

NHS
Social care
Self funded

From the start of the study, Vera's care needs were high. In the 6 months before the study she had already had a long hospital stay for treatment of breast cancer. She had a big care package at home. She then had another long stay in hospital after a fall, and although her assessments in this study did not show deterioration, she was assessed as needing a nursing care environment on discharge and went to live in a Specialist Care Home with Nursing.

 

Costs of care are taken from the Personal Social Services Research Unit Report, 2011, written by the University of Manchester, The University of Kent and the London School of Economics.