Dad wants to live in my brother’s rental house. How realistic is this?

I would be amazed if he gets the funding to pay for live in carers from the info you’ve given here. Most likely 4 times a day care calls as a maximum. However if dad has the money and his wishes are to live there until his money runs out then that’s a different story. But with paying full rent on top of carers I imagine his money will dwindle quickly and be more expensive together than a cost of care home.

Much better to go into a care home and pay privately. Remember when you look at care home fees you can deduct his pensions (plus attendance allowance if you are paying the care home yourself) and assuming he has a good amount of capital from the house sale and interest from investing it well. So the actual weekly cost may not be as awful as you think and will definitely be cheaper than full rent, bills and live in carers.

I would recommend being at that meeting so you can make it very clear what you are prepared to do. It is absolutely ok to have boundaries and be clear with the help you can provide.

In terms of your decision making, OP. My mother had a carer in for five hours a day at home, but the point came when she could not be left alone so I looked into the costs of a live in carer. As you have said, when you added in utilities and food etc it was more than the cost of a care home.

So my decision was that it was in my mother’s best interests to move to a care home. I never regretted that decision and she was actually quite happy there for several years, and the staff were brilliant.

But there is a SW involved asking your dad’s wishes, and dad is almost certainly going to say he wants to live in the rental. It is then your role to say a live in carer is not feasible due to the high costs, and the house itself is not suitable anyway.

I never had to argue the case with a SW, but the way I argued it with myself was that the care home move (rather than a live in carer) meant my mother’s funds would last longer so she could receive the best care for as long as possible. If her funds ran out, Social Services would then have to pick up the tab and at that point we would have no control over the care they chose to pay for.

Such a tough situation. I would break it down:

1. the current situation is untenable and needs to change
2. DB’s rental is NOT suitable without a downstairs loo
3. NHS/SW are adept and “reconsidering” if it helps lead to faster hospital discharges or cheaper options e.g. suddenly not having a downstairs loo might be workable
4. as pp said, it’s ok to have boundaries and part of being a good POA is being able to make objective decisions

It sounds like the best option would be a care home, but if not then a more suitable rental. If you crunch the numbers on both of those, that might help make the decision.

That doesn't take into account what he wants and that older people tend to have increased well being in their own/new home.

Agreed. We looked into live-in care for an aunt of dh. Since she’d have needed help at night, too, it would have worked out more expensive than a nice (I don’t mean the most expensive) care home locally.

@Denimes5 what this PP has said is what you need to be focusing on. As the sibling with PoA it is not your responsibility to provide any of the care your DF needs or wants, neither is it wise for you to endanger your own wellbeing in order to secure his. Your responsibility is to use his money to secure him the best living situation that meets his needs (whether he can appreciate or anticipate what those needs are himself or not). It sounds as if the rental property your DB is offering is not suitable for your DF in his current (and future) situation. Even with a stairlift installed, being in a property that only has an upstairs toilet is not going to work for very long. If your DF will be self-funding his care needs for a while, but you anticipate that should he live longer than these funds will cover, then you need to factor that into your deliberations. Multiple moves for elderly people is never a good thing. If you move your DF into your DB's rental property, you will be looking at another move (most likely into a care home) sometime in the future. The best solution for you now would be to find a care home that will allow the LA to continue funding his place once his self-funding money comes to an end. And unless your DB is also PoA, then what he wants or needs is really of no concern to either you or your DF. I wish you well in navigating these difficult paths.

He won't get funded 24hr care at home, the most would be 4 visits a day. If he gets a live in carer he becomes an employer. I would expect them to have their own bedroom and bathroom. Someone else will need to look after him when the carer is off duty. Stairlifts are not safe if someone has poor memory and can make falls more likely. In a residential home he doesn't have any responsibilities.

@SylvanMoon that is a very good point about an at-home care being unsustainable in these circumstances, so a move to a care home will be needed at some point.

