Care, disposal of assets and that trip to Switzerland

[DirectionsForUse]

My current circumstances mean that for the first time I'm thinking about what happens when people can't look after themselves. Previously it's always been an abstract thing that happens to other people iyswim.

Anyway, I have a couple of points I'd like views on.

Disposal of assets. We hear it on here a lot. You can't give away your cash or your house because "they" will consider it disposal of assets if you subsequently need care. This makes sense to me and I broadly agree that it's not right that the state picks up the tab so that children can have a large inheritance. (Even though I am potentially one of those children). However, where the care needer has given away assets, what do "they" actually do? If the money is gone what do they do to recover it? Is it a debt in the name of the giver or do they try and recover it from the beneficiary. Does this often happen IRL?

Switzerland. I hear it a lot. "I won't be spending my children's inheritance on care, I'll be off to Dignitas before that happens". My relative is well in themself but bedbound. Yes, his quality of life is not as good as it should be, but he's a million miles away from ready to die. He can play chess with the grandchildren, still provide emotional and practical support and advice to his children, enjoy a spirited political debate with visitors etc etc. His care is very expensive and potentially long term. Can you honestly say in that circumstance you'd want to die (if you're one who thinks you'll avoid paying for care)? I think my relative might have said that once, but the reality now he's facing it is he wants to hold on to a much life as he can. I think there's a big gap between needing care and no quality of life.

Not as interesting as I thought then

I am curious to know what happens when people do dispose of assets though

I think things are changing now with people giving their children money earlier in life. We are not wealthy by any means but we've always saved for the kids so that they can have a reasonable start in life. More money is being passed down the generations much earlier. I dont know anyone who has been investigated for disposal of assets to avoid care bills but if you've helped out the people you care about earlier in life at least you wont worry about there being nothing left for them if the worst does happen.

The flippant comments about Dignitas or "just shoot me rather than let me get in that state" are often made by people who have put no effort whatsoever into getting their paperwork in order. No one can do anything much for anyone unless things like power of attorney are set up.

As grim as it sounds, it's important to think ahead in all matters. Not just for your own benefit but for your loved ones.

We’ve had two close relatives (self-funded) in care homes.

A lot of people seem to be very naive about it - they apparently reason that if you’ve squirrelled your assets away, and it’s time for a care home (or a lot of expensive home care), no problem, the council will pick up the bill.

In reality there are many cases where relatives have to be absolutely on their knees with exhaustion from trying to give adequate care, before social services will even think about a council funded care home placement.
Having been there twice, to me it’s something of a luxury to be able to self fund - to be able to choose the time and place - and not need to involve SS much, if at all.

As for wanting a swift exit, I dare say it’ll depend on the person. Some people can’t bear the thought of helpless indignity (e.g. incontinence), whereas some may not mind. And of course anyone in constant pain may well wish to be out of it.

I’m hoping when my time comes assisted dying will be a thing in this country. I don’t really want to spend my hard earned cash on care home fees I want to spend it having fun and treating my family. Then when I’m at a stage that the vet would start talking about having a beloved pet pts I’ll be happy to go.

I do think we show more compassion to pets than people. I’ve known a woman with cancer slowly dying getting nil by mouth, family stood around watching her, it’s awful and pointless and you wouldn’t treat a dog like that.

I'm not talking about people who really do want to die. I'm talking about people who still have a lot of life in them but need some help day to day. Their care costs will add up long before they get to the assisted dying point.

@Woeismethischristmas

I’m hoping when my time comes assisted dying will be a thing in this country. I don’t really want to spend my hard earned cash on care home fees I want to spend it having fun and treating my family. Then when I’m at a stage that the vet would start talking about having a beloved pet pts I’ll be happy to go.

I do think we show more compassion to pets than people. I’ve known a woman with cancer slowly dying getting nil by mouth, family stood around watching her, it’s awful and pointless and you wouldn’t treat a dog like that.

I think OP’s point is that when it really happens it’s usually not that black and white. You can be in need of expensive care and still be able to live a meaningful and enjoyable life, including having fun and treating your family. It’s not like you are either having the time of your life or in the very late stages of dying from cancer.

Re disposal of assets - the local authority will count those assets in any financial assessment and family will have to fund care potentially.

OP, I agree with you that we need to be discussing this more. I don't have any magic answers though.

I agree with GettingLikeMyMother that if you have given away assets, i think it is more likely that you will be refused state funded care rather than they will specifically try to recover the value of the assets.

The dignitas thing is interesting too. I agree with you that many people who say this when they are in good health find that they don't really mean it when the time comes and they are in a position of needing care (I've seen this in my family too). Perhaps it's human nature to cling to life.

@DirectionsForUse

I'm not talking about people who really do want to die. I'm talking about people who still have a lot of life in them but need some help day to day. Their care costs will add up long before they get to the assisted dying point.

Well, assisted dying is only relevant to people who do want to die because their quality of life is intolerable. Which is the case for too many people even if not for your relative.

Why bring it up when it's clearly not relevant to your question other than to minimise the suffering of those for whom it should be accessible? Are you trying to make some goady point at their expense?

A lot of people say that if they ever develop dementia….

They evidently don’t realise that once you do have it, at least to any recognisable extent, you are probably about the last person to be aware of it, since you will no longer be able to remember - at any given moment - that you can’t remember anything.

So any careful plans you may have made, sleeping pills stashed under the mattress, etc., will very likely be in vain - you’ll probably have forgotten having stashed them in the first place, not to mention what you’d planned to do. And why would you want to do such a thing anyway, when there’s nothing whatever wrong with you?

