Example section for Indefinite Awards

Lorna is 68 years old and has had a severe head injury that has significantly impacted their personality 25 years ago. They live on their own in a rented flat and have input from mental health services, who have been providing input. They also suggested Lorna should apply for Scottish Adult DLA.

Lorna is supported by twice weekly support sessions from a mental health support worker and daily home care visits.

Their brain injury and the changes in personality they have experienced are permanent with low probability of full remission, with symptoms remaining stable and enduring. Lorna takes significant levels of medication to manage these.

Lorna has learned to live with their condition and their main restrictions are self-care and when they come into contact with other people. Lorna

• needs encouragement or motivation to get out of bed in the morning;
• needs frequent and repeated prompting to eat;
• needs assistance to manage their medication;
• will not wash unless prompted;
• will not wipe after using the toilet without prompting;
•  will not change their clothing unless prompted;
• is unable to engage and communicate with people independently without overwhelming anxiety.

Lorna therefore satisfies the daytime condition and has been in receipt of the middle rate of the care component since meeting the backwards test just over 24 years ago.

8 months Lorna was diagnosed with depression. Mental health staff who support Lorna on a regular basis convince them to report a change of circumstances. Lorna reports that they struggle even more with getting out of bed. They regularly lack appetite and need prompting to eat. It’s become more difficult for Lorna’s carers to successfully prompt them to engage with personal hygiene and Lorna often feels very low and hopeless. Lorna explains that they have been trialling different medications, but so far have not found a treatment that significantly alleviates the symptoms of their depression.

Lorna does not report any night-time care needs or any mobility needs.

The case manager reviews Lorna’s case. They establish that Lorna’s entitlement should remain the same, as they already satisfy the criteria for the day-time condition of the care component.

Even though Lorna’s depression is relatively new and the symptoms linked to this condition are likely to change if Lorna finds treatment that works for them, their needs in relation to their severe head injury are highly unlikely to change. The case manager establishes that, therefore, there are likely to be small changes in need over time, but it is highly unlikely that their overall needs will either improve or worsen to a degree that would impact entitlement.

This is due to the nature of the condition.

They check the decision-making guidance on review periods. They then review other relevant factors outlined in this chapter to understand the likelihood of Lorna’s needs changing.

The case manager decides it would be reasonable to award an indefinite award based on the likely longevity and complexity of their conditions and needs. They make the determination and submit the case for internal quality assurance