Paying for Care

Errata

But they will still have to meet the full costs of bed and board if they go into a care home - some £16,800 a year

[URL="http://"][/URL]

That's an interesting amount of money - I doubt if the cost of food averaged out over all care homes amounts to more that £20pw per head. For instance in today's Guardian a relative gives details of their dad's tea in a care home: one cold hard boiled egg, shell on, and a metal dish of tinned fruit salad.

pollypenny

I read yesterday's report on an old people's home and today's responses ( I don't now how to do links, sorry).

There is no way I would want that - a bottle of Jameson's and a bottle of pills, curled up in bed, with a book will sort me out.

Errata

Link here http://www.guardian.co.uk/society/2009/jul/14/older-people-care-home

The report is titled "A day in the life of an old persons home"

Newly_retired

Wow, that is difficult reading. Helps to put the recent suicide of Sir Edward Downes and his wife into context too.
Also helps me appreciate the wonderful home where my mum spent her last 7 months of life. She CHOSE to go into a home and told us that is what she wanted to do if dad died first. She was 92. She went initially for 2 weeks " for a rest", but within no time at all she had a new lease of life. No more worrrying about how she was going to get the day's meals, or managing to keep herself and the house clean. Her walking improved as there were handrails everywhere which gave her confidence. She enjoyed the company of the other livelier residents, especially the men ( and I don't mean that in any inappropriate way - they were just more interesting to talk to). There were outings: she was taken to a local amateur theatre, to the Mayor's tea party; there were visits from local church groups, services, entertainment, the hairdresser, chiropodist....
Yes there were drawbacks of course. She would have liked more to eat sometimes. She lost some of her clothes in the communal laundry system. She did have some lonely days. The best thing I did was get her her own phone line. I wish I'd done it sooner, but didn't, as her stay was only temporary, until she decided that the house would have to be sold. Although this would have had to happen for financial reasons, the main reason was that ( after years of lack of proper maintenance) it would have deteriorated rapidly over the winter, with no central heating, rotten window frames...... She understood this and readily agreed. There was no point in keeping it or spending money to upgrade it.
Maybe that was in the end what caused her to go downhill -the loss of her own home, the realisation that she was now there for the rest of her days? We shall never know, but she became ill and after a couple of weeks of excellent care in the home she needed to go to hospital, where she died 10 days later. In retrospect I wish I had placed her in a nursing home for her final days to die in peace rather than the public ward of a hospital. That is my only regret.

I tell this tale to show that it is not always a bad thing, and can be a positive choice, to go into a care home. My parents lived like paupers but when dad died we discovered there was enough money to pay for mum's care initially if that was what she wanted/needed. Selling the house would ensure that could continue.

I don't know what to think about the various proposals currently being put forward. It will almost certainly not be this government which puts a new scheme in place.
I shall try to pass some of my money ( savings and inheritance from sale of my parents house, as mum died before it was sold in the end) to my children before the state takes what is left for my care, but I realise that it is just not possible for everyone to receive free care in their old age and we all have to contribute one way or another at some point. The middle generation is squeezed enough already, supporting children, high mortgages, helping aged parents, going through redundancy......
I think there will have to be choices, not one system imposed on all. Nothing will ever be fair. There will always be those who will spend all they've got in order to get fully funded by the state. And there will always be those who need to be funded by the state. But if those who have saved can have the choice whether to pay up front ( or from their estate) or only pay out if they need to, this would seem fairer than a blanket imposition.

EdInvestor

There are three basic components to a care package - personal care, food and other consumables (incl things like newspapers,hairdressing etc), and accommodation.

Most existing self funders shouldn't have too much difficulty paying for the first two categories via their pensions with the help of existing Govt allowances ( some costs would go down in a care home, eg no council tax, no TV licence fee).

The problem arises with the accommodation component.Prudent people pre-fund their retirement accommodation by buying a home on a mortgage and paying it off before they retire, so they have very low outgoings for accommodation, basically just repairs and insurance. So finding the money to pay for this chunk of the care fees is a big problem.

One way of dealing with it could be to assess the contribution to the accommodation cost based on the rental income achievable for the person's home.Councils already have the capacity to do this quickly and easily via the LHA/HB system.Housing associations could then manage the freed up home so the person in care knows it is being looked after (ifr the family prefers not to do it themselves).

This helps with the council's waiting list, keeps the asset intact for the heirs and enables a contribution on an 'ability to pay' basis without penalising saving.It might also be a useful way for councils to keep tabs on rises in costs at care homes.The Government could make a further contribution by allowing tax free status to rental income being used to pay care fees as it does with existing care annuities.

Newly_retired

Well that is a really constructive approach - well thought out.

Errata

I think one of the difficulties is that a great many care homes have 30 or so beds. Economies on accommodation costs could easily be achieved if homes had 200 beds.
Some may be horrified by this idea, but the stark truth is that whatever size a care home is it will always be an institution. They can never be 'homely' or 'just like home' for the same reasons that hotels can't achieve that sort of atmosphere - whatever the publicity might say.
Having pondered and thought about the gov options - I don't like any of them !
My choice would be a ringfenced increase in NI. I believe society should fund society's health costs.

EdInvestor

Errata wrote: »

Having pondered and thought about the gov options - I don't like any of them !My choice would be a ringfenced increase in NI. I believe society should fund society's health costs.

But IMHO if care is to be completely funded from tax/NI then it needs to be run on a not-for profit basis and costs strictly monitored.In recent years the escalation in fees has been completely unjustified and the services provided are basically no longer affordable except by the well-off. This really won't do.

The biggest underlying gain for everyone though would be a breakthrough in prevention/cure for dementia/Alzheimers, and that's a very worthy place to distribute more Govt money..

monkeyspanner

Errata wrote: »

I think one of the difficulties is that a great many care homes have 30 or so beds. Economies on accommodation costs could easily be achieved if homes had 200 beds.
Some may be horrified by this idea, but the stark truth is that whatever size a care home is it will always be an institution. They can never be 'homely' or 'just like home' for the same reasons that hotels can't achieve that sort of atmosphere - whatever the publicity might say.
Having pondered and thought about the gov options - I don't like any of them !
My choice would be a ringfenced increase in NI. I believe society should fund society's health costs.

Count me as horrified. If we ever factory farm the elderly I will be booking my trip to Switzerland. I have seen what this kind of approach to elderly care produces in the NHS and it is appaling.

My MIL was in a care home with 14 residents and the staff ratio was about 1:1. It was as near to a home as you could get. If it smelt it was of freshly cooked meals (not institutional cabbage). There was no underlying disinfectant smell and it was very clean. The residents were treated with care and respect and made to feel at home. There was no question of my MIL being dumped on the hospital in her last few weeks and she died in her own room with her family beside her. Many of the staff attended her funeral and when we see them now they always have a kind comment.

EdInvestor

Looks like nobody is happy with these ideas.

http://www.citywire.co.uk/personal/-/blogs/money-blog/content.aspx?ID=349649&re=6202&ea=156896