FAQ’s

Frequently Asked Questions

Here are some questions that we have been asked. Please do email us some more


I have just been diagnosed with dementia and I live alone. How do I plan for my future?

It is a frightening diagnosis to face but there are many things you may want to consider to ensure your comfort and dignity both now and in the future.

Discussions with your GP and Consultant

It is vital to have a good relationship with your GP and consultant and that you feel comfortable about asking for advice.  It is advisable to be accompanied by a close family member or friend when visiting your GP or consultant as it is difficult to remember all that has been said and agreed.  At this stage the emphasis will be on enhancing your memory and keeping you in good general health.

Discussion with Friends and Family

It is usually helpful to have a broad and wide ranging discussion with friends and family members that you know have your welfare at heart.  When thinking about the future consider the possibility and practicalities of being cared for in your own home or whether you would prefer to be cared for in a residential home.  It is important to recognise that any decisions made at this stage must be seen as flexible and able to be reviewed.

Managing Your Affairs

It is probably advisable not to have a credit card if you find keeping track of your finances difficult.

It may be safer for you to use a debit card rather than cash but if you are unable to remember your four-digit number when using a chip and pin debit card you can ask your bank for a chip and signature card which enables you to sign your name as usual.  If you are unable to sign your name banks can provide photocards to identify you visually.

It may be easier for you if all your pensions and benefits are paid into your bank account and payments go out from the same account.  Most regular bills can be paid by direct debit which means that the bank pays the bills automatically so you will not forget them.  If you would prefer to choose a person you trust to manage your account for you your bank will set up a ‘third party mandate’ to enable this to happen.

If you feel you would like to arrange for all of your affairs to be dealt with by someone else if you become unable to do this for yourself you may consider making a Lasting Power of Attorney for Health and Welfare, and one for Property and Financial Affairs.  This is a legal process which enables formal decision making powers to be given to someone you trust but they only take over when you are no longer able to decide for yourself.

The Citizens Advice Bureau (CAB) is a good place to go for advice.  Trained CAB advisers offer free, independent and confidential advice about legal, financial and other problems.  To find your nearest CAB look in your local telephone book or ask at the library.  National CAB can be found on line at www.citizensadvice.org.uk

The Office of the Public Guardian (OPG) is another useful source as it protects people in England and Wales who may not have the mental capacity to make certain decisions for themselves, such as about their health and finances.  You can download forms from their website about Making and Registering a Lasting Power of Attorney, found at www.publicguardian.gov.uk.  You can contact them by email at the following address – customerservices@publicguardian.gsi.gov.uk; telephone them on 0300 456 0300 lines operate from 9.0. am to 5.0 pm Monday, Tuesday, Thursday, Friday and 10.0 am to 5.0 pm on Wednesdays; write to them at PO Box 16185, Birmingham B2 2WH.

Staying at Home

If you decide that you would prefer to be looked after at home there are services and benefits which can help to make this easier.

Services

Community Care Assessment

Local authority social services departments are responsible for assessing the needs of people who may need care services to enable them to continue to live at home.  Each local authority has its own assessment procedure and the social services department will publish information on how to apply, what kinds of services could be provided and who is eligible to receive those services.  You will be able to get the information from your social services department or your local library.  On line, GOV UK is the official guide to information on central and local services.  It can be found at www.gov.uk then go to the heading ‘Benefits’.  Move on to the sub heading ‘Benefits Entitlements’ and under this you will find a section ‘Find out about changes in care and support’. Enter your post code where requested and you arrive at your local council website which outlines the services they provide and the eligibility criteria they use.

Each local authority has its own criteria for deciding who is eligible for assessment and compares applicant’s needs against those criteria.

The assessment is carried out in your own home usually by someone from social services who may request extra information from other professionals such as your GP, consultant or community nurse.  The assessment involves looking at your needs and circumstances and assessing your finances as the local authority can charge for the services it arranges if you are able to contribute towards the cost.  The amount charged will vary according to the local authority but charges are meant to be ‘reasonable’.  How much, if anything you will have to pay for your home care is dependant on the amount of savings you have plus your income.

The kinds of services that you may find helpful are meals on wheels, home care and day care.  When the assessment has been completed a ‘care plan’ is written which describes the services which you should be provided with, who will provide them and when they will begin.  You will be given a copy of the plan and the name and contact details of your care manager who is responsible for seeing that the services are delivered.  You may have to wait for services to begin or some may start and others follow later.

