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Homecare 24/7

  • 01-04-2018 9:29pm
    #1
    Closed Accounts Posts: 339 ✭✭


    My aunt is terminally ill. Weeks/months to live. She is currently in hospital but wants to die at home. She is going home Wednesday. She says it is going to cost her 15 to 20 thousand a month
    for company to provide for 24/7 homecare. This sounds mad. Surely hse can provide some arrangement? Anybody know much about this area?


Comments

  • Hosted Moderators Posts: 17,422 ✭✭✭✭Conor Bourke


    My aunt is terminally ill. Weeks/months to live. She is currently in hospital but wants to die at home. She is going home Wednesday. She says it is going to cost her 15 to 20 thousand a month
    for company to provide for 24/7 homecare. This sounds mad. Surely hse can provide some arrangement? Anybody know much about this area?

    Where does your Aunt live? Given her short prognosis, is there any possibility of family being able to step up and help care for her? Why exactly does she need 24/7 care? It’s rare that someone would need that high intensity professional care tbh.

    If she’s still in hospital and hasn’t already been linked to a Palliative team, she should be. A medical social worker and the nurses on the ward should be working towards planning her discharge with her Public Health Nurse, GP, community Palliative Care team and if needed Community Intervention Team and Irish Cancer Society Night Nurses.

    So sorry to hear about your aunt, wishing you and her all the best.


  • Registered Users Posts: 27,939 ✭✭✭✭looksee


    Care is expensive, but agreed that sounds extreme. However there are a few things to consider. Depending on how well you know your aunt and how familiar you are with her affairs, it may be that you do not have the whole story.

    There are so many variables to this situation that it is almost impossible to offer an informed answer. The area she lives in, her personal financial circumstances, the nature of her illness and her incapacity would all affect her entitlements. In some cases there really are no entitlements - if you can pay then you do so, if you cannot then you have to accept whatever alternative is offered, probably a nursing home.

    If you are her nearest relative/carer then you could suggest to her that she should ask the district nurse to call and discuss options, or do it yourself if she is not able. If not, then apart from making that suggestion to whoever is her carer there is not a lot you can do. It is most likely that she will have spoken to a social worker in hospital, again, if you are her carer then you could get involved in that kind of discussion, if you are not, there is not a lot you can do.


  • Registered Users Posts: 27,939 ✭✭✭✭looksee


    Cornelius, that is true if the aunt has cancer, but there are other illnesses that do not attract the same amount of organised care/palliative care as cancer. Even then I think it only comes into play in the very last stages.


  • Registered Users Posts: 5,743 ✭✭✭appledrop


    I understand she wants to die at home but woukd she consider a hospice? She would receive very good care for weeks/months ahead + then if she really wanted she could go home at the end? 24/7 care is not impossible but hard + expensive to do at home especially if it's for months on end.


  • Closed Accounts Posts: 339 ✭✭frankythefish


    Her last wish is to die at home. Unfortunately we the extended family are unable to provide care due to the fact that we do not live nearby and we have work commitments as well as our own family commitments. Admittedly, she would not be easy to care for as she is in general very stubborn and extremely sick and quite confused (brain tumour, lung cancer and various other cancers). She is paying herself for this. How long she can manage to pay for it I do not know though


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  • Hosted Moderators Posts: 17,422 ✭✭✭✭Conor Bourke


    looksee wrote: »
    Cornelius, that is true if the aunt has cancer, but there are other illnesses that do not attract the same amount of organised care/palliative care as cancer. Even then I think it only comes into play in the very last stages.

    Palliative Care is available for anyone with a life-limiting illness and as the OP’s aunt has been given a short, terminal prognosis she is perfectly eligible for referral to either/both the hospital and community teams, the lady herself or the OP on her behalf would be well advised to seek referrals if they have not already been made.

    The ICS can provide night nursing for 10 nights to someone who is dying of a non-malignant illness, funding is sought elsewhere but it is available and certainly not unusual. Lots of people with non-cancer illnesses die very comfortably at home, well supported by a myriad of community supports including specialist Palliative care.


