Participants with a degenerative condition

A degenerative condition is a disease or condition that gradually causes permanent loss of function. This means the things you can do change and your ability to do tasks reduces over time.

Case

Neil is 43 years old and lives with his wife and 12-year-old daughter in a home they own. Neil lives with primary progressive multiple sclerosis and has high physical support needs because of his degenerative condition.

Neil’s plan includes funding for up to 6 hours of support each day to help him with his self-care. Neil’s motor control, memory function and bladder and bowel control are getting worse. He is experiencing problems with his balance, problem solving and concentration as well as fatigue and heat sensitivity.

He needs extra help with his personal care and mobility in his home. Neil also needs help so he doesn’t wander from home and to safely transfer in and out of bed and his wheelchair.

Neil’s goal is to be as independent as possible in his home and community. Neil’s allied health practitioners have completed an updated functional capacity assessment. The assessment shows Neil now needs more help with all his bathing, dressing and eating activities. It recommends extra NDIS support because of his neuropsychological function, like help to remember to turn off the stove.

The report recommends a hoist to assist with Neil’s transfers. Modifications might be needed to make sure his home is accessible now and in the future. A second person is needed to help with his transfers to make sure he and his carers are safe.

Would we fund this?

Yes, we could fund rental of a hoist while a more permanent solution is investigated.

We could also fund more personal care supports and 2 people to help with Neil’s transfers while we investigate if modifications might be needed to Neil’s home:

  • so he can remain in his home
  • so he can function safely in his home
  • to help maximise his independence and his functional skills.

Why would we fund this?

To decide if a NDIS support is reasonable and necessary for Neil, we think about the information he has given us against the NDIS funding criteria.

For us to fund more supports for Neil they must meet all of the NDIS funding criteria.

They must:

  • be related to Neil’s disability
  • help Neil to pursue his goals to remain at home and be more independent
  • help Neil improve his social and work activities
  • not generally be something that could be given by Neil’s family or friends
  • be, or is likely to be effective and beneficial in helping Neil
  • be value for money. This means that the costs of the increased support, is reasonable when comparing the benefits it will give, against the cost of alternative supports. We think about whether the increased supports achieve the same independence and functional outcomes for Neil as alternative available supports
  • be an NDIS support for Neil.

What else do we think about?

When we decide whether we should fund these NDIS supports for Neil, we think about:

  • his supports as a total package. Equipment or assistive technology may be needed to help with his personal care for example
  • other options like flexible equipment rental or NDIS supports to build Neil’s capacity to stay at home
  • if it’s appropriate for informal supports to provide personal care
  • if the extra NDIS support for Neil’s personal care will make sure Neil is safe in his home
  • Neil’s future needs and whether he can stay in his home in the long term. We may need to fund home modifications for Neil in the future.

The planner decides:

  • providing additional personal care to Neil is not the responsibility of his family and friends. So the planner increases the hours of personal care in Neil’s plan to 8 hours a day
  • to include funding for a 2:1 ratio of supports in his plan for 3 hours a day for his safe transfers
  • a package of flexible equipment rental is cost effective for Neil’s immediate support needs, and as his needs change
  • to include funding for an occupational therapist assessment to explore whether any home modifications would support Neil to remain in his home in the future
  • to schedule regular check-ins with Neil to make sure his current plan has the right NDIS supports as his needs change.

When we create a plan, we must think about NDIS supports as a total package of supports. To help us to do this we use the principles we follow to create your plan.

For more information, refer to:

This page current as of
2 December 2024
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