To think this is exploiting the Elderly and their heirs?

[BengalGal]

Is there a quick answer on care for altimizers with 80k income?

In the USA there is a sort of “retirement option” that people with a certain income can choose. It’s basically flats, often sold as high end flats, with a dining room, common areas, and a nursing/medical facility next door. You join these places when you are flush and sign away your fortune. The flat might go for 1.5 million, and a fixed annual fee, which allows you to eventually pay for meals in the common area, a weekly cleaner, laundry services, and finally the option to move from flat to hospital bed in the nearby facility for another fee. Your heirs get the flat, which they can sell for a fraction of the market value, like a third or a quarter (this is also fixed) but the company gets to make a profit reselling it to. The amount you pay for all these extras is fixed when you enter, but not any great bargain.

To me it sounds like a total rip off but people go for this because it’s so hard to get into any facility if you have a high care aging illness such as senility.

Does this model exist in the UK? My FIL is 90 and with meds still has his memory but it’s going. He has altimerzers. They have a guaranteed income of at least 90k per annum and probably more as my MIL still is a professor. They are US citizens. I would like them to retire here. What options might they have? They would prefer to live in Cambridge or oxford.

If your mil still works it would seem that the best option would be regular carers to their home. Unless she is struggling to manage his condition in which case she needs to look into an EMI care home local to her.. Sorry :(

That model doesn't exist in the U.K. (yet). There are retirement flats which are only sold to people aged 55 or over. They're maintained and secure, but don't usually provide care, although they might have a call facility for falls etc.

For demanding care needs, the choices are managing at home with external carers etc, or a care home.

I've not heard of the sort of scheme you describe in the UK.

I'm afraid dementia care is expensive here, too, at least for anyone with assets beyond a pretty low level. IIRC, if you have more than £23,500 you pay for your own care, so in many cases the family house will eventually have to be sold. Below that level of assets the state will pick up the tab, but because of the cost, the authorities will typically put off placing anyone not self funded in full time care for as long as possible.

Care homes are not cheap in the U.K. - £1000 a week would probably be a rough minimum anywhere like Oxford or Cambridge, which are relatively expensive areas.

An alternative would be a live in carer, but these can work out as expensive or even more, as a care home, especially if night time care is needed - this would normally mean more than one on shifts, and of course any carer needs their breaks and time off.

Speaking from experience, as Alzheimer's gets worse - which it only ever does unless the person dies first - there will very often come a point sooner or later when the person really does need 24/7 care, which is often very difficult or impossible to,provide at home, since it's so stressful and exhausting for family carers. And even with a live in carer, unless the house is very large it may be very difficult for anyone else to get their proper sleep at night. In the U.K., a care home is usually the only option once this sort of stage is reached.

I'm sorry if this is not much help.

PS, should have added, of course it's possible to pay for care help coming in 3 or 4 times or more during the day. A night carer is also possible to arrange, but this would typically be rather more expensive per hour.

There are warden aided flats where there is someone on site to deal with emergencies and assist with minor things. The one where my late grandmother lived had a communal room where various activities were organised for the residents too. If the individual needed personal care and cleaning you had to hire someone to come in and do this though.

Warden-aided flats can be very good in many cases, but would not solve the problem of exhaustion for the live-in spouse/partner of anyone with dementia past the earlier stages. Frequently they do not work well for anyone single with dementia, either, since the resident will often start wandering and getting lost, or knocking on (often frail elderly) neighbours' doors at all hours of the day and night, so that eventually they are asked to leave.

For this reason it is often advised to rent one of these if possible, rather than buying, since in the event of the person eventually needing a care home the flats can be difficult to sell, and in the meantime often very hefty service charges still have to be paid.

In our area there is a scheme where you can buy certain (large) houses for a proportion of the cost depending on your age, but when you die or want to move it then reverts to the owner and you get no money from it.
I can see the logic, but it does make me uncomfortable.
I can see someone in their 60s thinking great value. Buying this huge house (they're all big) for a fraction of the cost, then being trapped as they get older, finding that they cannot move to a smaller house which they can cope better in etc.

Think £2000 a week for a high end nursing home with good dementia care. 24 hour live in care at home is in fact cheaper, though obviously many people who do own a house can't even begin to afford this sort of care unless they sell their house.

There are lots of complexes where levels of care can gradually be ramped up. They vary a lot. AgeUK website and helpline are good and they also offer face to face financial advice sessions.

