What steps do we 50 somethings need to take to avoid the situation many of us find ourselves with our elderly relatives?

Totally agree that it is a myth that private is better. Many private and council paid for beds are in the same home. But even in ones fully private, the benefits are normally better decor, nice gardens, etc. Although this is a nice to have, it is the staff that make a big difference. And plenty of expensive private homes have a high turnover of staff and subsequently not great care.

My MIL's council-run care home is SO much better than the BUPA one my mum was in. The carers have all been there for ages and are lovely, there's a great atmosphere, and being council, all the checks and balances are very much in evidence. Despite being a dementia home, it's sparking and fresh.
The BUPA one had a high turnover of staff, who barely acknowledged us and seemed to treat my Mum as an inconvenience. And the place was dingy and a bit urine smelly.

My attitude to council vs private care has completely changed.

Great posts @giantrooster @finallyhere

Recognise that paid for care is substantially better than state-funded care and be prepared to sell your home to pay for it.

This has not been our experience with both parents. The local (to them) care home ran privately paid for beds alongside local authority paid for bed, the care etc was really very good and identical across both. Private cost in the region of £52k per annum

Some friends currently have parents in private only nursing homes. Granted the grounds are much more extensive and include a golf course and wine with meals. Sadly by the time people need nursing homes they can't actually take advantage of those facilities which are mostly to make the relatives feel better.

The one thing that paying privately does make easier is that there is no waiting around for SS assessment of needs and being allocated to a care home. We rang the preferred home on a Thursday, they had a room free and DF moved in on the Saturday.

Don't hoard and that includes money.
Don't worry so much about what you are leaving for the dc that it impacts your life plans. For example if you want to remarry and share combine your finances then do it. As long as you have a will of course.
One of our dc is already almost as well off as we are because of a huge inheritance.
On the other hand don't get to mid 80s with an enormous amount of savings that could have benefitted everyone earlier on.
Don't hide your will. You can also have add ons if you don't want to include someone or have special wishes.
Leave clear instructions.
Downsize to a good location regarding managing your accommodation and somewhere you are able to live in independently as long as possible near shops and bus routes.
Ours is also tenants in common with life time interest (or on marriage to another).

Oh yes another cautionary tale

Usually it's a good idea to make your LPAs joint and several ie more than one person but each able to act alone so as to have back up

However if you already know that your children don't get on and fight like cats and dogs then do not appoint them jointly.

Please please in that instance choose one person who you think will do it best and save the Dr from having to adjudicate at screaming matches at the best interests meeting.

All practical advise here is good, but the real issue is mental capacity.

We all think, we'll keep on going, thinking the way we do in our 50-60-70ies, but our outlook and look on what is important and sustainable for keeping up an everyday life change. Both due to physical and mental capacity.

Ad to that mix long term illness that change a person and dementia etc. the 60 years old who once swore they would never rely on dc, cannot see they are doing so, they feel they get on with things, blocking out that they might actually only sit on a chair all day without assistance, but it will be seen by them as doing it themselves. The lifeadmin., the food preparation/delivery, the trying to get them to eat, the non-recognizion of incontinence, it will be blocked out by many and if not, it's too much to deal with.

Sadly this is how many many people 'evolve' in old age, and I think that's the real problem. I've no solutions, only get cleaners, gardeners and carers before capacity is failing, because then the old person won't accept 'strangers' helping.

There is a thread 'cockroach cafe' (hope it's ok i refer to it) where all this unrecognized loss of ability is very obvious, I'm sure those elderlies never ever thought it would be them. I can recommend you take a read.

Please don't give you house to your children. We had a client ( Citizens Advice) who did this. Her sons then sold the house from under her. What could she do? Absolutely nothing.

Also as the child do not agree to take LPA unless you understand what your responsibilities will be and are happy to discharge them.

We are now getting more people with H&W LPA and some of them don't actually want it. They don't want to be the decision maker and would prefer hospital staff to be the ones to decide to eg put someone in a care home. However if you have LPA it is legally your decision and not the staff so if you can't face being the one to decide stuff like that then please do not sign up for it.
If you do and later regret it then you can resign it too.

My parents will was written so that when my mum passed away her half went to my sister and my son so 50 percent is worth about £400k my father can stay in the house till he dies
If he goes into care the lA can only touch my fathers half not the half that belongs to my sister and my son
If the house is sold for care my sister and son get their half and my fathers half is used for his care
The SW confirmed with me the other day that this is the case as it was all done before my mum died and is on the land registry

Do a legally binding advanced decision refusing resuscitation after a certain age or if you have certain diagnoses as well as making LPAs and save your children having to have those conversations with Drs.

Make sure they are well aware of your wishes about your medical care, finances and housing and ideally write them down so that they don't have the burden of having to guess what you may have wanted.

