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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To ask if people don't think they should pay their social care bills

77 replies

RoastingYourChestnutsHurtsAlot · 09/12/2014 20:50

Where is the money going to come from?

I'm genuinely confused on this one

OP posts:
oswellkettleblack · 10/12/2014 20:31

'It's absolutely not on that people can get the same care in hospital, the same education, the same care in other settings, the same state pension and so on without having to sell their homes -'

Because they have no home to sell. So what should be done with them? If you don't own a home you don't get the same level of education, care in hospital? Even if you worked, too, just weren't paid as much? Really? You are worth what you earn then?

oswellkettleblack · 10/12/2014 20:33

'alot of people on low incomes used to be able to buy their own homes but had to scrimp and save to do so.'

And a lot of people were still unable to do this, even with scrimping, especially in the past 14-15 years. But they still worked/work and paid/pay in.

iliketea · 10/12/2014 20:42

The problem is that many people think they've paid NI for their working life, they are entitled to get whatever they need on the state. But as a PP has said, it's likely that if you need several years of care plus input from the NHS, if you added it all up, you've probably paid less in that thre cost of what you are getting out.

Plus, effectively one of the main reasons people object is because of inheritance rather than depriving an older person who needs lots of care of their house (which they don't need anymore if they are in long-term residential care)

alemci · 10/12/2014 20:42

I'm sure that was the case but I'm making the point that it was easier to buy houses on lower salaries in the 50s.

NoArmaniNoPunani · 10/12/2014 20:55

I'll send myself to dignitas so my kids can inherit my home

Dapplegrey · 10/12/2014 20:56

Andmy - I agree with you, I would rather end it than go to a care home. Although it costs several thousand pounds to go to Dignitas in Switzerland, that is much cheaper than spending years in a care home.
The problem is, by the time one decided that it was time to get on a plane to Zurich, one might be too infirm to do so, so I don't know what the answer is.

3littlefrogs · 10/12/2014 21:54

As a nurse and a carer I would much rather end my life than go into a care home.

However, I realise that, for many reasons, this would not be an option.
I will make a living will, stating clearly that if I develop dementia, I do not wish to have active treatment for any other condition that I might have.

I would like my dementia to be considered a terminal illness and would not wish to be kept alive at all costs.

One of the relatives I care for is in her late 80s and has had worsening dementia for the last 5 years. She is in a home and has no quality of life whatsoever.

Yet - her diabetes is being treated with insulin injections. She cannot understand this and is terrified and distressed by all interventions including washing, dressing, and also, injecting. She is doubly incontinent.
Her heart disease is being treated with lots of expensive drugs.

If she knew what little dignity she had left, she would be mortified.

The cost of her care for the last 5 years has been astronomical. But it is not really about cost. It is about losing sight of the difference between living and existing. It is about completely disregarding the intolerable stress and anxiety endured by family members who, in addition to working, caring for children, supporting their DC through university, coping with their own health issues, have to be constantly on call to oversee the care, or lack of care, provided for their elderly relative.

The NHS cannot afford the massive drugs bill; GPs and community nursing services are stretched to the limit.

We are on a runaway train and nobody knows how to stop it.

Every single person should go and look around a few care homes and think very hard about what they want for themselves and their families in the future. Once you have dementia you cannot make any decisions about your care or your health. Neither can your next of kin. Unless you have made a living will, and lodged it with a solicitor and your GP.

SirChenjin · 10/12/2014 22:08

Oswell - I don't understand your response to my post Confused
My point was that we don't ask people to sell their homes to pay for anything else - indeed, up here nursing care is provided free but personal care isn't, so you can imagine the difficulties families face trying to prove that it nursing care their relative needs - so I don't believe that elderly people should be forced to sell their homes to pay for one type of state provided service when everything else is paid for from other revenue.

3littlefrogs · 10/12/2014 22:12

Nursing care is practically non-existent these days.
Even if you were on life support it would probably be classified as personal care.

I was amazed to discover that the need for nursing care is assessed by a social worker. Not by a nurse, or a doctor, or indeed any kind of health care professional.

