Assessing the mental health needs of older people
An essential part of meeting needs is ensuring that older people with mental health needs, and their carers, have sufficient financial resources and are receiving all the financial help to which they are entitled. A full welfare benefits check should be an integral part of any assessment, and many older people with mental health needs will benefit from help with applications and form filling, for instance for Disabled Living Allowance (Attendance Allowance). A number of voluntary organisations such as Age Concern provide this service, but the experience of completing the forms with an older person can be helpful for a professional assessor in opening up areas of discussion about how the person is managing.
Charging for community care services provided or arranged by Social Services is usual but can be extremely contentious, particularly where the needs being met are the result of mental ill health or where services are provided jointly with health organisations. NHS services are free to the service user but social services are means tested. The NHS is responsible for funding continuing health care, but in practice there have been problems with the criteria for eligibility, and the distinction between NHS and Social Services responsibilities is not always clear. The Department of Health is currently reviewing Continuing Health Care with a view to producing a national framework. Meanwhile practitioners will need to ensure that they fully understand the operation of their Strategic Health Authority's criteria for continuing health care and the Social Services Department's policies relating to charging.
Direct payments can be provided by Social Services Departments to people with social care needs so that they can arrange and pay for their care directly rather than have it provided for them. The take-up of direct payments has to date been mainly by younger adults with physical disabilities but the Department of Health is anxious to see the scope of schemes extended (36), and for there to be increased take-up by older people. Direct payment schemes should include support mechanisms to enable older people with mental health needs, and their families, to take advantage of direct payments if they have capacity and wish to do so. The social care Green Paper Independence, well-being and choice also includes a proposal for individual budgets as one idea for extending choice and control for people with social care needs.
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