Public Nursing Home Fees

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Ham Slicer

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Friends father has gone into a State nursing home. His only income is contributory pension, disability pension and small UK war pension.

In the form filling stage at present and his wife is just trying to work out how much she will be left with out of pension etc. Both are over 70.

Anyone any ideas would be appreciated.
 
Public Hursing Home Fees

It makes me angry that professionals still skimp on crucial communication at these important stages of change in peoples' lives!

Whoever (G.P., Health Visitor, hospital Social Worker) is/has arranged her husband's nursing home admission should have sat down with both of them and optimally a couple of younger members of the family, and discussed ALL the implications including going through the financial aspects. If all that is done before admission individuals and families have the much-vaunted "choices" about their care and can decide what they want rather than having it foisted on them.

That hasn't happened - again - so you are left plugging the hole in the dyke which is not the best position for this couple and must be making them very anxious!

First, there is a book called (I think?) "Retirement in Ireland" obtainable free from your local Social Security office. It is very clearly set out and has comprehensive lists of agencies who deal with/have expertise in different aspects of retirement. I recommend it highly as it was of great help to me during my mother's last years when I struggled to make sense of the system.

Secondly, the Matron or Director of the nursing home will have information on cost of the placement and available subsidies. Make an appointment to meet with her/him. Be sure you list your questions and bring notebook and pen to write down the answers. Make sure you are equipped with details of the pensions etc., before that meeting. By the way it is very reassuring to the person concerned (in this case the husband) to be at that meeting and to be actively included in the discussion and hear the facts about the financial implications. Admission to nursing care is NOT equivalent to regression to infant dependency!

If there are still issues and questions after the above, Citizens Advice Centres will go through benefits with you and help assess whether all sources of funding have been tapped etc., as well as having knowledge of the broader social and political situation.

Lastly there are dozens of websites and pamphlets 'about' costs and benefits. My advice is to ignore them as the language they are written in make them difficult to understand and apply to one's own case. They are general overviews and legislation.

All the best with it - and thankfully they have your help HamSlicer!
 
Re: Public Hursing Home Fees

Hamslicer,

I might if I may correct a few of items mentioned in the previous post. I will address those items in a few minutes - but in the meantime, if you want a definitive response to your question, you should read through the following.

To begin, you give no information in your question concerning the type of nursing home care this person has entered. There are no 'state nursing homes' in Ireland. Instead, there is a mix of public and private nursing homes that are regulated by legislation. If you are talking about someone who has entered nursing home care in Ireland I presume therefore your reference to 'state nursing home' actually means this person is now in an HSE public nursing home, or in a HSE contracted bed (i.e., public bed) in a private nursing home. But which is it? Public or Private? It's very important to find this out.

Furthermore, it is unclear to me whether this person has actually entered nursing home care in Ireland or whether they are an Irish national in receipt of pension from Ireland but have entered a nursing home abroad. There is for example, no such payment as a 'disability pension' in Ireland - where are these pensions/payments originating from - the UK or elsewhere?

You also give no indication as to whether or not the person who has entered nursing home care/their spouse holds any other assets/income.

If this person and his spouse are over 70 years and are ordinarily living in Ireland, then they would both qualify for a medical card. While this would not exempt someone from paying charges for long-stay care, it will mean that the wife will be entitled to free in-patient public hospital services and free prescribed drugs and medicines.

The situation in the past in Ireland in relation to long-term care of an older person was that they would hand over their pension book to the institition and the institution would in turn collect the pension and give the person back some pocket-money. The Supreme Court has found these charges for care were levied illegally and in January 2005 the HSE requested that public nursing homes halt the practice of withholding pension books from nursing home residents and paying residents allowances.

The HSE also advised that pension books of those unable to manage their own affairs should be given to guardians. The 2005 Act also provides that charges for care cannot be more than 80% of the max weekly rate of the old age (non-con) pension. The intention was to introduce regulations to impose a maximum weekly charge of 120 euro (approx 80% of the 2005 non-con) old age pension and that the nursing home resident would be allowed retain a minimum of 35 euro per week as pocket money. I am not sure whether these regulations have been introduced or not but I can check.

