To get annoyed when people try to avoid care costs

[paramedicswift]

People deserve good care in old care, potentially in their own home or in a care home.

While it is completely rational thing to do, people try avoid this cost by spending as much money as they can before they need this care or they give it away to family.

On one side, it is completely rational. I understand that people have paid taxes, national insurance and worked for their entire life. They have a desire to see this work to be passed onto their children for them to benefit from their hard work.

One the other side, it is incredibly entitled. To me, your care in old age is just another cost of life. It is like cost of food, cost of shelter. I wish I did not have to spend money on rent, food and travel to work. But I have to. This is just life.

It makes me even more angry when family inheritances come into it. It is just so greedy and horrible. I do not know why it is unacceptable to some people to apply for benefits and never work but completely acceptable to avoid paying for social care.

It is a bit of tragedy of commons because if everyone did it, then taxes would be wasted on caring for old people that COULD HAVE afforded the care themselves rather than important things such as education for children, public infrastructure projects and healthcare that benefit everyone.

To everyone according to their need. If someone cannot genuinely afford old age care and they did not deliberately avoid the costs, then I have no problems with state subsidised care.

Am I being unreasonable?

I disagree. If someone has a number of assets, then the implication is that they have been higher wage earners, and therefore paying much more into the system via income tax and nhs contributions. Why should then then be required to pay AGAIN for care on top of that? Especially if they are having to pay a sizeable amount of money for exactly the same care as someone who hasn't made any sizeable contribution to the nhs throughout their lifetimes.

This isn't a life luxury, like a car. It's basically a right to be able to live.

Frankly I think care for the elderly should be considered like schooling. There is a public system which is free for all, and guarantees an acceptable level of care. Aside from that, there is the private system, where if you pay more money then you get cocktail hour, or whatever the hell you want.

We don't say to parents "oh but you have more money so you should pay for your schooling, whilst bob across the road doesn't have to pay for his". Education is considered a basic right. Care for the elderly should also be considered as such.

There does, at some point, become a limit at which people start to really resent having to always, always pay proportionally more in, and yet rarely, if ever, see out.

what a waste of a life to save up all your money for future possible care costs. yawn. just live life and enjoy. none of my grandparents needed a care home, no reason why i will either, esp with my unhealthy diet

Trying to avoid it? Blimey.... my parents have just found out they can't afford it. They have a large house and garden, have had a comfortable retirement and have had no benefits for their entire life. at 84, having started to suffer from more and more intrusive health issues they reluctantly are selling their house. Over the last decade they have released equity from their home to bolster a diminishing income and now they have realised that the equity remaining isn't enough to pay for a home in a retirement village and the extortionate management fees - not to mention they would have to move on if their health deteriorates further to a residential home. I am trying to persuade them to move near me so at least I can help them.

Haven't read the whole thread but in reply to the OP - YABU and YANBU.

I can see it from both sides too, but I think the problem is the way the distinction is made the threshold is far, far too low.

My parents are now in their 70s and have worked hard all their lives and never taken anything out of the system, in fact they paid and AWFUL lot of tax because they were quite well to do.
Now they are penniless because a few years back they gave it all to me! This was done for 3 reasons:

1. To enable me to take full control of the family businesses and run then how I see fit without needing fathers input.
2. To guard against inheritance tax.
3. To guard against possible care costs.

I don't see why someone who has worked hard, gone without in order to buy their own home and generally behaved responsibly throughout their life should have to pay for their own care while someone else who has spent their life being more of a spender, enjoying cruises and new cars and the like while not putting anything by should receive the same care from the state for free.

Not fair!

Paying for your own care can be the difference between dying at home or in residential care

If you fund your own care you can have as many calls a day as you wish, heck you could even have a live in carer. Options that aren't open or rather aren't guarunteed to state funded individuals

If you're in residential care of course you should pay your keep. The care element should be the sole portion that is means tested - as with other state benefits.

This smacks of 'well he's got a blue lollipop, it may taste of ear wax but it's blue and I want it so I'll throw away my delicious pink one'

Goodness gracious Gouda why ever would you assume that people with substantial assets have been higher rate taxpayers errr no. It's called house price inflation.

Then again, I second your view that some core necessities should be wholly state funded at an affordable cost. Obviously this also extends to beveridge's other giant - the need for housing.

One of the bigger scandals is the growing number of relatives being asked - unlawfully - to make third party top ups to fund their parent's care. A third party top up is fine to fund a non-necessity, for example a nicer view, bigger room etc etc.

However what we are seeing - especially in London where property prices are badly out of kilter - is local authorities unlawfully asking for third party top ups to cover basic normal care - eg a basic room in a care home that is located near to the home of your primary carer, as opposed to a cheaper home further away.

It's not their fault. It's a response to the central government freeze on weekly care costs - but it means that a kind of care home "apartheid" is developing, mirroring what is happening in the broader housing world.

