Advice - Parents and care fees... options?

Keep_pedalling

Mark_H_3 said:

For the avoidance of doubt, the questions were never about inheritance, as all assets are theirs and can be used however they see fit, to get the best care they can.  Our concern, was can they force my mother to sell her home and put her in a care home, where she has said numerous times, she does not want to go! We want her to retain the asset, that would hopefully giver her/us choices, to ensure the best for her!

From practical experience (my step father and my mother)  the most likely occasion residential care comes up is after a period of hospitalisation, where the discharge team decide team deem it is not safe for the patient to return to their own home without support being in place in the form of someone else living there who can provide it.

In you situation you don’t have the funds to pay someone to do that, so unless a family member is willing to take that task then the only option would be residential care. At this point it won’t matter who actually owned the home as it does not change the outcome. With her complicated health issues she may actually be entitled to NHS continuing care so the house may not be need to be sold but she will still be in the situation she is keen to avoid.

Sarahspangles

Mark_H_3 said:

For the avoidance of doubt, the questions were never about inheritance, as all assets are theirs and can be used however they see fit, to get the best care they can.  Our concern, was can they force my mother to sell her home and put her in a care home, where she has said numerous times, she does not want to go! We want her to retain the asset, that would hopefully giver her/us choices, to ensure the best for her!

Anyway, sifting through the negative replies, I feel a few of you on here have helped to clarify - many thanks for taking the time.

From experience you’re unlikely to be placed in a position where the Council has the final say. The typical scenario is for the family to agree to a frail person being discharged from hospital to a care home, because the elderly parent very much wants to leave hospital and their own home is unsuitable, as well as the homes of adult children who might want to help. A bungalow with level access and plenty of space for wheeled frames or chairs is most sustainable. 

Mojisola

Mark_H_3 said:

My mother does not want to go in home, and we will do everything we can to ensure that does not happen.  Hopefully via home care etc. My concern is that as soon as the LA get involved they dictate what that care looks like.  My parents don't have a lot of money, so won't be able to contribute, other than the only asset they have, which is their house. 

I want to make sure they can't force her to sell the house and then put her in a LA care home. 

This isn't a concern - once the financial assessment is done, if your mother is deemed as being self-funding, it's up to her (and her POAs) what happens next.

I had to get the council involved to arrange a deferred payment scheme whereby they paid our chosen care home (up to the local level) while I sold the house.  We had to pay the care home the difference between council funding and their price.  The council was repaid after the house was sold.

If the council are involved in arranging home care, with the current financial pressures, it's almost certainly to be fewer hours than Mum actually needs.  She may have to make a contribution but the value of the house isn't counted in the assessment.

If the family are able to pay for extra carer's hours, set it up as a loan so that each person gets their money back before the estate is distributed.

elsien

Mark_H_3 said:

For the avoidance of doubt, the questions were never about inheritance, as all assets are theirs and can be used however they see fit, to get the best care they can.  Our concern, was can they force my mother to sell her home and put her in a care home, where she has said numerous times, she does not want to go! We want her to retain the asset, that would hopefully giver her/us choices, to ensure the best for her!

Anyway, sifting through the negative replies, I feel a few of you on here have helped to clarify - many thanks for taking the time.

Just to further clarify, if your mum is not able to stay at home and does need to go into care, the local authority (if they are the funders) don't care how the financial contribution is paid. If the money can be raised in other ways, for example by renting the property out, or by family agreeing to pay a top up, that is all they are likely to be worried about. That may not be financially viable, or you mum/her LPA might not want the hassle of being a landlord, but it is a possibility depending on rents and care home fees where you live.
If the house will need to be sold at some point, then the local authority would suggest a deferred payment agreement for when the house is sold.
Deferred payment agreements for people who own their own home and are moving into a care home | MoneyHelper

If mum has capacity then any decision about where she lives is up to her. However if the number of calls from paid carers/family still can't meet her needs, then she has to consider whether staying at home is worth all the risks of falling and being on the floor between calls. Or going to bed/getting up earlier than she might like because that is all the agency can offer. Or it just becomes unsafe for the carers if she needs to use a hoist and they decline to go in. None of which is beyond the realms of possibility. 
If she loses capacity then if she has an LPA they must act in her best interests. And families with LPA do sometimes have to go against their parent's wishes because there really isn't a safe way for them to stay at home. My mum has told me repeatedly she's not going in to a care home. And all I can reply is that many people don't; I will do everything to keep her at home as long as I possibly can, but if she ends up like my grandmother did then staying at home won't be possible once her money runs out. 

If you are not familiar with care act processes, it may be a good idea to start looking at that now, as that would identify your mother's support needs and how they would be met.
She would be eligible for one now, as would you dad as her carer, if that has not happened. Their choice, obviously.
Assessment and determination of eligibility under the Care Act 2014 | SCIE

Marcon

Mark_H_3 said:

The assets are all theirs!  We (Including my mother) want to have choice on how that is spent! It's not about me having the money, it's about giving them choices! 

