Upload
elvin-phillips
View
214
Download
0
Tags:
Embed Size (px)
Citation preview
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
• 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.
The whole person exists in contextCo
mm
unit
y/So
ciet
yFam
ily Netw
orks
Environmental NeedsEnvironmental Needs - Housing –Money- Facilities-Material Conditions
BODYBODYPhysical AttributesMedical Conditions
MINDMINDSelf EsteemPsychologyCognitive
Intelligence
SPIRITSPIRITMeaning
Will PowerReligion
Determination
Value SystemsLawsSocio-Economic PoliciesDiscriminationOppressionCulture/EthnicityResources
Family HistoryRelationshipsCommunicationsExpectationsFamily Needs
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
• 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?
• Disability Allowance
- Long term
- Social assistance payment
- 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?
Carer’s Benefit
- 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 full-time care and attention
- Unpaid - Jobs kept open for carer for the
duration of the leave.
Medical Cards• Access free of charge to:
- Family Doctor or GP services
- Community health services
- Dental services
- Prescription medicine costs
- Hospital care
• Means tested
• 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
• 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)
• Carer’s Benefit
• Carer’s Allowance
• €196.00 personal rate; €326.10 with qualified adult
• SWA including one child, €225.80
€213.00
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