Care Home Costs

phillw

cloud_dog said:

jimexbox said:

Have a read of the care home funding changes, which are meant to coming into force October 2023.

It seems nothing you've paid before this date counts, but going forward fees are capped. 

I think it is a little more granular than that, e.g. care costs might be limited but not associated living costs.  I'll admit not having read it in detail but that is my understanding from the early announcements.

https://www.gov.uk/government/publications/build-back-better-our-plan-for-health-and-social-care/adult-social-care-charging-reform-further-details

The cap will not cover the daily living costs (DLCs) for people in care homes, and people will remain responsible for their daily living costs throughout their care journey, including after they reach the cap. For simplicity, these costs will be set at a national, notional amount, the equivalent of £200 per week in 2021 to 2022 prices. DLCs are a notional amount to reflect that a proportion of residential care fees are not directly linked to personal care, like rent, food and utility bills and would have had to be paid wherever someone lives. This is in line with the Commission on Funding of Care and Support’s 2011 recommendation. The £200 level is about £60 less in 2021 to 2022 prices than a proposal set out in 2015, ensuring people get to keep more of their income and assets.


£200 a week seems a lot to me, but staying in a hotel would cost more.

xylophone

In England, self funders can claim AA, either at the lower or higher rate (depending on care needs)

Yes -  my relative's relative (for whom he had PoA) received lower rate and then higher rate as she reached the point of needing day and night care.

She was also entitled to a "nursing care component" which was claimed by the nursing home and made a small difference to the fees - every little helps!

Her capital was held in various savings accounts/investment accounts and she also had a couple of current accounts.

Her pensions/other income was paid into these and used to finance the fees - the accounts were topped up as required from capital. 

gm0

It will be interesting to see how people and families already in the system for a fairly long time are ultimately treated.  i.e. whether it is a year zero / day 0 / value 0 approach and whether its consistent nationally or fiddled with at LA level.  For existing spend. 

If rolled out slowly across LA's without a national "cutoff spend from date" applicable to all. (and requiring look back). It will be a post code lottery when your clock starts for spend to be counted.  Which is even worse.   Perhaps an arbitrary extra year of carehome fees for some people.  On  postcode.

The guidance link above is not explicit as this stuff is not finished. 

The new system would drop the contributions to the personal living piece about 200/week once the cap is reached which is - as designed - a huge benefit - to longer term users of nursing care settings who don't fit the shorter average stay length to death due to their specific medical conditions or other factors.

If you have been in the system a few years you may well have paid up to the new lifetime cap already but may get to do it again  under the new system before benefiting from the limit.  So >2x 

It's classic means tested benefits stuff.  New claims.  Existing claims change of circumstances,  Migration to a new benefit, transitional reliefs.  The more you argue (in the political and media space) about winners and losers and lobby to compensate the latter via more complex procedures and more data taken into consideration then the more complex it gets and the longer the implementation ultimately takes to get in place successfully. 

An element of rough justice may be part of the price of admission to get this up and running for 2025

bostonerimus

The average stay in a care home is between 2 and 3 years and I think everyone should plan for that. If you have POA for someone then you must manage the money of the benefit of that person rather than with a mind towards inheritance. So low risk is the most important factor and that means something like a saving account or accounts with insured and well respected institutions.

Funding LTC is a real issue and the large number of families that have to deal with it will undoubtedly create political pressure for a solution. The current England/Wales system doesn't seem to be sustainable and it will be complicated and expensive to come up with a solution. I'm generally against means tested benefits and would like to see a good level of care provided for everyone along similar lines to the initial philosophy of the NHS. My grandparents on both sides were in a Local Authority care homes starting in the 1960s and there was nothing to pay and my father was in hospice for a few months in the 1990s and again that was free to my mother. Things certainly seemed better back then.

I'm in the US and all my family is back in the UK so many years ago I took out LTC insurance that will pay $300/day up to a max of $350k to help with the cost. In the US Medicare will pay for short stays involving healthcare and Medicaid will pay if you fall below certain income and asset levels, but many families simply cannot afford the high cost of care and either go bankrupt or muddle along trying to care for the elderly at home. There is a thriving business of lawyers who will transfer assets of people in an effort to reduce their net worth so they qualify for Medicaid, but that's a dodgy area.

[Deleted User]

Deleted_User said:

My Mum has just gone into a care home in Scotland aged 94 years. I hold power of attorney.