Quite apart from any ethical considerations, why anyone would want to give away their assets and throw themselves onto pure local authority provisioning in the current squeezed climate is beyond me.

means testing for consumption of services on basis of need is more unfair than taxation of income/wealth on ability to pay
no-one has control over disability or illness like dementia
this is hugely exacerbated by house price variation
when we bought this house, I was not disabled. now I use a wheelchair - the house is totally unsuitable; it is not adaptable
we can pay the existing mortgage from non-means tested benefits but obv cannot increase it to buy a suitable or adaptable house
accessible social housing would be paid for from money from the sale so it's a one-way decision. it would be subject to bedroom tax when dd leaves home and dd and dp would lose the house if eg I died. would dp get rehoused on his own? highly doubtful. Dd would inherit nothing which obv puts her at a disadvantage for buying her own house.
we would have been better off renting a council house to start with and had priority for a transfer - but of course we didn't know that
we can make sensible financial decisions if we want - disability will take it all away

Have you seen an OT about the adaptations? A relative became a wheelchair user over time and applied for a grant from social services through their OT department. Can you not do that?

My mum has Dementia and has been in a care home for nearly 18 months now. She pays £750 a week and is completely self funding. It's not that she is paying for her own care that bugs me, it's that she is subsiding others in the hone that are paid for by the LA, as they are able to negotiate fees down. We recently had a SoVA meeting with LA regarding my mum and their solution was that she should also fund extra 1:1 hours. They would not have suggested this if she was not self funding.

And the new care cap coming in next year is crap! My mum will have to spend in excess of £120,000 on order to reach the £72,000 threshold.

maninawomansworld, you are right, it is completely and utterly unfair.

Care is very expensive. You have the capital costs of the housing and having to pay for staffing.

What I do not understand by what you have just said, is that you feel that it is unfair to you that your father should have to pay for his care. Because if he did, you would not receive any money.

It is unfair, not to you or your grandfather but to everybody else. All things being equal, by the council giving your grandfather money and your grandfather giving you money, you have taken the money from me.

Logically does this make sense for you? If money goes from A to B and then B to C, you are effectively giving money from A to C?

Basically, I am paying for your inheritance.

I get that your grandfather worked hard. So am I. There is just not enough money in taxation to pay for your grandfather's care in addition to your inheritance. It is unfair that I should have to pay for both.

People cant help having a low paid job littleredhen. Someone has to do them.

I recognise a couple of user names from this thread who have been on the benefit bashing threads and the hypocrisy IS exactly what i would have expected.

People work extremely hard in low paid jobs littleredhen and have just as much right to be in that care home as you and yours do.

Unfuckingbelivable.

figment top-ups are not illegal. It varies by council as to whether they are permissible, but there is no reason as to why they can't be asked for if the local council allows them.

The real crime in care is that state-funded residents fees are around 1/3 lower than the fees being paid by self-funders. Councils 'set' their fees every year and it's up to the home if they will accept them. Many don't as it is simply impossible to remain profitable on £500/week. Where they do accept them, private payers effectively subsidise the local council.

Excellent explanation paramedicswift

Ruby actually I am correct. Top up fees - asking relatives to top up the fees individuals can't afford - is illegal where they are used to pay for the standard level of care to which individuals are entitled, as I explained in my post. They are also, as you say, ubiquitous. Here is an article about their misuse - www.theguardian.com/social-care-network/2013/jul/22/malpractice-over-care-home-top-up-fees

I was lucky to have access to a brilliant charity - care advocates uk - that advised me when the council asked me for top up fees.

(In our case, my mum was privately funding and had a house, so we should never have been asked for top up fees, but I was wrongly asked to make them once her assets fell below £24k and before the house had been sold).

Anyone who isn't clear about what they should and shouldn't be paying can get good advice btw from the talking point forum of the altzheimers uk website. The volunteer forum managers are also really kind and supportive!

That's true paramedics. Your parents should not save so they can help their children. They should save to help the people who didn't bother to save at all.

Johnfarley what you are talking about here are payments of many hundred pounds a week. It's not possible to "save" for payments at this level unless you are an exceptionally high earner. In practice, most fees are paid out of pension income topped up by the sale proceeds of a house. So the significant division is usually between those who bought and those who rented, as opposed to those who saved and those who didn't!

Fluff cake I agree that the new "care fees cap" is a load of rubbish. It is typical conservative policy, designed to look as if they are tackling a problem while actually making no difference - at the same time ignoring the real elephant in the room, which is what to do for all those in the future who have limited equity in property.

Only a very small minority of people will be in residential care for long enough to reach the cap - unless, of course, market fees go up in response to the message sent by the cap that this is the permissible "pot" of money that residents can legitimately be expected to spend - normalising even higher fees.

Let's not forget what having alzheimers/dementia means.

