Transcript PALLIATIVE CARE STUDY DAY 2010

PALLIATIVE CARE STUDY DAY 2010
Financial Aspects of Family Support
Ciara Savage, Senior Medical Social Worker,
Beaumont Hospital.
Role of Social Work
Mission Statement:
“ To provide an effective Medical Social Work
service which facilitates optimal social and
emotional well-being among patients and
those affected by their illness.”
Psychosocial Assessment
• Primary tool in a Social Worker’s kit!
• Initial and ongoing understanding of
patients circumstances.
• Evaluate psycho-social functioning.
• Wide ranging questions.
• Based on Interaction and Holistic view.
Psychosocial Assessment
• Building of trust between worker and
patient/ family member.
• Stressors identified – often financial.
• Advocacy – central to MSW work
Common Financial Concerns
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Loss of Income
Costs of treatment
Costs of ongoing care arrangements
Costs of travel to care
Delays in application process
Increased GP/ Medication fees.
Sick Leave
Recent Research
• National Cancer Registry Ireland and Irish
Cancer Society (Sharp and Timmons, 2010)
• Significant financial impact a diagnosis of
cancer can have for patient and family.
• Travel and medication costs can be major
burden.
BODY
Physical Attributes
Medical Conditions
Value Systems
Laws
Socio-Economic
Policies
Discrimination
Oppression
Culture/Ethnicity
Resources
MIND
Self Esteem
Psychology
Cognitive
Intelligence
Family History
Relationships
Communications
Expectations
Family Needs
SPIRIT
Meaning
Will Power
Religion
Determination
Family Networks
Community/Society
The whole person exists in context
Environmental Needs - Housing –Money- Facilities-Material Conditions
Framework for holistic assessment - the whole person exists in a context: From Good Pracices in Palliative Care : A
Psycho social Perspective (1998) David Oliviere, Rosalind Hargreaves & Barbara Monroe.
Financial Stress
Can have far reaching consequences:
• Impact on relationships
• Impact on Self-Esteem
• Impact on treatment
• Physical manifestations of stress
Case Example
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45 year old male
Lung cancer
Self-employed
Married- 2 dependent
teenage children
• Wife works part-time
• Mortgage
Issues:
• X qualify illness
benefit
• Wife’s means
assessed for DA/SWA
• No medical Card
• Large Mortgage
• No income protection
Case Example cont.
Potential Plan:
• Get in touch with local CWO re. SWA/
mortgage supplement etc.
• Medical Card Application – Advocate on
behalf
• Approach ICS etc, with permission
• Support throughout treatment
What’s Available?
• Illness Benefit
• Invalidity Pension
• Disablement
Pension
Social insurance
payments based on
PRSI contributions.
What’s Available?
- Long term
- Social assistance payment
• Disability Allowance
- Age range 16 – 65
- Disability expected at least
one year.
- Means Tested
Supplementary Welfare Allowance
• Weekly allowance
• Paid to people who
do not have enough
means to meet their
needs and those of
their qualified adult or
any qualified children
• Payable while
awaiting claim for
social welfare benefit/
assistance or pension
if no other income.
• Means tested
Supplementary Welfare Allowance
• Rent Supplement : assistance with rent in private rented accommodation.
• Mortgage Interest Supplement: assistance with the cost of mortgage
interest repayments.
• Diet Supplement: assistance with the cost of a special diet prescribed by
your doctor or hospital consultant.
• Heating Supplement: assistance with the cost of heating a home in certain
circumstances.
• Exceptional Needs Payment: once off payment to help meet essential
exceptional expenditure, which a person could not reasonably be expected
to meet out of their weekly income.
• Urgent Needs Payment: assistance in emergency situations.
What’s Available?
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Carer’s Benefit
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Social insurance payment based
on PRSI contributions.
Compliments the Carer's Benefit
Scheme with regard to leave.
Carer's leave allows employees
to leave their employment
temporarily for a period up to
104 weeks to provide full-time
care for people in need of fulltime care and attention
Unpaid
Jobs kept open for carer for the
duration of the leave.
What’s Available?
Social assistance payment
Carer’s Allowance
Means tested
Can be on Carer’s Leave
Medical Cards
• Access free of charge to:
• Means tested
- Family Doctor or GP
services
- Community health
services
- Dental services
- Prescription medicine
costs
- Hospital care
• Income assessed after tax
and PRSI is deducted,
rather than total income.
• Allowances made for
expenses
• If the costs of meeting
your medical needs cause
financial hardship
allowance made.
Other Schemes
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Long-term illness
GP visit card
Local Authority Grants
Tax relief – employing a carer etc.
Concessions for Disabled drivers
Rates (selection)
• Disability allowance
• Illness benefit
• Supplementary Welfare
Allowance (SWA)
• €196.00 personal rate; €326.10 with
qualified adult
• SWA including one child, €225.80
• Carer’s Benefit
€213.00
• Carer’s Allowance
Under 66 €212.00; 66 or over €239
Charities
• Irish Cancer Society -
Financial aid; travel2care
• Marie Keating
• Protestant Aid
• Marie Curie
• Sick and Indigent Roomkeepers’ Society
• Local Hospice Groups
Useful Resources
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www.welfare.ie
www.citizensinformation.ie
www.cancer.ie
www.mabs.ie
www.hse.ie (to get health centre details etc)