Care Home Fees Conundrum

Mojisola

lisyloo wrote: »

Mojisola - Did you Dad want to go into a home? Many people don't even though it might be the best thing for them.

fred246 - same question, was she averse to going? My MIL (dimensia) did not want to go into a home (but was keen to get out of hospital). We had to "wait" until she fell and was moved from hospital to a home as she wouldn't go voluntarily.

He wanted to get out of hospital and a care home was the only option so none of us actually chose it - what we found was that he was much happier in the home we chose than he had been at home.

We were very fortunate to have a not-for-profit care home company in the area which puts more emphasis on spending money on carers rather than 'stuff'. We looked at several homes that were like 5-star hotels with cordon bleu chefs but the carers were very thin on the ground and Dad would have been one resident among a crowd, milling around large lounges.

The home he went into organised their residents into small 'families' so that he was one of about ten who had their own lounge and dining room and could get to know each other.

billy2shots

lisyloo,

It's perfectly normal to draw conclusions from our own experiences but I think your letting your personal situation influence your thought process. Your family member with arthritis and cellulitis is perhaps a world away from what some of us are talking about.

You also mentioned another family member who had dementia that was making choices.

I'm not trying to teach a grandmother to suck eggs and I know you must be perfectly aware already but.....

Dementia can be a very slow process, someone can lead a perfectly happy life for many years with early dementia. Forgetting the odd name, appointment or recent event would hardly require someone to move into a home.

Then there's the middle ground.

Then we get to the end where someone 'forgets' how to swallow, move or function in anyway.

Dementia effects everyone differently and the speed at which some detorates is a mystery. I've cared for people who had dementia for 15 years. I've also cared for someone with dementia who developed it and within a year was bedridden and being peg fed (straight into the stomach).

lisyloo, when asking what people with dementia want (that's what you have been able to do with family members) you must take into account that the person no longer has the mental capacity to make that choice. It's those people that may not be suitable to live within their own homes. Those people that might be eating raw food, those people that walk out the front door in their night clothes and get lost, those people left to sit in soiled clothes for 6 hours waiting for their next visit.

Every care provision is perfect for someone. The issue is when that care is no longer enough yet that's all they are left with.

lisyloo

Your family member with arthritis and cellulitis is perhaps a world away from what some of us are talking about.

I've seen the entire range.
There are points when they were better off at home and points where they needed and still need 24/7 care.
I'm not sure why you think I'm disagreeing with you.

The issue is when that care is no longer enough yet that's all they are left with.

Yes, we agree, some people are failed by hard pressed local authorities when they don't have their own financial resources AND they don't have advocates in place.
Our parents would have been in disgusting homes in Bristol had we not fought for better placse for them.

As you've seen you won't find many tax payers vounteering to fix the situation although you will find soe (justin welby) calling for change - usually those who won't be paying for it.

The only advice I can give people not already there yet is to put an LPA in place.

xylophone

It is fair for those who have the means to pay for their own care to do so but it is not fair for them to be expected to pay extra to subsidise those for whom the LA will not pay the going rate.

I am coming round to thinking that for those who require twenty four hour care in a nursing home, the fees should be tax deductible.

lisyloo

I am coming round to thinking that for those who require twenty four hour care in a nursing home, the fees should be tax deductible.

Just providing information here, but most who require nuring care will get


state pension or min income (£159)

attendance allowance (£85)

NHS funded nursing care (£155)


So should have at least £400 per week coming in (not using the word income).

le_loup

xylophone wrote: »

It is fair for those who have the means to pay for their own care to do so but it is not fair for them to be expected to pay extra to subsidise those for whom the LA will not pay the going rate.

I am coming round to thinking that for those who require twenty four hour care in a nursing home, the fees should be tax deductible.

Now there's an original thought. It's certainly a halfway house between people resenting paying and those who have not been able to save.

One of the difficulties of it though is the bureaucracy required to destemming NEED as opposed to desire. A bit like the present NHS Nursing Care determination - doctors, carers, all sorts involved in the decision. I have seen the range from the perfectly fit who would like their cooking, bed making, cleaning and washing done for them and the really demented who's family cannot get continuing nursing care even though they need qualified nurses to inject and keep an eye on them.

I guess, if any of this was easy, something would have been done before now. Perhaps it was when we had geriatric hospitals!!

Terry_Towelling

Am I wrong in thinking that where an individual has a primary health need in order to survive, they should be in receipt of Continuing Health Care (CHC) funding from the NHS. There is an application process to go through but it doesn't have any means test attached to it.

If it is deemed necessary for that primary health need to be met in a nursing/care home, the LA will pay for the healthcare and board and accommodation too - again no means test and no 'asset stripping'.

One would have thought that anyone in end-stage dementia or requiring 24 hour care, hoisting etc would qualify for this funding.

Or have I missed something?

elsien

CHC funding is specifically for nursing needs and there has to be a degree of intensity/complexity. It covers a number of different domains and is very hard to come by.

Dementia and the need for 24 hour care does not qualify you on its own. Needing to be washed, fed, hoisted etc, are considered to be social care needs not nursing needs. It does not apply to people who need residential rather than nursing care.
Depending on the level of need, the person may get a nursing top up, or they may be fully funded. CHC funding should give the option for people to stay at home, although in practice this is rarely offered.

xylophone

So should have at least £400 per week

Which doesn't go far against fees of £60,000+ a year......

xylophone

24 hour care, hoisting etc would qualify for this funding.

No - I know of someone who can stand but not walk, ( so requires hoist/wheelchair) is doubly incontinent, deaf, suffering from progressive dementia, requires to be washed and dressed, sometimes helped with feeding herself and checked day and night for skin integrity, but who does not qualify for CHC funding (only four not five boxes ticked apparently).

She does qualify for higher rate AA and having recently moved to a nursing (as opposed to care) home because of increasing nursing need, she does qualify for the nursing care element.