The Process is Raising Eyebrows.

The process of finding a care facility for Alzhiemers sufferers isn't difficult, but in Dad's case it did raise some eyebrows. 

From memory, once Mum had decided to place Dad in care the process went something like this:

• She contacted the Mental Health Unit to organize a referral for Needs Assessment.

• The Mental Health Specialist visited Dad at home to correctly assess his status so a report could be sent to the Needs Assessor.

• Shortly thereafter, the Needs Assessor contacted mum regarding the Needs Assessment - she asked a few more questions.

• The Needs Assessor then advised Mum (I believe via letter) on the level of residential care required, based on all reports received.
  
  I can’t remember the exact terminology, but basically Dad needed Level 3 care.  We found out later that meant Psycho-geriatric care, which we eventually dubbed Lock Down.
• At some point Mum had questions on how to pay for care and any subsidies available.
  
  This is where she hit the wall of overwhelm and called in the whanau to help clarify things.   I understand she was getting visits, phone calls and information from a lot of quarters, not to mention us kids asking how things were going, was she on top of it etc – it was all a bit much to deal with.

• Discuss options and plan of action with Needs Assessment and Service Co-ordination.
  
  Mum was living up north. We, the whanau, had decided it would be best for Dad to be in Auckland for a couple of reasons.  Firstly, there were only 2 facilities in Northland that the Powers That Be said were suitable.   The one nearest Mum, about an hour away, had a less than agreeable reputation – so we struck that off the list without bothering to view it.  The other one was two hours drive away from Mum and three hours drive from any of us. 
  
  Secondly, we figured if Dad was in Auckland he would be closer for all of us to visit, taking the strain off mum a little.
• A website with recommended facilities for Level 3 patients in Auckland was sent to us, so we could go and have a look.

• Visit a number of rest homes/hospitals.
  
  My sister and I did most of this. I think mum was still somewhere between denial and overwhelm, so didn’t want to face this task.  Besides, I guess she figured we would find the right place.
  
  It was at this point, after we had viewed the first care center, that we knew Dad's assessment was wrong.  Dad was not in need of Level 3, psycho-geriatric care.

• We called the Needs Assessor.
  
  Why have you decided Dad needs Lock Down?
  
  She explained, her role is simply to ID the type of facility required based on the reports she receives from the Specialists.
  
  We rang Mum to determine who Dad’s Mental Health Specialist was.  She told us he was on holiday, it would be best to get hold of the Mental Health Nurse.
  
  We duly rang the MH Nurse and asked who the Covering Specialist was. She played Gate Keeper and, after ascertaining we had issues with the Level 3 assessment, which she herself was surprised at, (she was fairly certain Dad’s Usual Specialist wouldn’t have supported this decision), she offered to find out what was going on.
  
  She got back to us with this:
  
  The Usual Specialist, who went to see Dad for a one on one visit when Mum initially requested a Needs Assessment, has gone on holiday and took Dad’s file with him. (Raised eyebrows – What?)
  
  The Covering Specialist only had previous notes to go on.  He never did a one on one with Dad and I don’t believe he ever rang Mum.  He wrote the report that went to the Needs Assessor based on available notes. (Frowny eyebrows – What?)
  
  If we wanted Covering Specialist to do a personal assessment, we will have to wait till after the New Year.  (We were currently in late November)  Until then, our options were keep Dad at home or send him to Level 3 Lock Down.
  (Normal eyebrows, deep breath, let it out slowly).
  
  We asked 'Why he couldn’t be sent to a Level 1 or 2 facility?'  Because care facilities only accept patients based on their assessment level.  As Dad was on L3, a facility set up for care of lower level patients would not take him.  Soon after this phone call we learned that Dad had earned too much over the years to be eligible for any government subsidy.  This meant he would be paying all accommodation and care expenses himself.  In other words, a private patient.
  
  We also found out that, if you’re privately paying, you don’t actually need an assessment.  The assessment process is largely so the care facility can ensure they’ll receive their fee from the government, and different levels of care receive different funding per patient.
  
  If you are a private paying patient, you can get into any facility you choose, so long as they have space and are happy to have you.
  
  I confirmed this with the MH Nurse.
  Yes, she said. If he is privately paying, you can do that.
  Eyebrows shot up 'Really', then knitted together with determination. That is what we did.