In terms of inaccuracies in the previous post, there are no 'social security' offices in Ireland - there is a network of social welfare local offices that issue payments to those on various social insurance and social assistance schemes. To my knowledge (and that of my colleagues) and also including a check of the Department of Social and Family Affairs - that Department did not issue any book/booklet called 'Retirement in Ireland'.

It appears that the previous poster has had a negative experience in terms of accessing long-term care for a family member/friend. However, there are a few things you should be aware of:

(a) it is not the repsonsibility/job/role of any GP, health worker(?) or hospital social worker to assess income or provide financial advice on the implications of anyone entering long-term institutional care.

(b) there is no such thing in Ireland as a Citizens Advice Centre. Instead, there is a network of Citizen Information Centres or Citizen Information Services - that are funded by Government (unlike in other jurisdictions). Staff in Citizen Information Centres are not qualified to provide expert advice on long-term care options for anyone, nor have they the same level of expertise in terms of assessing social welfare benefits as staff from the Department of Social and Family Affairs

(c) information on social welfare benefits and entitlements and public health services is being provided to a high degree by a range of statutory agencies here in Ireland. I disagree fundamentally with any suggestion that you should 'ignore' this information - or that the information provided is simply 'an overview' or just 'legislation'. There are many official sources of information that are constantly updated, reviewed, improved, and that strive to provide comprehensive information on rights and entitlements.

I hope the above has been of assistance. As I mentioned earlier - you need to provide more detailed information regarding the type of long-term care this peson entered before it will be possible to provide a more definitive response to your question.
 
Re: Public Hursing Home Fees

Thanks for the help folks. I think I've tracked down the answer from Oasis.

My understanding is that all the fathers income of c€300PW will be taken by the nursing home except between €15 and €19PW which will be kept by spouse as pocket money

There is a meeting set up next week with someone from HSE so it should be sorted from there.

Thanks again.
 
Re: Public Hursing Home Fees

:rolleyes: I rest my case about the obsessive focus on semantics and rhetoric which substitute for concern for the needs and lingua franca of the client which pervade the public services. Unfortunately I recently recycled the book referred to - obtained in one of the many offices dotted around Dublin found at the end of a blue-and-white street sign saying "Obair" or "FAS" or "Seosalig" sometimes all three on them.............OOPS I mean "a network of social welfare local offices that issue payments to those on various social insurance and social assistance schemes"

I re-iterate my advice to bring a notebook and pens to your meetings.

My "negative experience in terms of accessing long-term care for a family member/friend" can be represented by a single anecdote. A social worker's conclusion that my 83-year-old mother "had Alzheimers" based on her response to the question "Can you tell me what this place is?" with "The Union" as the staff were ignorant of the history of St. James Hospital Dublin.

In our case when the 'services' realised we would not tolerate being bullied and having decisions and arrangements made without appropriate consultation and full discussion they stopped the bullying. I wish you success HamSlicer in easing the transition for this couple at such a difficult rite of passage!
 
Zegar,

I sympathise with your situation. I've spent many years looking after sick relatives and it's not easy.

Referring to the original question I asked and the course of events I can tell you that my friends father collapsed one day and was moved to Naas hospital for treatment. Having spent about 8 weeks there was them moved to Public Nursing Home. The transfer was made quite quickly to the nursing home of choice (reasonably local, best facilities) following a visit to local TD.

Maybe a visit to local TD might get some results.

Best of luck
 
ZEGAR said:
Need serious advice..
I am at my wits end !!

My mother was diagnoised with cancer a few years ago.She is fighting it and things are looking up.
In the middle of her treatment my Father's mum got sick and came to stay with my parents.
My grandmother had since been diagnoised with
Alzheimer's which is getting worse...I live away from home so I cannot offer much help....
My grandmother condition means she needs 24 hour care..My mother now is confined to her home for the day and spends her time chaNging nappies and wet sheets.She is not able for this in her condition.
Every time I visit I see my mother getting weaker,She has become depressed and its killing me.
Both my parents are in their 60's..
The have the home help and respite care provided but there are other expenses my parents must carry privately...This situation is runiing theri lives...
They cannot affort a nursing home and my grandmother had no assets..........How do I get my Grandmother into a public nursing home ASAP...
Click to expand...