Services may be provided directly by social services or arranged through other agencies such as health or housing departments, or voluntary or private organisations.

Home care workers can help with personal care if you are having difficulty in washing and dressing for example or they may prepare simple meals.

Day care may be available locally in the form of day care centres or drop in centres and provide social activities and a meal.  Transport to and from these centres is often provided.  You may also be put in touch with centres run by local groups or charities.

Direct Payments

If you have been assessed as needing community care services you may prefer to make a request to the local authority for a Direct Payment so that you can arrange and pay for your own services.  Rules vary across local authorities and they must be convinced that you can manage the payment alone or with assistance.

Benefits

Do check with the Citizen’s Advice Bureau (CAB) as you may be eligible for a range of benefits such as: Attendance Allowance if you are over 65 and you find things like washing and dressing very difficult or you need someone to make sure that you are safe.  This benefit is tax free and does not depend on National Insurance contributions.

Going Into Residential Care

If you decide that you would prefer to be cared for in a residential home you need to speak to a social worker about your options in regard to funding and claiming assistance from your local authority.

Each local authority carries out an assessment against the criteria for eligibility on any application to receive local authority funding to pay for the costs of residential care.  If it is established that you have assets above the criteria you will not be eligible for local authority funding. The assessment will take into account all your income from pensions and benefits and capital including savings, investments and the value of your house.  Any investment with a life assurance element will not be included in the assessment.

Any amount contributed by the local authority towards your care fees will depend on your income and capital.  The full amount of your state pension and fifty per cent of any private pension will be classed as income.  Your allocation will be calculated after allowing you around £22 per week for personal expenses.  If you are trying to sell your home the local authority can provide funding towards your care fees while you wait for a sale, this is called the Deferred Payment Scheme.

I am really worried about one of my friends

I am really worried about one of my friends who lives alone.  She has always been late for appointments but now seems to have even less sense of time.  She is also finding it increasingly difficult to find her way round neighbourhoods she has known for years.  What can I do to help her?
Finding out that a friend has dementia is bound to be distressing but understanding the reason for her behaviour can be reassuring in that you can attempt to help her as the condition progresses.
It is possible that your friend is not suffering from dementia but she does need to see her GP so that other conditions can be ruled out.  The kind of symptoms you describe can also be caused by infections, depression, stress and other illnesses.
Try to persuade her or help her to make an appointment with her GP, go to the appointment with her and make sure you make a note of what is said as it is often difficult to remember later.  If your friend thinks there is nothing wrong with her and is cross that you are ‘making a fuss’ it might be advisable to phone the GP before the appointment as people with early dementia often manage to present themselves very well in medical consultations and GPs get a false impression of the situation.

Discussions with GPs and Consultants

It is vital to have a good relationship with GPs and consultants and to feel comfortable about asking for advice.  The GP may give your friend a physical examination and do blood and urine tests to help exclude other possible conditions.  When the results of these tests are received the GP may reach a diagnosis or may refer your friend to a specialist for further investigation.  This could be to a neurologist, elderly care specialist, psychologist, or psychiatrist specialising in dementia.  Your friend is entitled to have a second opinion so do ask for a referral if the GP does not suggest it.
There are technological and psycho/sociological investigations that can be carried out to help diagnose dementia.  Some people are referred for a brain scan which may be a CT scan or MRI scan.  Others are referred for memory tests, commonly the mini-mental state examination (MMSE) which involves questions and tests investigating the person’s memory, language and mathematical skills.  Some people may be referred to a memory clinic that specialises in diagnosing dementias.
If a diagnosis of dementia is made your friend may have drugs prescribed that can slow down the advance of the disease.  She should also be told about local services and support.

Discussion with Other Friends and Family

It may be helpful to have a broad and wide ranging discussion with your friend and her other friends and family members that you know have her welfare at heart.  When thinking about the future consider the possibility and practicalities of your friend being cared for in her own home or whether she would prefer to be cared for in a residential home.  It is important to recognise that any decisions made at this stage must be seen as flexible and able to be reviewed.

Further Help from Home for Home

There is more information about possible ways to cope with this situation in the Hope For Home FAQ’s Dementia and Living Alone.