Meet the Other Phone. A phone that grows with your child.

Meet the Other Phone.
A phone that grows with your child.

Buy now

Please or to access all these features

AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To think this is exploiting the Elderly and their heirs?

71 replies

BengalGal · 04/09/2018 06:37

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.

OP posts:
Aus84 · 04/09/2018 09:23

In Aus one of the bigger companies doing this don't allow you to onsell the unit. You have to sell it back to them for a fraction of the price and then they sell to the next person and take the profit. I think if you do your research beforehand and know all this, it's ok. Some people (the heirs) are up in arms because it eats into the inheritance. But surely the elderly persons quality of life and the care they would receive being in a facility like this trumps all that. They should be able to choose how they spend their final days and do so in as much comfort as they can afford. You just need to do your research and make sure you choose a facility that actually gives the care the they advertise.

Pythonesque · 04/09/2018 09:28

The financial aspects of this are interesting. Dementia care can, I think, be more demanding than other situations.

As part of some financial planning my mother is doing at the moment, it has been suggested that (since she would "never move into a home"), a pot of £50k per annum for 5 years would be a reasonable amount to allocate for in home care if it is ever needed.

But I agree with other posters, moving your parents, nice though it sounds, may not be feasible in terms of immigration requirements (do your own research! on a full cost basis perhaps visas are available?), and may not be realistic in terms of loss of familiarity for your parents.

Good luck coming up with a viable solution for the next few years though.

BengalGal · 04/09/2018 09:37

Thanks for all the feedback. It seems this model is coming.Hopefully it won't be as iron clad as the contract the better off elderly are tied into in the states. (the poor and middle class are just dependent on what is on offer in their particular community and this varies greatly from state to state) Of course it is not exploitative for people to pay for their own care. The thing that is a rip off about the US model is they target people who are well, and offer them this guarantee that should they need it they will move into the attached hospital bed --- not a home with a room at all, a bed in a ward is more how it is. And you are really stuck there even if you hate because you can't sell it without incurring this huge loss, like 750k GBH or 1-2 million dollars. They would never consider my inlaws except that my MIL is still working and has assets and my FIL has a heart history that makes it seem it won't last more than a few years max.

It sounds like there might be more straight care homes that are here and you can get into them ? I will definitely look into more of these resources next week. My DH husband is now taking 10 days to go with them to see all the options near his sister. I just think my MIL is going to hate them once she is trapped in one. It might seem nice now, but once she can't drive, and really she shouldn't even now, she will hate it. It's very hard to find walkable communities in the states. Everyone drives everywhere in most places and certainly in these set ups with the exception of one near Stanford and even then it's a long walk for an old person to the town. Oxford and Cambridge have enough academic and cultural stimulation and music and shops and cinemas (and grandkids that could visit often).

From what I read it's not that hard to retire in the UK if you are old and can pay your own way and in some way identify with the UK. My MIL is 83. My FIL was an Anglican priest and my MIL is an academic and they have grandchildren here so it's quite easy to pass that test. Their health insurance is US based so that might cost more but I think the cost of private health care is somewhat equivalent to the out of pocket expenses they might face, at least at this time..

Given the high death taxes I can see why it makes sense. You only need a guaranteed income of 30k each and have they well above that. After four years you apply for leave

OP posts:
Tortycat · 04/09/2018 09:38

Bowerbird whereabouts is it? DM has alzheimers and I'm needing to think about care options- it sounds great

Ariela · 04/09/2018 09:41

Yes it does exist,this one is about half an hour away, and my friends mum is considering selling up and moving in, but as it's not finished she is worrying about the building noise (another section to be built including more community facilities eg gym, swimming pool) . You buy a house or apartment in the complex, and if you deteriorate then you can get extra care.

BengalGal · 04/09/2018 09:41

Oops, posted before I was done typing! After four years you can apply to stay. I think their income and their grandkids, who would now be university aged, and the looming death duties, would make them good candidates for staying. At this stage they might qualify for the NHS, but certainly not before and maybe not at all. But again, the private options are not that bad, not as expensive as the US yet. The UK is heading that way, but hopefully will have the sense to turn it around to something more like the Swiss model, where state and private insurance work hand in hand and everyone can have affordable health care.

