Personal Expenses Allowance - case study form

Personal Expenses Allowance Case Study Form

Help us to highlight the needs of older people living in care homes

We are looking for older people - or members of their families or carers - to share your experiences with us of problems with the Personal Expenses Allowance.

If you, or a relative or friend, live in a care home and receive the Personal Expenses Allowance, what items do you normally spend the Allowance on? What essential personal items are you unable to afford? Do you have access to the kind of activities and services that you would like to and are able to in the care home you are living in?

Required fields are marked with *

Name of older person living in care home
Age*
Care home*
Area*
Person telling the story (if not older person living in care home please indicate your relationship to them)
When did you move to live permanently into residential care*
How long have you been at the care home you live at the moment*
Story* (How much Allowance do you receive? Describe your/ your relative or friend's experience of living on the Allowance, including specific examples of items and services that you spend the Allowance on and things that you cannot afford. Have you ever had to spend your Allowance on paying for health services like chiropody? What activities and services would you like to have access to in the care home that you currently live in?)
Being able to share your story with the press could help Age Concern campaigning work. Please indicate if you would you be willing to speak to any of the following (please circle as appropriate)
Print journalists?*	Yes No
Have your photo taken?*	Yes No
Speak to broadcast journalists and be filmed if asked?*	Yes No
Age Concern would never put a journalist in touch with you or your family directly without your prior agreement. All calls are vetted by the media team and your first point of contact would always to a member of Age Concern staff.
Telephone number
Email*

We would like to keep you informed about Age Concern's charitable activities. Please tick the box if you DO NOT wish us to:
	tell you about our charitable activities
	pass your details to the trading companies of Age Concern England, Age Concern Scotland and Age Concern Cymru so that they can inform you about their products and services
	pass your details to other reputable organisations

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Personal Expenses Allowance - case study form

Personal Expenses Allowance - case study form

Personal Expenses Allowance Case Study Form