Care Home Funding

LHW99

Also check if Gran's mobility problems would entitle her to Attendance allowance (possibly the lower rate). That isn't means tested and can help fund extra care at home.

badmemory

Normally anyone self funding & needing a care home would get the highest rate attendance allowance. If she doesn't then she probably doesn't belong in a care home. Perhaps it is time to bite the bullet!

Does Gran have any signs of dementia? If she does then go the care home route. If she doesn't then you should make sure that she does not uinder any but the most dire circumstances enter one. GO FOR REHAB! Then make sure that Gran attends every available centre that provides anything that stimulates her mind. Even if it comes down to every member of the family contributing a couple of quid a week to provide a personal trainer. That would be an absolute bargain compared to visiting someone in a care home, especially someone as young as your grandmother.

lisyloo

Does Gran have any signs of dementia? If she does then go the care home route.

My MIL has dimensia.
Initially she received a carer at home (whom she got dressed for !!) and was also taken to a day care center for a day.

My experience where we live is that social service DO understand about social needs and understnad that paying for day care/care at home is much cheaper than paying for hospitals and care homes, so they WILL provide help for people's mental state. This was all free for MIL except she had to pay about £4 for a two-course lunch, but transport was provided with someone to escort them (in addition to a driver). She was only able to go to this whilst she could bear her own weight.

She really loved the day care center for the period whilst she attended (which was unfortuntely short).

So I would say get all the help you can and be assured that there will be an ARMY of doctors, district nurses and social workers trying to keep your Gran out of a home not just for economic reasons but for her wel-being. Be aware that people with dimensia do not tend to improve once they are in a home, so it's a bit like a "departure lounge".

You can't just decide she has dimensia. She will need to go for tests and a second time so they can compare. Also make sure her hearing if ok. If hearing is imparied them that might appear as if someone is confused or ignoring you but can be jsut a hearing issue.

My MIL also got anti-depressants that helped her mood enormously. No idea if that's an issue here but jsut thought I'd mention it.

Also there are charities who can send round a volunteer to chat, play cards, do jigsaws or whatever she enjoys.

So be assured there is much help out there but residential and nursing home are a last resort for all the reasons given.

As well as attendance allowance your mum could claim for carers allowance if she qualifies.

badmemory

I would suggest not letting anyone know that she may be self funding until you have to. Also avoid hospital stays. My mother showed no signs of dementia (to other than those who knew her best) but her 2 week hospital stay with a broken hip had a dreadful effect - they were adamant she hadn't had a stroke. She went from someone who had been making their own meals from scratch to someone who struggled to make a cup of tea.

She never had a diagnosis of dementia despite every doctor she saw after that asking why she hadn't as 2 mins in her presence made it obvious. A diagnosis costs them money, money which is frankly no longer available.

DairyQueen

VixterW wrote: »

Hi everyone,
My grandmother, who is in her 70s, recently suffered a medical problem that has dramatically reduced her mobility. She is working on rehabilitation but her preference is to go from hospital into a retirement home where she can receive some care.
She owns her home jointly with my mum, and has some savings. When we have discussed a place for her she has become upset at the thought of her savings being taken for use towards the care while others who don't have savings don't pay the same. Her plan has been eventually to gift her savings to her family.
My question is whether there is a cut off around when she can gift the funds. I believe that once she goes into a facility they will increase control over her assets, so is she better moving money around before it gets to that stage? Or is it already too late since she is in hospital? I would like to make enquiries to the homes she is interested in but would not like to jeopardise her wishes for her assets.
Any advice would be greatly appreciated.

Many thanks
Vix

Apologies for this long post but you have touched on an issue that is high focus in my life at the moment.

Making decisions about supported living arrangements is a financial/practical/emotional minefield. We have recently been tiptoeing through this minefield with my MIL and are now beginning again with my parents.

There are many types of care and support available in theory: everything from a little domestic help in her own home through to a high-support care home. However, the options available to your GM will be determined by her needs, wishes and assets; versus cost, and availability of family, care agencies, and sheltered housing/residential homes, in your area.

My experience suggests that the first hurdle to negotiate is the tension between needs and wishes. In the case of my MIL (and my parents) the attachment to independence has been so strong that the need for support is marginalised/denied at the cost of health and safety.

The second hurdle (the one that you are facing) is the resistance to self-funding - especially when self-funding means the loss of their main asset - often the source of lifelong investment and security - their home. My MIL flatly refused to consider a residential home for several years for this reason alone. The consequences on her health and safety were sometimes life-threatening.

This resistance isn't always about a perception of injustice ("I must pay loads and others get it all for free"), nor is it always about a desire to preserve an inheritance for children. Sometimes people voice these two things as objections rather than admit that it's just too scary to part with their main source of financial security. In doing so they must also accept that their lives are reaching the end. We spend our whole lives investing with an eye to the future. The only time we let go of that aim is when there isn't that much future left to us.

Like I said, it's a minefield.

We don't know much about your GM and her circumstances but there are a few things that can be assumed as they apply to everyone. Please correct any wrong assumptions to receive advice more specific to GM's circumstances.

1) First step is to correctly assess GM's needs. If she is in rehab under the NHS then her housing/care situation should be assessed, and her immediate needs met, before she will be deemed ok to leave.

2) The Local Authority can be very helpful regardless of whether they are paying for none/some/all of a person's care. They have a duty to assess GM's needs and to put together a care plan with input from GM and her family. They are able to provide information on care/housing options local to GM, and will also make sure that GM is receiving any benefit to which she is entitled.

3) Who pays for care is secondary to the needs assessment. GM does not have to agree to a financial assessment by the LA but she will definitely not receive help with funding care of any kind unless she is assessed. She may also miss out on benefits, like AA, to which she may be entitled but unaware.