PourMyselfACupOfAmbition · 10/12/2014 22:29

The concept of the welfare state has gone completely bonkers in this country. It was to protect people, to provide equality of opportunity and a fair distribution of wealth. It was never intended for people to save up all their life to then 'draw back out of it' because they paid their NI and therefore viewed it as some sort of personal entitlement!

grovel · 10/12/2014 22:52

3littlefrogs, your post above at 21:54 is so right. I simply don't want to live when / if I am confused ,frightened and expensive to the state. My FiL is living in a very expensive (private) home where the care is magnificent and kind but he is clearly distressed and anxious the whole time. I profoundly hope that pneumonia will take him soon - for his sake. They tried sedative medication but he became a zombie. Equally awful.

oswellkettleblack · 10/12/2014 22:55

'so I don't believe that elderly people should be forced to sell their homes to pay for one type of state provided service when everything else is paid for from other revenue.'

Because the cost is stratospheric. Is 'up here' North England?

OddFodd · 10/12/2014 23:04

Voluntary euthanasia would sort out a lot of these costs. Most very elderly people with poor quality of life (so needing to live in a nursing home) I've known have had enough. But we do insist on keeping them alive. My grandmother died when she was 104 and spent the last 5 years of her life wishing she were dead. What on earth is the point? You wouldn't do it to a dog.

oswellkettleblack · 10/12/2014 23:10

But the second anyone talks about restricting drugs or treatments to elderly people the hue and cry is up to the stratosphere. So it's like 3frogs says, runaway train no one knows how to or wants to stop.

mamadoc · 10/12/2014 23:41

I am happy for my home to be sold to pay for care fees.

I am happy for my parents home to be sold for care fees. They taught me to make my own way in the world and not to expect an inheritance and I will say the same to my DC.

I am even happy for my private care home fees to some extent to subsidise others.

There are care homes that basically don't accept local authority funded people, those that accept a mixture but charge higher fees to self funders and those that are pretty basic and full of LA funded people as private payers would not choose to go there. It's just supply and demand.

The local authority pays a 'benchmark' rate which barely covers costs. It's a bit like the 15hrs free nursery funding. Some private nurseries don't accept it as it doesn't cover their costs and they can fill the places with people paying full whack.

So to some extent, as a general rule you get what you pay for in a care home although there will be instances where two people are getting the same service and one is paying more. Your choices are restricted if you can't pay privately same as anything in life.

Do people really think that care homes are raking it in and are vastly profitable? It's completely untrue. The majority of the costs are staffing and there is a minimum number of trained nursing staff per shift as well as care assistants (depending on the registration eg nursing or residential). There really are not huge numbers of care home owning millionaires. One of the biggest companies, southern cross, went bust a few years ago. It is in no way easy money. It is a highly regulated industry with regular CQC inspections and a lot of risk associated. If a resident comes to harm even accidentally CQC can close it to stop new admissions and that happens a lot. That is a huge business risk.

I'm not a care home owner BTW I'm a Dr who visits care homes a lot and from what I see the majority are trying hard to do a good job.

elastamum · 10/12/2014 23:55

Having seen the experience of my aunt suffering from dementia in a care home and both my parents dying of cancer at home I think that the lack of assisted dying in this country demonstrates an appalling lack of humanity towards the old and the terminally sick.

I am never going to a care home. I fully intend to sell up whilst I am young and fit enough to move and give my assets to my children. Having seen my loved ones suffer through the alternatives, I am quite happy to take the assisted - or even non assisted dying route when the time comes.

mamadoc · 10/12/2014 23:57

I am quite shocked by all the people suggesting euthanasia as a handy solution to cut costs too.

My view is that all life has value. The lives of frail elderly people with dementia just as much as anyone else.

What about children with severe LDs who need lifelong care in a care home. Should we put them down at birth too to save the state money?

Average life expectancy on admission to a care home is actually only 2 years ( although of course some people would live a lot longer)

Of course I don't believe that we should be striving officiously to keep people alive. I doubt that most folks in a care home need their blood pressure pills or statins but they are entitled to good care to keep them comfortable and as good a quality of life as possible. I don't think the majority of old people with dementia in care homes are distressed and suffering although some are. It is very, very sad for families but that doesn't equate to needing to put people down. I find the dog comparisons especially distasteful.