I have to have these conversations every day as an elderly care Dr and most people say 'we never discussed it' and are very distressed (case law requires we consult relatives on resus decisions wherever practicable) The people who are not distressed are the ones whose family 'gave them permission' to make the hard choice. They feel much better as they can say 'here is his advanced decision' or at least 'we talked about it and he was always very clear'

To be legally bringing it has to be in writing signed and witnessed and you should
make your GP and relatives aware of it and give them copies. My mum had one after her cancer diagnosis and I am soon going to talk to my dad about doing his too although he is well now. I know he does not want resus if he gets dementia like his parents did.

From the other side if it’s your parents Don’t be scares to say “fuck off “ to both them and the SW 😂

I’m sort of going through this with my father
The only way to get him to get the help that he actually needs as opposed to what he wants is to basically do nothing refuse to get involved .
Refuse to be on call for lifeline pendants so you not the one woken at 3am 3 times a week
Refuse to be someone who will liase with social workers and carers so you don’t have to take endless phone calls
I only deal with the SW by email so that I have complete record of what’s being said and done . She seems to be ok as she know how I feel about my dads stupidity 😂but she has to go with his wishes - but I don’t and I won’t .

I see it as they say my father has capacity so therefore he has the capacity to know that I’m not getting involved in his wrong decisions
I’ve let the SW deal with the care and repair team to fix stuff at my dads house rather than having to take time or to do it myself
I will still visit him I don’t mind doing his shopping and some cleaning but that’s it
I live close 10 min walk so it’s not hard for me to visit but I’m not being the first point of contact

I've gone looking for information about the 'bungalow legs' thing because my mother goes on about this and how awful it was that we encouraged her to move to a retirement flat without stairs. The news reports were based on a 2018 study (Tomioka et al).

TBH there were two age groups in the study - 65-75 and 'over 75'. The benefit of stairs was seen particularly in women of the younger age group without disabilities. Decline of all sorts was strongly associated with being older. My mother moved at 83 and already had a highly dodgy hip at that point, which was one of the reasons we were keen for her to move. At 65 she was still working 4 days a week, at the gym, exhausting us all etc. It's very easy to extrapolate results 'for older adults' and not realise it means people in an age group we barely regard as old any more. The very old (85plus) are in a slightly different category.

I do think it argues against moving in a preparatory way when you're still absolutely fine, unless you are diagnosed with a progressive disease for example - if you know you have e.g. MS or MND, that's a different picture. A healthy 70 year old should think about how to manage if stairs become impossible but shouldn't necessarily eliminate them from their lives.

Take care of your health now. Have provision for your care in later life. Accept that your needs will change and make plans before it's too late.

My grandparents drove my mum close to breakdown. Both suffered from dementia. Lived in a rural area with no services or transport and stubbornly refused to move in with family or to a more manageable sized home, closer to relatives and amenities. After age 65, my nan did nothing apart from watch TV for the last 20 odd years of her life, didnt want to go anywhere/do anything (think she suffered from anxiety). This left her with various health conditions due to inactivity, ironically leaving her completely housebound in the end. She also started losing her hearing but refused to use a hearing aid, which left her unable to properly socialise. We're convinced her lack of activity and socialising resulted in her cognitive decline.

My parents have certainly learned from this that they need to have a plan. I'm mid 30s and already concerned about my future - I can only afford to rent a houseshare and I'm unlikely to have kids now. God knows how I'll afford care home fees or sheltered housing. Costs a fortune.

@AgnesWaterhouse1566

Watching with interest. I'm in my 50s with parents in their late 70s and I suspect I'll downsize before they do.

I have already started making a conscious effort to get rid of stuff (and not to buy too much more).

To be honest I think it's hard to avoid many of the issues around making your child a 'sandwich' generation adult - looking after kids and older parents.

My mum went into sheltered housing at 80 when she was still very active. She went out on jet skis that year on holiday!

Fast forward to 84 years old and she was diagnosed with Alzheimer's following a fall.

She did a LPA for both health and finances - which was a godsend so that's a must. She also expressed where she wanted to live on the form and she sat down with us and went through all aspects of her funeral. Her view was she wanted to make sure we knew what she wanted before she forgot what she wanted! Again a godsend when she died last year as I had everything from readings to hymns to music and flowers on the PC so just printed it all out and handed it to the funeral director. Covid put paid to some of her wishes but she got the majority of it.

But the appointments (she was diabetic and had a heart attack at 82) took a lot of organising. I covered 27 separate ones one year...

Organising carers in her home became an issue later in her life until it became time for a care home. The care home actually took so much pressure off us. She was a council tenant so we didn't have the choice of when/if she went into a home until she really couldn't cope any more. Had we had our way she'd have gone into a home a year or so earlier and it may have prevented the 6 falls she had until she was deemed unable to cope happening.