When my grandma was about 70, she became a bit forgetful. It started with little things like getting names mixed up, then forgetting where the teabags were or to fill the kettle. It got progressively worse over the next five years to the point where she wasn't safe to be on her own, couldn't cook or chose her clothes, was accusing my grandfather and my mother of stealing from her purse. She became hard work but still very fit physically.

From the age of about 74 to 77 she went to the day centre twice a week to give my grandfather a few hours break.

By 77 she was far worse, little memory, no or minimal conversation, mood swings, a danger to herself and others due to things like leaving on the gas, leaving taps running and this was day in day out and there were occasions where she would escape at night and once was brought back at 2am by two police officers in her nightie with no shoes - she had been found wandering in the village. At this time two weeks in five respite were available in a geriatric mental health unit. This would have been acceptable on an ongoing basis except the service was closed (I am talking here 25 years ago).

My grandfather by now was 80 years old and it was very very hard work looking after her. He also had the complete support of my mother. It affected both their health and my mother almost had a break down when told the respite care was stopping and to find a private home for her. She visited several and they were not equipped with sufficiently qualified staff to care for my grandmother who need specialist nursing care for her mental health condition.

My husband and I took on the local trust and social services and my grandmother was allocated a place in a geriatric mental health unit (of which there need to be far more).

My grandmother developed alzheimers when she was physically fit and the disease ran its full course. In her last five years her memory was completely gone and she could barely feed herself. In her last five years she forgot how to feed herself, then she forgot how to swallow. After a few years managing with a cup of tea with hel she moved to a sippy cup, administered daily and over several hours by my mother. She also became doubly incontinent and had to be changed and dressed daily.

In the months before she died she dropped to five stone, possibly less, because she had forgotten how to swallow, she developed TIAs in the last year and bit more slipped away with each one, the family bought her a vibrating bed to prevent bed sores. She slipped away aged nearly 85 able to do as much for herself as a new born baby. She was visited daily by my mother and my grandfather to ease the pressure of looking after her from the staff. She had superb clinical care but needed also family support even in that sort of specialist unit. In a different sort of place she probably would have died very quickly and not very nicely and my mother and grandfather would probably have been broken.

Alzheimers is a terrible terrible disease I don't think those who haven't seen it run its full course really understand the levels of care that are required and it most certainly is not social care alone when more than just the interactive memory fails. It is something that should be funded like cancer and heart disease by the NHS. If it is not and if it is just accepted then developments for its prevention will suffer because they won't be funded because the state won't care enough because it will not be picking up the tab.

I am probably at higher risk of it than most; my mother at 79 is at the point my grandma was at 70. I will of course look after her because she looked after my grandma - to the best of my ability at least. Fortunately money is not an issue but this isn't about money this is about dignity and the provision of acceptable standards of clinical and social care for people who are suffering from a disease and it is morally and ethically wrong to fund it differently from the funding available for any other disease that might leave a person incapable of controlling their basic bodily functions. I very much hope I die before I develop it and that my children are spared the suffering and I am spared the State and the levels of care and morality that now prevail within it.

I completely disagree that that you OP are paying for someone else's inheritance, you are not. You are paying your taxes like most of us do, and maybe paying towards the care fees of people who didn't bother to work hard and contribute to the tax system, but you aren't paying for anyone else's inheritance.

I'd understand your irritation if maninawomansworlds grandparents hadn't contributed through tax, but they did. If they had assets worth passing down, they probably contributed quite significantly. They won't be receiving from the state anything that other people don't receive.

I agree with PtolomysNeedle. I'd have liked to have been able to put it like that.

If wealthier people continue to give away their assets to avoid imheritance tax or care fees, then their children will have to pay higher income tax and possibly an annual wealth tax, like some countries already have.

The better off always subsidise the others, so just choose how you prefer to do it - receiving less of an inheritance windfall or paying MUCH higher annual tax.

The question is should ALL services be free to everyone, i.e a very high tax economy, or should only some services, such as the NHS, be free to the well-off.
e.g. should everyone in the country receive Housing Benefit, free school meals etc, whatever their income ?

Whatever happens it has to be fair. I think higher taxes are fine but I would want some assurances that the money is being spent sensibly and not on research into using the name "Winterval" instead of Christmas and I would front line staff in the NHS to receive proper customer service training with an emphasis on treating all people respectfully rather than an emphasis on collecting date relating to ethnicity. It doesn't matter what ethnicity people are, they are all entitled to be treated with the highest levels of respect available in the country in which they are in. Also information about care provided in the previous 12 months best provides information about what is likely to be required in the next 12 months. Trusts shouldn't need an ethnicity form to determine it. Look at the treatments that have been given.

Beaufortbelle- agree with every word. My DM was similar, it is heartbreaking to watch. We also had trouble getting respite, we were happy to may virtually any amount to get it as it would have helped her stay at home for longer, but sadly suitable respite for dementia sufferers is not always available, no matter how much you are prepared to pay. Day centres are closing, many will no longer take dementia sufferers are they are more work. Proper care should be provided but sadly we are a long way off that happening.