OP posts:
Ariela · 04/09/2018 09:45

The good thing about the one I posted about is that it is a relatively easy short walk into a nice and fairly lively village with lots going on, good church community, various societies, cafes, a Waitrose a Tescos and dentist, physio, gym, doctors etc. Also the railway station is 5 mins walk you can easily go into London or Reading, it's on the mainline to Paddington. This is why friend's mum was looking at it (likes to go out and about to visit friends/museums/art etc)

juneau · 04/09/2018 09:52

How do they feel about moving to the UK in their 80s/90s OP - far from all they've ever known? Have you spoken to an immigration lawyer about this? I really think you should before you get too deeply into planning and convincing your MIL that this is the right thing to do. It really isn't that easy to just move elderly relatives over to this country who have no right to reside.

BengalGal · 04/09/2018 09:54

The Australian example is the same I bet. The thing that is exploitative is the well partner or surviving partner can't leave without incurring a huge loss. So you sign your income and assets away to this one company, who is promising to do it all, but you pay for it all, at above market rates. The rates are fixed but do go up with inflation, just at at fixed amount. It's a really complex contract you sign and you really are signing away your fortune to a single care home company or complex of companies. It's not just heirs that should be up in arms, its the older people themselves. You pay for the meals, the cleaning, and eventually the hospital bed. It's just a guaranteed place that is on offer, and the swankiness of the original apartment. Heirs or surviving spouse, same deal, try to exit and you are paid like a 4th of what you paid for the flat, with some percentage to make it sound like it is not a total rip off.

I got familiar with the model when I managed flats for stanford University and residents there were considering this brand new model built near the university in 2003. Now it's everywhere. It's a few big real estate corporations who have become health care corporations. Very profitable for them.

OP posts:
hypatiently · 04/09/2018 10:00

I too have been looking to bring my mother to live here as she has now retired and I am her only child. Unfortunately, the Visa restrictions have become much tighter and and the retired persons of independent means category has been closed:

On 27 November 2008, the retired persons of independent means immigration
category was closed to new entrants. This means applicants:
• cannot enter the UK in this category
• already here in a different category cannot switch into retired persons of
independent means

assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/674717/retired-persons-of-independent-means-v12_0.pdf

They can apply as an adult coming to be cared for by a relative but you will have to prove the following:

  • you need long-term care to do everyday personal and household tasks because of illness, disability or your age

  • the care you need is not available or affordable in the country you live in

  • the person you’ll be joining in the UK will be able to support, accommodate and care for you without claiming public funds for at least 5 years

www.gov.uk/uk-family-visa/adult-dependent-relative

So it may be difficult to prove that care is not already available to them if you have siblings in the US and you do not intend to be the one caring for them on a daily basis.

Personally I think this is cruel and ridiculous and I hope the Visa rules change!

IrmaFayLear · 04/09/2018 10:05

There is a new place near me, which even has a Michelin starred restaurant! The best properties are about £850K, but you get to stay for life, however that ends up.

All homes are expensive. The pil have used up their entire savings and house, about £700K, on care, in quite a mediocre home but one which could deal with mil's extreme dementia.

As others have mentioned, I don't think you can "import" elderly parents just like that and you need to consult an expert on this.

IrmaFayLear · 04/09/2018 10:10

It may be cruel and ridiculous for you , but can you imagine the costs if everyone was allowed to bring their elderly relatives to live here? With increasing life expectancy and the obvious additional health needs, elderly people are expensive. We already have a ticking time bomb regarding the cost of caring for an ageing population; accommodating and asking tax payers to finance newly-immigrated elderly people is just impractical.

hypatiently · 04/09/2018 10:14

I should have been clearer: I was't saying that everyone should be allowed - just that closing the category for those of independent means is ridiculous if the concern is cost to taxpayers.