  • Registered Users Posts: 27,939 ✭✭✭✭looksee


    Well it comes down to her preference in the end. If she has money and/or property and she wishes to use it to have her last bit of time at home, then she is should do it. She does however need a representative to work with, say, a solicitor to manage her affairs as she becomes less able. If the money does run out it may be possible that she would end up in a hospice or a nursing home.

    She presumably has had conversations with a social worker in the hospital to ensure she has a representative, it is very unlikely that she would be discharged home if she did not have someone to take overall care of her, albeit with 24/7 care by an agency. I would say that the most you can do is check with the hospital that this has happened, however they will not discuss her affairs with you unless you are next of kin.


  • Registered Users Posts: 27,939 ✭✭✭✭looksee


    Palliative Care is available for anyone with a life-limiting illness and as the OP’s aunt has been given a short, terminal prognosis she is perfectly eligible for referral to either/both the hospital and community teams, the lady herself or the OP on her behalf would be well advised to seek referrals if they have not already been made.

    The ICS can provide night nursing for 10 nights to someone who is dying of a non-malignant illness, funding is sought elsewhere but it is available and certainly not unusual. Lots of people with non-cancer illnesses die very comfortably at home, well supported by a myriad of community supports including specialist Palliative care.

    And, I am afraid, many more die at home supported only by their spouse or whichever relative has taken on care. I am sorry but the 'myriad of community supports' is, in my experience anyway, not very accessible at all, due mainly to the lack of man/woman power at ground level.

    What you say about the ICS is in line with what I said, other diseases do not have that support.


  • Hosted Moderators Posts: 17,422 ✭✭✭✭Conor Bourke


    looksee wrote: »
    And, I am afraid, many more die at home supported only by their spouse or whichever relative has taken on care. I am sorry but the 'myriad of community supports' is, in my experience anyway, not very accessible at all, due mainly to the lack of man/woman power at ground level.

    What you say about the ICS is in line with what I said, other diseases do not have that support.


    No, what I said is that they can and do provide their night nursing service to patients with non-malignant (ie not cancer) illnesses in the exact same way as for people with cancer, the only difference being at the administrative end re source of funding.

    I deliver end of life care at home, my experience is broadly different to yours it seems. Anyway, it’s irrelevant to this discussion as the OPs aunt has a diagnosis of multiple malignancies so should theoretically be eligible for all available supports.


  • Closed Accounts Posts: 942 ✭✭✭Ghekko


    Private nursing fees could well be that. We were quoted over €2500 per week for private carers and they couldn't administer meds so didn't work out. Relative had to go to hospice as it was quickly apparent that being at home was a non runner. The pain was too bad. While it's admirable to want to facilitate your aunt at home it may not work out, especially if none of you live nearby, as was the case with our relative. I hope you can find a solution between you.


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  • Registered Users Posts: 5,743 ✭✭✭appledrop


    That's why I also suggested a hospice. If she has that many complications could be very difficult to manage at home to ensure that she is comfortable. That's before the cost is even considered.


  • Closed Accounts Posts: 339 ✭✭frankythefish


    Thought I d update. Aunt died Sunday. Had only gotten out of hospital the Thursday. Bed, hoist, chair, oxygen had to be all ready of course. Previously wet room, wheelchair ramp etc had been put in (in previous months). We had hired private homecare company to provide the day care. At night, the Irish Cancer society were to thank for the provision of a night nurse. They give 10-15 nights. We only got to 3 of course. Home help would come in for bit during day as would palliative care. Just updating as this info might be useful to someone in the future. We the family asked for all donations to go to irish Cancer society as a way saying thanks. They were wonderful


  • Registered Users Posts: 5,743 ✭✭✭appledrop


    So sorry to hear this news. I hope you + your family can take comfort from the fact that she did manage to get her wish + be cared for at home.


  • Registered Users Posts: 27,939 ✭✭✭✭looksee


    Sorry about that, franky, but better than a drawn out situation. We did much the same thing, room preparation and various things installed, but very limited time to use them. Glad to hear you got the home care, and she got her wish.


  • Closed Accounts Posts: 942 ✭✭✭Ghekko


    Aw sorry to hear that. Condolences to you and your family.


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