What happens if my relative needs a long term nursing home placement in the future?

For many people and their families the need for a Nursing Home placement is something which comes out of the blue. Sometimes it is triggered by a hospital admission or falls at home or sometimes it comes when family members who have struggled to maintain a parent or relative’s independence find they themselves are no longer able to cope.

For many people and their families the need for a Nursing Home placement is something which comes out of the blue. Sometimes it is triggered by a hospital admission or falls at home or sometimes it comes when family members who have struggled to maintain a parent or relative’s independence find they themselves are no longer able to cope.

These realities usually bring many mixed emotions both for the potential Nursing Home resident who often fears loss of their independence and worth in society and for their families who are often left feeling guilty that they have not been able to look after their parent or relative at home.

In 2009 a new method of funding Nursing Home places called the, ‘Nursing Home Support Scheme’ better known to the public as, ‘The Fair Deal,’ commenced. This new scheme of funding replaced the previous ‘Subvention’ scheme. Subvention was a form of means testing which often led to older people being left in a position where they had little choice other than to sell the family home in order to pay Nursing Home fees.

The newer Fair Deal Scheme was based solely on the ability to pay of the person requiring the nursing home placement and was carefully structured to remove the need for the older person to sell their home.

The Fair Deal is made up of two contributions, the first contribution comes from the Nursing Home Resident and the other from the HSE. The National Treatment Purchasing Fund (NTPF), were given the authority to negotiate bed rates with all the Nursing Homes in Ireland who wished to take part in the Fair Deal Scheme. The resident’s contribution, plus the HSE contribution, is equal to the weekly bed rate agreed between the Nursing Home and the NTPF.

Should you or your relative require a Nursing Home placement you can collect an application form for the, ‘Nursing Home Support Scheme’ (Fair Deal) from your local Nursing Home or download it from the HSE website, www.hse.ie.

Provided you are a spouse or an adult relative of the person needing the nursing home placement you can complete the application for your relative. Once the form is completed and sent to the local office listed a care needs assessment will be triggered. This assessment is usually carried out by a nurse or therapist in the HSE and is used to determine whether the person in question has needs which can be most appropriately met in a Nursing Home or whether their needs could be met by remaining in the community with available resources.

If the assessment outcome supports the person’s need for a nursing home placement then funding will be agreed in principle. This means the person who requires the nursing home will receive a letter stating that nursing home care has been approved. The letter will also state what the financial contribution from the person themselves will be.

This contribution is based on 80% of the persons pension + 5% per year of the value of the person’s own home, should they own a home. The 5% per year of the value of their home only stays part of the contribution for three years after which there is no further claim on the person’s home. There is also a contribution of 5% of the value of the person’s savings which only applies to savings the person has above and beyond €36,000 or €72,000 for a married couple. Finally there is a contribution based on land, additional properties and/or owned businesses at 5% of the values per annum for as long as the person remains in a Nursing Home. These contributions when added together form the person’s total contribution and the remainder of the Nursing Home fee is paid for by the HSE. Once you have received the letter agreeing the Nursing Home level of care and stating what the person’s contribution will be, the person is then held on a waiting list for approximately four to six weeks before funding is finally released. It is important to wait for this confirmation of funding release as the HSE will not back date funding and therefore if you make a Nursing Home placement prior to this confirmation you could find yourself with an unexpected bill.

For further information you can download a guide to the Nursing Home Support Scheme from the HSE website. (www.hse.ie). Guy Walton RN, SPN(DN),BSc. Tel: 043 3348033. Guy Walton is Director of Nursing at Laurel Lodge Nursing Home in Longford.