She is self-funding but (in Scotland) everyone in a care home gets £212 per week paid by the local authority for "personal care". This is universal (not means-tested), I know this doesn't exist as such in England (but may exist in a different format).

The fees (after deduction of the local authority contribution) are (currently) £1205 per week. We are being threatened with a mid-year inflation rise in October, then another one in April 2023, it's terrifying for those trying to plan.

The annual fees are 52 X £1205 which is £62,922. Mum is lucky to have two occupational pensions plus full state pension. After income tax, her annual income from pensions is £26,327. This means that £36,595 has to be found from capital.

At the moment I am paying the shortfall on the monthly fees (after putting all pension income towards the fees) from cash savings. Her cash savings stand at about £161K. She also has a discretionary managed share portfolio standing at about £500K which will be used if and when the cash savings run out. She has very little incidental expenditure (just hairdressing, chiropody and toiletries) which I pay for myself.

It's a huge and worrying financial burden but Mum is now very frail, immobile,  with advanced Alzheimers' (and other issues) and needs the best of care. I am (so far) reasonably satisfied with the care she is receiving but, at the price we are paying, I somehow never feel totally satisfied.

Sometimes I look at the younger, and apparently fitter residents in her care home and wonder how it is all being paid for. I looked after Mum at home on my own for 4 years and don't regret it for a moment but I realise that not all families are able to do this.

Sadly my mum passed away in her care home on Sunday, having been in a care home only since 20 May this year. I am glad, for her sake, that she was able to spend the last 3 years at home with me. Although hard at times, she had a good quality of life despite her frailty and other issues, and I was able to adapt things at home to help her without too much difficulty. It's easy to say looking back that I enjoyed being a full-time caregiver, but I genuinely did and I will cherish the memories of the time we had together, and the enjoyment we had doing things like trips to the seaside, during those years. 

I was fortunate to be in good health, retired and without responsibility for children, and so was able to choose to look after my mum when she would otherwise have been in a care home. I make no judgement on anybody who is not able to do this. Like everything important in life, the care of our elders in their declining years is full of guilt and unfair judgement sometimes made by others who don't understand our individual circumstances.

I was forced to educate myself on the complicated system of care home funding in a very short period of time in the spring of this year. My heart goes out to everyone grappling with these issues. My hope is that things will get better before I need to go into full-time care.

nomorekids

Deleted_User said:

Sadly my mum passed away in her care home on Sunday, having been in a care home only since 20 May this year. I am glad, for her sake, that she was able to spend the last 3 years at home with me. Although hard at times, she had a good quality of life despite her frailty and other issues, and I was able to adapt things at home to help her without too much difficulty. It's easy to say looking back that I enjoyed being a full-time caregiver, but I genuinely did and I will cherish the memories of the time we had together, and the enjoyment we had doing things like trips to the seaside, during those years. 

I was fortunate to be in good health, retired and without responsibility for children, and so was able to choose to look after my mum when she would otherwise have been in a care home. I make no judgement on anybody who is not able to do this. Like everything important in life, the care of our elders in their declining years is full of guilt and unfair judgement sometimes made by others who don't understand our individual circumstances.

I was forced to educate myself on the complicated system of care home funding in a very short period of time in the spring of this year. My heart goes out to everyone grappling with these issues. My hope is that things will get better before I need to go into full-time care.

so sorry for your loss. Thank you for the info in this thread

bostonerimus

Deleted_User said:

Deleted_User said:

My Mum has just gone into a care home in Scotland aged 94 years. I hold power of attorney.

She is self-funding but (in Scotland) everyone in a care home gets £212 per week paid by the local authority for "personal care". This is universal (not means-tested), I know this doesn't exist as such in England (but may exist in a different format).

The fees (after deduction of the local authority contribution) are (currently) £1205 per week. We are being threatened with a mid-year inflation rise in October, then another one in April 2023, it's terrifying for those trying to plan.

The annual fees are 52 X £1205 which is £62,922. Mum is lucky to have two occupational pensions plus full state pension. After income tax, her annual income from pensions is £26,327. This means that £36,595 has to be found from capital.

At the moment I am paying the shortfall on the monthly fees (after putting all pension income towards the fees) from cash savings. Her cash savings stand at about £161K. She also has a discretionary managed share portfolio standing at about £500K which will be used if and when the cash savings run out. She has very little incidental expenditure (just hairdressing, chiropody and toiletries) which I pay for myself.