I love the way you assume the worst! 

It's the opening sentence of your first post....rather a lot of people coming onto this forum are only keen to protect their inheritance, so not that unreasonable that people wearily make that assumption, which you've now corrected.

This article is from 2019 but is largely still relevant/accruate and I think might give you some reassurance: https://www.saga.co.uk/magazine/money/personal-finance/care/paul-lewis-paying-for-care

lisyloo

Mark_H_3 said:

My mother does not want to go in home, and we will do everything we can to ensure that does not happen.  Hopefully via home care etc. My concern is that as soon as the LA get involved they dictate what that care looks like.  My parents don't have a lot of money, so won't be able to contribute, other than the only asset they have, which is their house.  I want to make sure they can't force her to sell the house and then put her in a LA care home.  Having her stay at home and them supporting would be the best option.... hence wanting to protect the house for her.  All assets are theirs and they can spend it however they want.  They have asked me to ask the question.... thanks

You'll be relieved to hear that residential care is the last resort for local authorities not the first.
This is for both economic and wellbeing reasons.
The local authority would prefer family did the job but appreciate that's often not possible, so the first port of call is daily visits.
There's all sorts of technology available these days to assist if someone has mental capacity.
Examples are - pull cords, wrist alarm, pendant, cameras, motion detectors, crash mats.

local authorities usually work with families and indeed the individual if they have the capacity to both make and express decisions.
There will be exceptions but that doesn't apply here (absebt, uncaring families, person lacks capacity).
The house cannot be used whilst there is a survivor in it, but that's not the case once one of them has passed away.
Be aware that local authority care is very basic - so it won't include a fabulous package of activities or could be inconvenient for travel or in some cases can involve sharing rooms.

If she did need care after your father had passed away then the house would have to be sold, but then if she's fee paying she/you can choose whichever home you like or indeed a live in carer.

I think you are worrying unnecessarily because the LA will want the cheaper option of keeping here at home.
The limit is generally 4 times a day.
It's only once her needs exceed that limit, or become medical or she isn't safe that a care home would start to be discussed.
Often what happens (and it happened in my family) is that the person will have a fall (or a series of falls), end up in hospital and at that point the decision is taken that they need to be in a residential home.

But initially I think you/their fears are unnecessary as the LA will want to keep her at home with both family and professional care.
I can say from experience that you need to keep your eye on the carers.
I am not saying they don't care but they are very busy so if the elderly person doesn't fancy a shower then they can (for example) go without a shower for a long time. This is in a large part due to time pressure on the carers.

Bimbly

I suggest it might be helpful to give Age UK a call to get it clear in your head what happens when an older person needs care and how it is funded: https://www.ageuk.org.uk/information-advice/care/

It seems to me that a lot of your worries are coming from uncertainties over these issues. Once you have clarity, you can maybe look around at what the options might be should the time come. Such as equity release to pay for care.

Having the house pass to your mother in the event of your father's death seems the simplest. With Power of Attorney you could arrange such care if necessary using that asset.

lisyloo

I have my doubts as to whether the house could be passed on to other beneficiaries and bypass your mother if she is a "dependent adult" but I'm not a lawyer.
I think the wills should be looked at again to see if they reflect what your parents want especially if they were made some time ago.
There's a huge difference between the worst and best care homes and it could make a massive different to your mother's life.
The best ones are purpose built (corridors for carers to walk alongside clients) and have a long list of fulfilling activities and trips.
Local authority care is a safety net, so enormous difference.
Worst care your parents could be split up from each other and some distance away.
Our parents were married 60 years and despite accomodation being available together the local authority wanted to split them up on cost grounds.
You will need to provide them with strong advocacy all the way through.

westv

lisyloo said:

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I can say from experience that you need to keep your eye on the carers.
I am not saying they don't care but they are very busy so if the elderly person doesn't fancy a shower then they can (for example) go without a shower for a long time. This is in a large part due to time pressure on the carers.

And a large part of their time seems to be taken up by them doing admin - based on the experience of my wife's nan a few years ago.

lisyloo

westv said:

lisyloo said:

.

I can say from experience that you need to keep your eye on the carers.
I am not saying they don't care but they are very busy so if the elderly person doesn't fancy a shower then they can (for example) go without a shower for a long time. This is in a large part due to time pressure on the carers.

And a large part of their time seems to be taken up by them doing admin - based on the experience of my wife's nan a few years ago.

It’s not my experience, but they do need to keep records for obvious reasons as often they are administering medication and sometimes minor treatment e.g. applying cream or patch. Old people are slow to move so it’s a common complaint that the careers don’t have enough time. As In all areas of life tax payer funding is subsistence level only.
my mil did however go to a day centre with transport provided so sometimes there are some other services available.