My DM still genuinely thought there was nothing wrong with her when she could no longer even make herself a cup of tea.

My mum was Dutch. She had terminal cancer and at the end of life stage where things became too painful she opted for euthanasia. I don't clearly remember her, she was only 6 when I died. I was really shocked when I found out (in my 20s), but I'm glad she had the choice to ease her suffering. She was well informed - she was a Dr herself, she'd been through bouts of 1980s radiotherapy which left her with lots of other issues, and she'd reached the stage where prolonging her life would just have been endless days of pain. I am glad she had the choice.

The dementia thing does indeed need 'five minutes to midnight' planning, and our evil enforced suffering laws prevent that. It should be possible to make an advance statement which allows a lethal drug to be adminstered in the future subject to certain situations. I don't want to reach the state where my only emotion is fear and when my eventual death will be seen as a relief.

I don't think many people in similar circumstances to your relative would necessarily want to die at least not yet it sounds as if he still enjoys various aspects of his life even though he is bed bound. And his care costs (presumably still at home?) while very expensive, are not yet a pressing matter.
I had a relative in a similar position (MS) who was well-off but all her income (and more) went on her 24-hour care at home. She ran out of money, her condition worsened and just at that point, she died.
I think she gave up/decided she should go. She retained control until the end as she was adamant she would not go into a care home.
Your relative doesn't sound as if he's anywhere near that point.
If he runs out of money he will gave to reassess his choices but may still be able to have care at home with the local authority paying some of it. It would be cheaper for them than paying for his residential care.
If he gives money away at this point then the beneficiaries of this would be chased for repayment of his costs.

Why bring it up when it's clearly not relevant to your question other than to minimise the suffering of those for whom it should be accessible? Are you trying to make some goady point at their expense?

I thought I'd explained that. My point is that people say they won't incur care costs because they will end it all first, but lots of people need care long before they are at that point. So even if you think you would use Dignitas or something similar, it won't necessarily prevent your estate going on care.

@Cupidity

My mum was Dutch. She had terminal cancer and at the end of life stage where things became too painful she opted for euthanasia. I don't clearly remember her, she was only 6 when I died. I was really shocked when I found out (in my 20s), but I'm glad she had the choice to ease her suffering. She was well informed - she was a Dr herself, she'd been through bouts of 1980s radiotherapy which left her with lots of other issues, and she'd reached the stage where prolonging her life would just have been endless days of pain. I am glad she had the choice.

Yes, my post wasn't about the rights and wrongs of euthanasia, but about the fact that there can be a big time gap between starting to need care and wanting to die.

@SiobhanSharpe

I don't think many people in similar circumstances to your relative would necessarily want to die at least not yet it sounds as if he still enjoys various aspects of his life even though he is bed bound. And his care costs (presumably still at home?) while very expensive, are not yet a pressing matter. I had a relative in a similar position (MS) who was well-off but all her income (and more) went on her 24-hour care at home. She ran out of money, her condition worsened and just at that point, she died. I think she gave up/decided she should go. She retained control until the end as she was adamant she would not go into a care home. Your relative doesn't sound as if he's anywhere near that point. If he runs out of money he will gave to reassess his choices but may still be able to have care at home with the local authority paying some of it. It would be cheaper for them than paying for his residential care. If he gives money away at this point then the beneficiaries of this would be chased for repayment of his costs.

Yes I agree with all of that. Before he was ill though he would have been someone who said he would take steps to make sure his estate didn't go on care. The reality is that people may need care long before they're ready to die.

He's not planning to give anything away, I was just pondering what happens when people do.

Is there a point when deprivation of assets kicks in? Is it x years before needing care or a specific amount?

Deprivation of assets hinges on the timing and the intention when you gave the assets away.

Age UK and Which have very helpful information about this.

Ah OK, so you can give money away whilst still in good health with no knowledge that you might need care, but not once the need for care becomes known?

So when the advice, often given on here, is that a perfectly healthy parent can't give someone their inheritance early because it might be considered deprivation, that's wrong?

I've got no intention of doing any of this btw. I'm just wondering how many people do "get away with it". I'm inclined to agree with PP that it's better to self fund if you can to give you more choice and control over the kind of care you get.

Thanks @notthe1Parrot I’ve had at look at age uk and it seems very much to be at the discretion of the local authorities. Presumably councils want to reduce their budgets and would go for deprivation of assets more often than they would not?

Great grandparents have given great grandchildren money for christenings etc at various points depending on kids birth order. They’re now in their 90s and although I think the gifts would be under anyone’s radar due to the smallish size, obviously don’t know if they’ve given monetary gifts to others that could all add up iyswim?

There is is nothing, grimmer than being stuck dying a slow and painful death.
....

Think ahead and sort out paper work.

A family member of mine tried to do the disposing of assets (more because her husband died and she knew if she had gone first who he would have left his money to rather than care costs).

I refused outright but out of curiosity checked it up and it looked like a nightmare for me if she needed care or did not live a certain amount of years after the transaction happened.

There is no time limit on deprivation of assets. There are a number of factors councils must consider in deciding there has been DOA including whether the person had a reasonable expectation of needing care at the time, whether there is a pattern of giving/spending, whether there was a deliberate intention to avoid paying for care.

The Care Act guidance is very easy to follow on this and has plenty of examples. If a person has transferred the asset to a third party, the third party is liable to pay the council the difference between what it has charged and what it would have charged if the person still had the asset.

Sorry should have said not uk based but would imagine legally it would be well worth researching nationally as well as at a local level