Hello all

I have a client on MRC and considering going for higher rate care. Client has personal aid call alarm around her wrist, when she pushes it in a medical emergency the call aid centre contact either a member of her family or paramedics to come to her assistance. The client has had to use this various times when she has had seizures during the night, which could harm her brain, if she does get the help she needs. Seems to me that she needs watching over, for DLA purposes, or will the DLA say as she has a alarm to call assistance that she has solved the problem and does not need watching over or at risk etc.

I would have thought night time seizures should normally be a good indication of night care needs. You say the seizures "could harm her brain" -- has she a history of prolonged and repeated seizures, or even status epilepsy (a series of fits without regaining consciousness in between) ?
These sorts of seizures are always considered a medical emergency and DWP guidance indicates that high rate care appropriate on supervision grounds.
-- she says gets enough warning/aura to use alarm ?
and anti-convulsive medicatiomn is not effective in controlling the seizures?

alban

Sorry if this seems like teaching anyone to suck eggs, but I had a similar case only last week, which came to us - unfortunately - already at appeal stage...the client had sought a revision based on encouragement to do so by her social worker/agency carer...the evidence was good around the night time needs and the fact that the client had had cause to use her "careline" equipment several times at night supported the arguments she had initially made in her "anytime" request...problem was that she never really completed the review form on her day time needs, and the existing award of Mid Rate Care was for her night time needs and it was actually daytime care that was the issue!! This had not been picked up by anyone until the DM submission.....just a thought!!

(we were lucky in that we managed to obtain evidence her care needs had increased during the day...but this was more for attention than supervision...and we won...hurrah....however, the whole thing could have gone belly-up if 1/ the chair had taken a similar view on the careline equipment which you describe 2/ we had not managed at the last minute (and it has to be said, by "shaming" the SW into writing a full written report) to get the necessary evidence.

I'm afraid its an all-too-common example of well-meaning advice being given inappropriately!

Surely, the purpose of the care line sytem is that you then receive the attention you require - and such attention at night will be for a substantial period ...in fact any attention subsequently recieved night or day in a case such as this will be fairly substantial - the careline is purely a means of summoning attention -

Department of spanners in works: if a seizure could harm her brain (which is true) having attention won't stop it doing so, as attention will not stop the seizure happening in the first place. Indeed unless there is somebody actually with her (rather than say downstairs watching the telly), when the seizure starts they won't even be able to help her lie down in a safe place, remove dangerous objects and check she doesn't swallow her tongue and bash her head.

What does she need someone to do for her once she has had a seizure? Eg, calm her down, clean her up if it's that sort of seizure, make her a cup of tea?

This is one of the most conceptually difficult topics in DLA.

Whilst attention cannot stop something happening, it is the attention that a person might need following the event that is the all important factor - if one has broken a limb whilst falling, or any such occurance which necessitates even a precautionary visit to a hos[pital then there isd the attention need.....in the case of serious epilepy for example, where grand mal attacks are unpredictable, what one can quite rightly be said to be providing is supervision with the intention of providing immediate attention when needed.

I've known two people that have died following epileptic seizure. Nothing on the planet would have stopped the siezure occuring, but contstant supervision would have saved thier lives.

Anyone who has done a first aid course knows that an unconscious patient is a medical emergency, and an unconscious epeliptic is no different.