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PIP - descriptor 3 Managing medication and therapy - Sleep Apnoea
Hi,
Has anyone had any difficulty with getting a Continuous positive airway pressure (CPAP) device recognised as at least an aid for 1 point? technically my service user doesn’t need any assistance what so ever with using this device or being motivated to use it so we cant go for the other descriptors.
The first tier tribunal has not awarded the aid point for this and I am awaiting the statement of reasons, just looking to see if anyone has had any experience of this.
Thanks in advance!
I would be interested to hear how you could argue that a CPAP machine is or delivers ‘medication’.
I would be interested to hear how you could argue that a CPAP machine is or delivers ‘medication’.
I have a client that just stops breathing when sleeping unless he uses a CPAP. He also has extreme fatigue due to his cancer and outsleeps the machine. If his wife did not top up the machine it would burn out. Unfortunately she has to switch it off to top it up and this causes him to awake very abruptly and scares the living daylights out of him.
Not surprisingly, the DWP did not award any points for help using the machine.
Edited to say he did get a point for an aid but it wasn’t specified if it was for the CPAP or a dosette box
[ Edited: 2 Aug 2016 at 09:42 am by annief ]
That should come under C (2 points) (or even D if it takes a long time) as I look at it. If someone needs help using their CPAP machine it seems quite clear that they need ‘assistance to manage therapy’. However, if they use the machine unaided (as per the OP) I am struggling to see how they need to ‘use an aid or appliance to be able to manage medication’. Then again I don’t know a great deal about CPAP machines which is why I was curious…
Just thinking out loud but does it need to deliver medication? I wonder how close the relationship between the aid/appliance and the medication must be. I’m not seeing anything in the activity which says the device itself has to be the thing which delivers the medication. It just needs to be something which helps you manage medication. So, for example, if someone needed oxygen to get their breathing to the position where they could take medication?
Not applicable to the problem posted by the original poster I am guessing but possibly productive in related situations.
As for the OPs issue, I am also struggling to see a way through.
mmm
well, it’s an aid to breathing and sleeping
https://www.britishsnoring.co.uk/shop/cpap_sleep_apnoea.php
but doesn’t deliver medication, only air at a continuous pressure to enable the person to breath properly through the night and thus wake refreshed having slept properly. i don’t see how air can be called medication. Therapy, yes, medication, no.
i imagine there will be the odd serious cases where it is in fact an aid to staying alive, sleep apnoea being what it is, might depend what sort he has
http://www.britishsnoring.co.uk/snoring_&_sleep_apnoea/what_is_sleep_apnoea.php
but i agree with others, can’t see this fitting in and acquiring any points at all on his facts…
Could it be argued that the air being provided could be “other regimen” and so if one receives medical treatment the treatment itself must be the receiving of medication itself!
Interpretation
2. In these Regulations —
“medical treatment” means medical, surgical or rehabilitative treatment (including any course or diet or other regimen), and references to a person receiving or submitting to medical treatment are to be construed accordingly;
The FreeDictionary by Farlex…
regimen noun…
The systematic application of remedies to effect a cure:
care, rehabilitation, therapy, treatment.
I have just spoken to a friend who uses a VPAP machine herself (Variable Positive Airway Pressure). She says that hers has an oxygen feed so blows in a mix of air and pure oxygen. She says that these are less common but by no means unique. May strengthen the argument for ‘medication’ if oxygen involved, I don’t know?
AnnieF, I have been puzzling over your client’s comments above. When you say ‘top it up’ do you mean the humidifier, or is something else being added? I asked my friend about the risk of a CPAP burning out if left on for long periods but she was unaware of such a thing (save the machine being old or faulty). Are you able to explain to satisfy my curiosity?
That’s excellent information Billy, much appreciated,
As far as I was aware it was going to be a straight forward case, (other descriptors under appeal as well)
Oh how I was wrong!
Cheers
Could it be argued that the air being provided could be “other regimen” and so if one receives medical treatment the treatment itself must be the receiving of medication itself!
Interpretation
2. In these Regulations —
“medical treatment” means medical, surgical or rehabilitative treatment (including any course or diet or other regimen), and references to a person receiving or submitting to medical treatment are to be construed accordingly;
The FreeDictionary by Farlex…regimen noun…
The systematic application of remedies to effect a cure:
care, rehabilitation, therapy, treatment.
I don’t think that definition is relevant to the descriptors at issue, John. Without having read every word of the Regs, ‘medical treatment’ looks like it is used in Reg 29 in relation to hospitals. In the Schedule, where the assessment is, there are the following definitions used in the descriptors in activity 3:
“manage medication or therapy” means take medication or undertake therapy, where a failure to do so is likely to result in a deterioration in C’s health;
“medication” means medication to be taken at home which is prescribed or recommended by a registered –
(a) doctor;
(b) nurse; or
(c) pharmacist;
“monitor health” means –
(a) detect significant changes in C’s health condition which are likely to lead to a deterioration in C’s health; and
(b) take action advised by a –
(i) registered doctor;
(ii) registered nurse; or
(iii) health professional who is regulated by the Health Professions Council,
without which C’s health is likely to deteriorate;
“therapy” means therapy to be undertaken at home which is prescribed or recommended by a—
(a) registered –
(i) doctor;
(ii) nurse; or
(iii) pharmacist; or
(b) health professional regulated by the Health Professions Council;
In short, I think you are saying that it is arguable that any kind of treatment must be ‘medication’ as defined in Sch 1, but I don’t think that is the case. (Even if I’m wrong, I don’t see how the definition in Reg 2 is any help in getting to that answer, as it is just an argument based on the ordinary meaning of the word ‘medication’ to me).
I think Claire is probably right that it is therapy that he doesn’t need help with, unless there is an argument that
1) it is medication - do others think that pure oxygen is ‘medication’?, or
2) assistance, prompting or supervision is reasonably required to manage use of the CPAP reliably - the OP seems to rule this out, but the reliability factors might be some help, potentially…
Jon
That should come under C (2 points) (or even D if it takes a long time) as I look at it. If someone needs help using their CPAP machine it seems quite clear that they need ‘assistance to manage therapy’. However, if they use the machine unaided (as per the OP) I am struggling to see how they need to ‘use an aid or appliance to be able to manage medication’. Then again I don’t know a great deal about CPAP machines which is why I was curious…
That’s what I was arguing, ironically he only needed that single point for the enhanced rate of daily living.
Yes she has to refill the water compartment as it runs dry
Resurrecting this thread as I have a client using a CPAP machine (amongst other medical equipment). One of the issues he has is motivation (has PTSD and depressive disorder) as well as physical issues incl chronic respiratory illness.
He has a lot of equipment CPAP, nebuliser etc which need to be regularly cleaned and he says he needs help with this due to fatigue and motivation issues.
I am wondering if the cleaning of medical equipment could be argued as being part of managing therapy/medication.
If he is not using the equipment properly, i.e. it’s dirty, surely he would run the risk of sub-optimal treatment at best and infection at worse??
CSPIP/40/2015 stated that assistance in setting up therapy should be included in “assistance to be able to manage therapy” so arguably, this should include making sure that the equipment is prepared for use, i.e. clean.
Thoughts?
[ Edited: 22 Jun 2017 at 12:02 pm by Catblack ]