It sounds like an intolerable situation but unfortunately as your parents have taken on the role of providing accommodation and care for your grandmother the powers-that-be now assess her needs as less than those of - say - someone in the same condition living alone. The burden on the family is never taken into account. Is your mother claiming the Carer's Allowance? She meets the criteria in every respect. It's around Euro 100 per week and will help towards the expenses. Unfortunately working-age people don't realise the state of affairs with provision for later life. It isn't 'glamorous' and makes everyone feel uncomfortable and helpless........which is why they have few advocates. I learned recently that families are now having to purchase wheelchairs and zimmer frames themselves (a wheelchair can cost over 1K) and where the family can't afford it, the elder person faces confinement for the rest of their days. Bad, bad bad!
 
I disagree with Marie's assertion that the burden on a family is not taken into account by health professionals in terms of assessing long-term care options for an older person.

Zegar didn't indicate whether the public health nurse or family doctor has been informed about the current living conditions. I presume that this has happened but if not - you should contact them as soon as possible.

Furthermore, the grandmother should be in receipt of a medical card so prescribed drugs and medicines and public hospital services should be free of charge. However - Zegar's mother is also entitled to a medical card on her own behalf (irrespective of her means, as a result of her medical condition), so I hope she has applied for this.

Have you also been in touch with your local branch of the Alzheimer's Society? While they can provide respite care, etc. they may also be able to advise on long-term care services/dedicated Alzheimer units in your area.

May I quickly correct 2 things from Marie's post above. It is not possible on the basis of your original post for anyone to say that your mother 'meets the requirements in every way' for Carers Benefit. Carers Benefit is a means-tested payment and only the Department of Social and Family Affairs can determine whether your family are entitled to this benefit.

In addition, Carers Benefit is not 'around €100 a week', with effect from January 2006 this payment is worth €180.76 per week. However even if she doesn't qualify for Carers Benefit, she may qualify for Carers Allowance - again family income is taken into account in determining eligibility and this weekly payment is also worth €180 per week.

If your parents are not already claiming any of these payments, they should consider contacting their local social welfare office to apply. It might also be possible to claim these paymnets be back-dated retrospectively - you'd need to check this however.

The immediate issue however seems to be an assessment of your grandmother's current condition and provision for her continuing long-term care. Could you confirm whether or not your family doctor/public health nurse has been out to visit your family home to assess the situation?

Given your mother's existing medical condition, I would imagine your HSE Area would assess your case as being of high priority.

CMCR
 
Just reading up on some oasis.ie info regarding Subvention for private nursing homes...Can anyone please expalin why it is that being on a non-contributory pension is more beneficial as opposed to a Contributory ??

Apparently you are in a more beneficial situation if you are on a Non-Contributory pension and can possible avail of extra subvention if you fall below certain levels....
 
Hi Zegar..

You can get different levels of subvention depending on how much you are worth. At nursing home stage of life, you seem to be better off with no money as the government will have to pay for your entire stay. If you have family and / or income, you receive far less benefits.

Bottom line.. Make sure you spend your money before you go into a home cos the government will end up taking as much as they can!!

My dads in a nursing home btw, so I know this from experience!
 
Well according to what I have read if you are on a non-contributory pension with no other income or property you can get above the 190 max subvention if you pension total falls under a certain threshold.This calculation is done by taking 75% of you pension as the working figure (remaining 25% considered pocket money)..So if 75% of your non contributory pension falls below this threshold you may be entitled to 190 plus extra....Wheer as those that contributed get no extra help......

Am I right...Please correct if need be
 
I dont know all the figures, but yes, if you're poor and havent a penny, the government have to look after you. If you've contributed all your life, have a nice nest egg, the government scr*w you to get it off you. Ok, I'm obviously a little one sided, but I believe a new (?) system has been introduced to clear the hospital beds of people who should be in a home, and they only pay €120 per week too.
 
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