@Denimes5 how about proposing your dad goes into respite care in a care home for a month, to see how he gets on. He may be amenable to that as a temporary option (which obviously you are hoping/intending will be permanent) and if he likes it there, problem solved.

And “carers” tend to focus on the individual rather than housekeep, so you might still need a cleaner etc and to do the household running yourself. If he has mobility issues that would be 2 carers to do personal care and get him up and to bed. Family member currently pays £1500 pw for 3 visits of 2 carers. No CHC funding even though bedbound.

You don't get free 24/7 carer for that.

A care home is the best option unless your dad is very very rich.

If you have both health and welfare, and financial and affairs LPOAs then you are the decision maker not the social worker.

The social worker's role is to complete a Care Act Assessment to say what level of care he needs and a capacity assessment to establish if he is able to make decisions about how his care and support needs are met and where he lives.

If he lacks capacity then the decision about what happens next is yours to make.

You only have to consider options that are actually feasible options and choose which of the available options is the best one.

Making a decision that relies on unwilling and unable family members to provide care, that costs more than a suitable alternative is unsustainable and not cost effective and therefore isn't a feasible option.

Have you looked into extra care sheltered housing? Cheaper than a care home, own tenancy but with care in site 24 hours.

You need a referral from social services I think

Being LPOA does not mean you have to provide care, this is what carers are for. A care home is going to call OP in an emergency like a care agency will. If you dont want to be the main organiser, you prob should try and share things with your brother.

What’s safest for your dad and best for you mental health wise is a care home. Today is the best your dad will ever be. Think long term. Needs now likely outweigh wants.
There’s your answer.

But in an emergency the care home would call an ambulance or arrange for the GP to visit. The call is just to keep you informed. There’s no need for you to go eg to the hospital unless you want to. In my ER’s case it isn’t practical for me to go, so the home sends a carer with her until she’s admitted.

Whereas a carer at home would expect someone to turn up and take over.

Has dad had a formal capacity assessment to determine whether he has capacity to decide for himself where he lives.

No, you’re conflating two different issues. As his daughter, you need to ask yourself if you can provide the level of care he would need to remain living at home. I think it’s fairly clear that you can’t (and that’s fine!). Then, as his LPA, you need to decide which of the remaining options open to him would be in his best interests. From what you’ve said here, a care home would seem to be the best option.

FWIW, OP, I’m a GP and deal all the time with families facing these issues. I’m a strong proponent of care homes when the time is right, because I have seen spouses and adult children brought to their knees, time and time again, by the pressure of trying to provide this level of care for an older person.

Also, to echo another poster, dementia isn’t something that can be ruled in or out based on a scan. Has he had a full assessment with a geriatrician or other qualified professional? Because if he really had no short-term memory then he almost definitely does have some form of cognitive impairment/dementia, and this may affect your plans going forward.

I cannot tell you how much my DP regrets not insisting his mum went to a care home at the first signs of dementia. They kept her at home, they have carers seceral times a day. She's lonely and miserable. She calls and texts her 3 kids constantly (like 50 plus times a day) and now they are stuck because trying to get her into a care home seems cruel as she cannot remember much and it would be terribly confusing for her.
He isn't really able to live independently by what youve described and moving him to then move him again in a few years just seems alvery disruptive

@Denimes5 I am sorry to say this but at the point where your father is it will only get worse. So opting for even an adapted rental (which your brother's clearly isn't) with live in carers (that would ruin him financially) is pure stupidity. It's not like he wants to stay in his home with a carer so why rent some place when he will soon have to go into a care home anyway. It doesn't make sense. Your brother has to find someone else to fund his mortgage...

Don't over complicated it, ask his GP or sw to undertake a capacity assessment, don't rely on a carehome co ordinator. Are you dealing with his finances at the moment, how are the carers and rent getting paid. If he lacks capacity you can start his welfare poa acting in his best interests at all times, preferably in discussion with his GP,sw, carers and family.

GP's can't do capacity assessments for social care decisions only medical ones.

Thanks, I didn't know that. The sw, community nurse or therapists can though which might help.