There are a few retirement villages cropping up. I'd Google to see if any in your area.

My FIL is 90 and with meds still has his memory but it’s going. He has altimerzers. They have a guaranteed income of at least 90k per annum and probably more as my MIL still is a professor. They are US citizens. I would like them to retire here. What options might they have? They would prefer to live in Cambridge or oxford.

If they are not also UK citizens, their options to move here are extremely limited, even with that level of income. That's your main issue, not that you think memory care homes are a rip off.

With an income of 90k plus per annum they can afford to get in home care for as long as possible and then move him to nursing home for the final stage if needed. Given his age I would say investing in an American facility was pointless, not to say damaging as they’ll both really need what they know around them during this difficult time.

With your FiL having dementia I'd be looking at having home care several times a day. As soon as that's looking unmanageable I'd be moving him to a care home which also provides nursing care so he'd wouldn't have to leave once he was in the later stages.

There is one near me!

It has been built on a large site within the grounds of a large, old country house. I don't think it is going to be run on the same lines financially but that remains to be seen. It is owned by a GP who has moved out of London. There are different levels of care provided and she has great vision for the facilities and hopes to encourage lots of links with local people to ensure a social life for the people living there. She also hopes to invite people to come and do workshop in crafts, arts and music. I haven't been to visit yet because I was unable to go to the open day and I am not sure how many people are living there presently but it sounded good. It is in the north west so nowhere near you I'm afraid but there maybe one.I would advise you to contact Social Services as they will have a list of places available near you which will give you some idea.

Do your ILs have any right to reside in the UK? You say they're US citizens, so AFAIK they would be allowed to visit, but have no right to permanent abode here. As for accessing any state care or help - they would need to legally immigrate to the UK and get ILR before they could access any right to NHS care and I see no way that a senile 90-year-old could do that.

They would be better off with home carers. When I lived in the US and was a home visit nurse, I visited a few people who had 24 hour care at home, some families employed people directly (cheaper) and managed to cover the week that way, other had a mix of a couple of regular carers who worked 12 hours at a time and and then agency who covered days off and rare holidays.
Are they even eligible to live in UK? It doesn't sound like it. Also with Dementia, they are better off in familiar surroundings for as log as they are safe, moving is very traumatic.

And that's before you consider how important it is for people with dementia to be able to remain in familiar surroundings. I imagine any kind of move could be extremely distressing for him, let alone one to a foreign country full of people with funny accents.

I haven't seen anywhere that runs on the model you describe in the UK. What you would probably be looking for here is usually called "extra care" - like retirement flats, with common areas, etc, but also with carers available for personal care, and you can choose how much care you need and then increase it as you get older. Generally run by private care companies for the local authorities.

This model does exist in the uk. See providers such as McCarthy and Stone, Churchill etc-elderly people Purchase their own flat, pay a service charge, have options to take meals in the restaurant or purchase care from the in house staff. I have managed services for Mac Stone-they are actually pretty good as a rule-and the buildings are usually beautiful. Very expensive though!

I also don't see where an elderly person's paying for their own care is any way exploiting his/her heirs. Then who should pay for it? The taxpayer so that a privileged few can inherit money they never earned?

Caring Homes uk also operate on this basis and usually have one floor in their buildings as a specialist dementia unit....

I have a relative who lives in a McCarthy and Stone and it seems really nice tbh. You have your independence but with communal lounges and gardens there is company if you want.

Live in care will cost you somewhere in the region of £800 per week. If the income you state is net then they'll be fine. If you can, keep him at home as long as possible as it will help and, generally speaking, people with Alzheimer's deteriorate rapidly out of their own environment.

Alternatively, and depending on the severity and how much his wife is around and prepared to do, you might only need care for a few hours in the morning or during the day, this will be somewhere in the region of £25 per hour.

What does he want? Don't make decisions for them in isolation if he retains any capacity. Which reminds me, make sure you sort out power of attorney while you still can so that you can use their money for their care should you need to do so.

To give you an idea of costs, I’ve just paid a total of £22.5k for 24/7 carers for a period of just over two months for my dad. He needed end of life care.

This model does exist in the uk.

With a nursing home attached, as the OP describes?

Do you mean this kind of thing? They do exist but provision is patchy. It's a growing market though.

www.belong.org.uk/locations/didsbury