I would encourage everyone to make an advanced directive and appoint a health and welfare (and financial ) LPA to stay in control of decisions.

mamadoc · 11/12/2014 00:02

If people want to kill themselves I have no problem with that but I have a big problem with people wanting to 'put down' frail, incapacitated people who are 'a burden'.
The distinction is easily blurred as this thread demonstrates. I think disabled campaigners who oppose assisted dying on slippery slope arguments have a good point.

whitechocolatestars · 11/12/2014 00:18

There are some grossly incorrect generalisations on this thread which I just can't overlook.

As background, both my parents require care. They have experienced a tragic set of circumstances that has led to a rapid deterioration in their health with long term consequences. They are self funded and now face spending tens of thousands of pounds a year on care alone, in their own home.

I cannot tell you all strongly enough how I feel about the suggestions that as a child of parents suffering cruelly through the final years of their lives, money grabbing inheritance is the last thing I could give a damn about.

To those who have suggested it, all I can conclude is that this ignorance is born of jealousy because other people have more than you do. Be thankful you are ignorant, the reality is painful and no amount of inheritance could compensate for it.

There also seems to be some suggestion that going into a care home is a choice. Believe me, if it was, you couldn't pay me to take it.

Now to some facts.

There is a huge difference between care, homes and care homes. People have suggested that those seeking funding in care homes just want free accommodation and that social care is synonymous with care homes. This is wrong. Care is available and is mostly provided IN the home. In reality there are several tiers of support available ranging from daily home visits, to live in care, up to care homes. Costs tier accordingly. We should be maximising all these options before using care homes as a last resort. The important point here is that it is the CARE which should be funded, not the home. I don't think anyone would argue that the home / accommodation aspect of any care package should be funded by the individual. But why should 50 odd years of tax and NI contributions to healthCARE become redundant because you have saved more or worked harder than someone else?

Next, it is true and grossly unfair that self-funded patients pay up to 1/3 more than state funded. Those who have been frugal or sensible are subsidising state funded patients and only the care industry is profiting.

Next, it is incorrect that you can choose not to sell your house and expect a state funded care home place. As noted in pp, deferred payments can be made whereby they are claimed against the value of the house on death. It's crucial to remember that there is often a vulnerable spouse who still needs accommodation too, so selling is just not that straightforward. Given that care homes cost around £50-60,000 per year, per person, the average house is not going to pay for many years.

Finally, with the upcoming pension changes in 2015 and increasing popularity of equity release meaning that people are able to draw down lump sums on pensions and assets for any purpose, my biggest concern around funding social care in the future would be people spending / giving away (within the 7y period free of iht) their savings in the knowledge that their place will be funded anyway.

The care act 2016 goes a long way to introducing some fairness and standards in the system in my view. For those not familiar with it, it proposes that there should be a cap on any individual's lifetime spending on care costs (not accommodation or food).

This is a change which I wholeheartedly support because I believe in looking after the generation who worked so hard to shape the country in which we live, not penalising them for doing the right thing by working hard, saving or for growing old.

Sorry this was such a long post.

MidniteScribbler · 11/12/2014 00:35

I'm not the UK, so the system here may be a bit different, but I can't see why a homeowner should not be allowed to rent out their primary residence in order to use those profits to pay for their care. Upon that person's death, the property can be sold/passed on to the family for inheritance. That way the person does not lose everything they have worked to accumulate during their life, but the state is not funding their care home either.

radiobedhead · 11/12/2014 01:08

They could rent out their home, yes. As long as the care is paid for no one cares where the money is coming from.

My grandma couldn't have just done that though. Her bill was about £2,500 a month. She wouldn't have got anywhere near that in rent. Then you take into account estate agent fees, maintenance and her inability to mentally be a landlord...

sashh · 11/12/2014 06:13

gamerchick

Within the prison near me there is a special 'unit' for older long term residents, similar to a care home. It looks nice from the outside, hanging baskets and the like.

But I think by the time you need nursing care, well you would be released on 'compassionate' grounds.

3littlefrogs · 11/12/2014 06:40

The average rent would only pay for about a quarter of the cost of care home fees.

3littlefrogs · 11/12/2014 06:43

mamadoc - I do not support voluntary euthanasia, but I wish we didn't keep people with zero quality of life alive indefinitely.

FamiliesShareGerms · 11/12/2014 06:51

I don't see that my personal desire to pass on a nest egg to my children should outweigh the need of the state for me to contribute to my care bill, including selling my house if I don't need to live in it anymore

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