4) There is no suggestion that GM is not mentally competent, nor likely to lose competence anytime soon. That is very relevant to whether she drives the decisions, or whether others do so for her.

The next priority is to determine whether residential care is the best/only option to meet GM's needs, and what GM wants, and why. Assuming that residential care meets her needs and wishes, her concerns about self-funding need to be dispelled. She may need reassurance about her future financial security.

5) GM's age suggests that your mum is under 60. I have also assumed that GM's home is part-owned by mum but that mum lives elsewhere. Also that GM has been living alone. Those circumstances are such that GM would likely be assessed as needing help at home if she returns there, and that GM's 50% investment in the house would not be disregarded if she went straight into residential care.

6) There is nothing that you, mum or GM can do to avoid GM self-funding residential care. The issues considered by the LA within the scope of 'deprivation of assets' are very wide. Yours would be a prima facie case if GM disposed of any major asset. That includes 'selling' her %age of her home at a reduced price to a family member.

7) The basis for disregarding GM's share of her home in an assessment for residential funding is very narrow. The disregard is designed to protect those that live permanently with GM, especially if they are vulnerable. The LA will investigate any claim for disregard very thoroughly so it's not worth trying to give a false appearance that the criteria is met.

8) Residential homes are very expensive and are designed for those whose physical wellbeing is at high risk unless they have someone around 24/7, and/or require 24/7 assistance with the smallest activities of daily living (making drinks, preparing food, washing dressing, etc.). GM doesn't sound like she is in these categories.

9) GM also doesn't sound like she has any life-reducing, systemic health issues. Someone in their 70s could easily live another 15/20+ years. The typical length of stay in a residential home is under 4 years. Residential homes cost anything from £600-1200+ per week. The vast majority of the good ones are £900+. GM's pensions, and any benefits, will offset the drain on savings to some extent but, unless GM has a significant amount of savings/investments, or her home is very valuable, that kind of cost is likely unsustainable for 15/20 years. GM would therefore end-up LA-funded at some point. That could mean transferring to a different care home as many have now stopped offering LA-funded places.

10) There are still some good residential homes that offer both self-funded and LA-funded places but they are disappearing and the waiting lists are high even for self-funders. It's also a lottery re: whether any are within GM's area.

11) Even self-funders struggle to find a place in a good residential home. My MIL had to wait six months for a place at her preferred residential home. She was lucky as she lives in a large town in a wealthy area. She had a choice of three homes, two of which are very good. Rural areas often have less choice; less wealthy areas have fewer choices. LPA-funded have the least/no choice.

12) As for NHS-funded residential care. Forget it. Unless your GM has high dependence on medical nursing care to maintain her health 24/7 then this is not an option. My mum is severely disabled and dependent on a wheelchair. She has a severe form of progressive MS and can't walk, move from bed or chair without help, dress, shower or even make herself a drink. She is so disabled that she has received the highest form of DLA for over 25 years, but she does not require continuous medical care so would not qualify for NHS-funded residential care.

In summary, your post suggests that residential care isn't the only, or even the best, solution to GM's needs. Residential care would definitely be self-funded. There is no way that the taxpayer would foot the bill in GM's situation, and no way for her to unfairly circumvent the rules that apply to everyone else. LAs have become very hot on this kind of evasion.

Unless she has a large pension and/or portfolio of savings/investments (enough to sustain fees for 15/20 years), or her home is very valuable, she is unlikely to be accepted by some homes now, regardless of whether she self-funds, as there would be such a high probability that she would outlive her means and become dependent on the LA.

The demand for good residential care is so high, and LA funding so reduced, that many homes don't just limit places to self-funders, but to self-funders whose profiles suggest their savings will outlive them. Other residential homes must charge higher costs to self-funders in order to subsidise the unrealistic amount now provided by the taxpayer for places funded by the LA. Some good homes simply keep a few LA-funded places available for those residents who have an unexpectedly long stay (i.e. they outlive their savings). If no such place was available when your GM ran-out of money then she would be transferred.

Good residential care costs a lot to provide and someone must foot the bill. The care system is not designed to feather a few family nests at taxpayer expense. LAs are struggling to fund care for those who genuinely can't afford to pay. If, as you suggest, GM wishes to add to the taxpayer burden simply to keep her assets intact, she is unlikely to receive much sympathy and support here. If, however, her concerns are less about her own welfare than about stuffing the pockets of her family, she needs reassurance about where her family's priorities lie before any decisions are made.

Your GM is not alone in thinking that entering residential care is like shopping for a high-service, extended-stay hotel, or that such a hotel can be provided FOC with a little footwork. My experience is that this area is right at the sharp end of one's ability to pay, and that ability to pay is closely assessed by both the LA and the home at the outset. Once resident the home's interest in GM's finances is marginal unless the monthly bill isn't settled. The LA will stay close to the finances of anyone who is, or becomes, dependent on taxpayer funding.

If your family wants complete peace of mind that GM will live the rest of her life in comfort, and if you want to ensure she receives the best quality of care, then there are two ways of meeting that need: self-pay or self-help.

Terron

My Dad had to go into residential care. He did not have dementia but was too weak even to sit up in bed and since he had already been through rehab earlier in the year they did not consider it likely to work a second time.

He was self-funding as his NHS pension covered the cost. One of my sisters had a LPA for him.

He started to regain his strength and after a few weeks was able to walk short distances, though he was not supposed to do so alone as he would get dizzy spells. He insisted on going to the toilet alone and several times fell when doing so. The final time he banged his head and as he was on a blood thinner he bled into his brain and died.

Browntoa

Existing thread on exactly the same subject

https://forums.moneysavingexpert.com/discussion/5771112