It's a huge and worrying financial burden but Mum is now very frail, immobile,  with advanced Alzheimers' (and other issues) and needs the best of care. I am (so far) reasonably satisfied with the care she is receiving but, at the price we are paying, I somehow never feel totally satisfied.

Sometimes I look at the younger, and apparently fitter residents in her care home and wonder how it is all being paid for. I looked after Mum at home on my own for 4 years and don't regret it for a moment but I realise that not all families are able to do this.

Sadly my mum passed away in her care home on Sunday, having been in a care home only since 20 May this year. I am glad, for her sake, that she was able to spend the last 3 years at home with me. Although hard at times, she had a good quality of life despite her frailty and other issues, and I was able to adapt things at home to help her without too much difficulty. It's easy to say looking back that I enjoyed being a full-time caregiver, but I genuinely did and I will cherish the memories of the time we had together, and the enjoyment we had doing things like trips to the seaside, during those years. 

I was fortunate to be in good health, retired and without responsibility for children, and so was able to choose to look after my mum when she would otherwise have been in a care home. I make no judgement on anybody who is not able to do this. Like everything important in life, the care of our elders in their declining years is full of guilt and unfair judgement sometimes made by others who don't understand our individual circumstances.

I was forced to educate myself on the complicated system of care home funding in a very short period of time in the spring of this year. My heart goes out to everyone grappling with these issues. My hope is that things will get better before I need to go into full-time care.

Sorry about your loss. Almost everyone will have to deal with elderly care in some way so it's an important thing to think about and plan for...but it's not something we really want to contemplate. My Dad had a long battle with cancer and my Mum took care of him through several years of outpatient treatment and then the final months of hospice. My Mum then stayed at home for another 15 years. She didn't want to move into more sheltered accommodation, I think for mostly emotional reasons, but she was definitely slowing down and dementia and memory loss were becoming bigger issues. My brothers would visit every day and they saw the decline and we had just persuaded her to move into a flat that was very close to one brother and more suited to her ie no stairs etc. But the next week she had a stroke and passed away. So in some ways it was a good scenario because she lived a very independent life until 88 and then the end came quickly.

savetilibleed

My Mum was in a care home for near on 7 years. Her house was sold to fund the ever increasing fees. Her house sold for more than that amount. She also had an annuity/pension from my late Dad's work and of course her state pension which helped slightly towards the fees every month. I also applied for Attendance Allowance for her which contributed another bit. I had PoA and put some of her money into several fixed term accounts which paid out interest monthly with of course available money in an easy access account to transfer money over when needed to pay the fees. These fees started out at £3000/year and were £4692/year by the last year. By the end of it all about a third of the money was consumed. But I did have to work hard at getting the best savings rates at a time when interest rates were on the floor.

It is possible to purchase a care annuity which consumes up front a sizeable sum but that then pays for the fees (you have to factor in fee increases and also take a guess at how long the person might have to live). Other costs were toiletries, occasional hairdressing, minicab fees for hospital appointments, family birthdays/christmas presents etc, clothing sometimes.

bostonerimus

savetilibleed said:

My Mum was in a care home for near on 7 years. Her house was sold to fund the ever increasing fees. Her house sold for more than that amount. She also had an annuity/pension from my late Dad's work and of course her state pension which helped slightly towards the fees every month. I also applied for Attendance Allowance for her which contributed another bit. I had PoA and put some of her money into several fixed term accounts which paid out interest monthly with of course available money in an easy access account to transfer money over when needed to pay the fees. These fees started out at £3000/year and were £4692/year by the last year. By the end of it all about a third of the money was consumed. But I did have to work hard at getting the best savings rates at a time when interest rates were on the floor.

It is possible to purchase a care annuity which consumes up front a sizeable sum but that then pays for the fees (you have to factor in fee increases and also take a guess at how long the person might have to live). Other costs were toiletries, occasional hairdressing, minicab fees for hospital appointments, family birthdays/christmas presents etc, clothing sometimes.

With interest rates rising, annuities should become more attractive. I think a good solution would be to tag a bit onto NI so that people didn't have to worry about paying for a care home. Failing that it's something that really needs long term planning from the individual similar to pension saving. Maybe some LTC insurance or deferred annuity that can be bought when you are young.