Some of those things you can't future proof unfortunately but the expression of wishes and getting LPAs in place are a must.

We plan to downsize eventually and, at that point, we'll help DS out with some cash. That way, if we have to spend our house, he'll at least have had something from it. But we're bringing him up not to expect to have the house. Both our mums had Alzheimer's so we're not banking on not having to pay for care. Our house is ours to do what we want with so care home or round the world trip, DS may not get a huge inheritance. We're not going to live a measly retirement if there's money in the property just to hand it on. We'll help where we can but that's the best we can do. Otherwise the care will fall to him and, having been through that, I wouldn't wish it on him. I'd rather have seen mum in a home (which was lovely) earlier and feeling more secure if she'd have been in the position of being able to pay.

Get rid of anything your adult children might find distressing to stumble across after your death.

I found my dad’s very misogynistic, violent 1970s pornography which upset me hugely. And my brother found my mum’s letters from the early 80s, which included plenty of complaints about him as a kid. He was very upset by that.

Our parents knew they were dying and should have taken care of this.

@saraclara yes that's the thing isn't it, what you tell your DCs you want in old age bears little relation to how that plays out when you're frail and elderly.
I still remember my DPs railing about my GPs and telling me they didn't want to be a burden when they were older, and here we are and they are in their 80s. They are fiercely independent but things are coming up - should DF still be driving, they could really do with a cleaner but refuse to have anyone in the house. Covid-19 has made it all worse as DM won't let them go anywhere so I'm their only source of light relief
My USA cousins have moved to a retirement village early 60s - maybe that's the way to go, but the way they've been talking about the clubs and activities they have joined they already seem to be mid 70s at least in their outlook so prematurely aged by the experience.

Bungalow legs? Given that in most countries stairs don't feature in people's homes, how on earth do they manage to avoid it?

Anyway, apart from de-cluttering (which I'm trying hard to do), we pretty much all have to face the fact that whatever we think now, when it comes to that time, we are very likely to think differently.

My mum spent her whole healthy life saying that we must never look after her in her old age (she'd had an awul time when my gran moved in with us and had dementia). Then when she had her stroke, she gave my DB and I hell because we couldn't take her in (she was paralysed down one side and needed hoists, specialist bed, a wet room, 24 hour care and a wheelchair friendly house, none of which we could accommodate) and she had to go to an extra care facility.

Oh and until a few years ago, she also spent her life saying that no way did she want keepng alive and would rather top herself than grow old and frail with a poor quality of life. But every time this 88 year old woman goes into hospital, at 6.5 stone and with bones like a bird, when they ask about a DNR, she demands that she is kept alive at all costs. Despite them describing exactly what will happen to her ribs if they try.

My PIL had mirror wills. They both had state pension and a private pension so weren’t badly off.
When FIL died MIL inherited everything obviously.
Now this money, and eventually the house, is being eaten into for MIL’s carers and eventual care home. If she didn’t have this money it would have been funded.
I think it would have been better if they’d left their half of the house to the kids, with provision for the other person to live in it as long as needed, and the money given to the kids.
When MIL finally goes there will be very little left.
And I’m not trying to profit here, before anyone has a go, its what I’ll do for our kids.

My parents downsized in their early 70s into accommodation that is a private flat with shared social space, wardens etc. My father has his two LPAs set up for finance and care, a living will which explains his desire not to be resuscitated and all his paperwork in order. My sister is a signatory on his bank account and for his shares. It's all sorted.

I'm in my late 50s and have downsized to a large 3 bed flat ground floor and basement flat.

I will happily have my flat sold for my care costs if needed or do equity release for care at home - there would be space for a live in carer. I have a good pension lined up.

Don't understimate how much room you need in old age. If there are two of you there could be two walking frames for outside and two for inside. Disability aids take up room and little bungalows get crowded very quickly.

Have a wet room that can accomodste both yourself and a carer plus walking frame or wheelchair. If you stay in a house make sure it has straight stairs or a stairlift becomes even more expensive and they are very expensive!

Get utilities and bank accounts on line, they could be remotely managed by your family. Discuss power of atterny early on and make sure your family know which solicitor has the will.

Funeral bill will appear before the will is sorted, my mum put money into an account that we joinly accessed which meant i could sort the funeral and flat clearance etc without using my own money. Funerals are expensive. Decide what you want for a funeral and where your ashes are going or your family could be distressed wondering if they are doing the right thing.

My mum left a list and contact numbers of everyone she wanted to be told of her death plus hymns for the funeral and even which vicar she preferred! Made it so much less stressful

Don't leave any surprises in the will, my DF left everything to a wife we didn't know he had who was my age, but that could be a whole other thread....