Child Disability Payment decision making guide
Day and night criteria
CDP individuals who receive dialysis during:
- either the day or night are entitled to the middle rate care component (CDP regs, reg. 16(3))
- both the day and night are entitled to the highest rate care component (CDP regs, reg. 16(4))
Day and night must be considered relative to the routine of the household where the individual lives (CDP regs, reg. 11(6)(a)). This is likely to be different for each individual.
For CDP, this generally involves considering when the parents or carers get up and go to bed, rather than the individual’s bed times. If the individual’s parents or carers either:
- stay up to provide attention
- get up to supervise the individual
when they would normally have already gone to bed if they did not have to care for the individual, this counts as night-time care.
Nina, 5 years old, starts her haemodialysis when she goes to bed around 7pm. Her parents set up the dialysis and stay with her until she is asleep. The haemodialysis lasts approximately four hours. They then check in with her from time to time until the dialysis has ended, which generally is around 11pm. Afterwards, they:
- help Nina use the bathroom if she needs it. She tends to feel dizzy after dialysis and could hurt herself without support
- disconnect the tubes and clean the dialysis machine which takes them about 30 minutes
- go to bed around 12.15am
In this case, only the day criterion is satisfied as Nina’s parents prepare and supervise the dialysis before they normally go to bed. Their night-time routine therefore isn’t impacted by their daughter’s treatment.
Sonia, who is 10 years old, used to receive haemodialysis during the day in her local hospital. This however:
- led to her regularly missing school
- required her grandmother, who is her carer, to drive for over an hour to and from the hospital
Sonia has therefore started receiving haemodialysis at home every night, starting around 8.30pm. This means that Sonia has to go to bed earlier than before. Her grandmother, who has been trained to assist her by the hospital:
- sets up the dialysis once Sonia is in bed
- stays with her until Sonia is asleep, which normally takes 30 minutes
- checks on her during the dialysis which takes approximately four hours
- has to clean and put away the machine and tend to Sonia once the dialysis has finished
Therefore, she has had to change her sleeping pattern from her usual bedtime at 9pm to approximately 1.30am. The case manager decides that Sonia’s dialysis satisfies the night criterion, as:
- the individual's carer would normally go to bed at 9pm
- the majority of the care takes place after the household’s bedtime