IrmaFayLear · 04/09/2018 10:23

I suppose that people could provide all the proof of independent means, and then have those means mysteriously disappear once they arrived. The fact that this category has been closed indicates that there must have been some abuse of the "independent means". Unfair on those who genuinely mean to rely on their own assets; there are always those scammers who muck things up for honest people.

Aus84 · 04/09/2018 12:04

OP I dont know if I can link an Aus news site because of different country VPNs but here is an expert from a recent-ish article:

"Retirement villages such as Aveo collect an exit fee when a resident dies or leaves. It is a fee unique to the retirement village industry. It is generally based on a percentage of the purchase price on a sliding basis over the number of years of occupancy.

The fee can be extremely lucrative for Aveo. In the company’s most recent Freedom Aged Care contracts, the exit fee charged by Aveo after just two years is 40 per cent of the value of the property. Some units are now selling for $600,000, which means that for each unit that changes hands every two years or so, Aveo pockets a cool $240,000.

It also means that the higher the churn or “turnover” of residents, the more exit fees the company collects.

The joint investigation has obtained a number of letters sent by Aveo to outgoing residents threatening legal action if they reveal any aspects of an offer, including any discussions, to anyone other than their lawyers. “If you disclose the confidential information for any other purpose, we may suffer loss and may have legal rights against you.” Buyback offers from Aveo also include such threats.

Aveo is the most aggressive listed operator in the country, stinging residents with a menu of fees that eat up a lifetime of savings within just a few years. Aveo has a stated target turnover of 10 to 12 per cent of residents each year. That is equivalent to about 1200 units a year, which is high by industry standards. It’s a numbers game.

If Aveo hits its target, and the average exit fee is assumed to be approximately $75,000 per unit, then Aveo would make $90 million in exit fees each year.

This will only increase after Aveo’s move to a new model that will lift unit prices and hike exit fees to 40 per cent after two years. Some of its older contracts have an exit fee of 20 per cent while others rise to a maximum of 33 per cent on a sliding scale over five to seven years.

Aveo declined to be interviewed for the story.

In a statement Aveo said it was “committed to enhancing the lives of older Australians by improving living choices”. It added that Aveo rates very highly on resident surveys.

In answers to a series of questions, Aveo denied it was more aggressive than other operators saying its exit terms were more favourable and substantial than available “from almost any other operator”.

It says it does not generate a profit from ongoing service fees and it does not churn residents.

In Geoff Richards’ case, Aveo relied on a clause in the contract that says if the “owner” dies, his/her successor loses the right to continue to reside in the village even if they are a de facto partner.

A letter sent to Richards from Aveo says a title search shows the proprietor of the unit was Harry Nash “and not yourself”. It says “sub clause 3 (i) of the agreement provides that a person other than the owner is not permitted to live in the unit without the express written consent of the manager … we have not given such consent so your occupancy has no standing under this agreement.”

He was initially told he could only stay in the place he owned if he sold it to himself, enabling Aveo to collect the exit fee, which was almost $100,000. But the agreement fell apart and Richards found himself looking for a new place to live outside the village.

Aveo says it tried to negotiate with Richards and that he was not a permanent resident and that it had asked Nash to put him on the title.

However, documents seen by Fairfax Media-Four Corners prior to Richards’ settlement show that Richards was treasurer of the owners committee at Veronica Gardens and was in charge of the committee’s bank account. Other documents show Richards and Nash had held discussions with Aveo for Richards’ name to be put on the title, however Nash’s cancer worsened and their focus shifted to Nash’s health.

After Nash’s death, documents show that Aveo’s offer was withdrawn. Further, the documents show that before Nash’s death, Richards, Nash and another man were running a mail order business from a residential address. It was that address, according to Richards, that Aveo would later state that proved Richards was never a permanent resident.

The joint investigation has obtained numerous Aveo contracts, which include clauses that some lawyers describe as complex and draconian, particularly when the unit is freehold. These include residents potentially losing the right to reside in the village if they become bankrupt, if they vacate their unit for more than two months without Aveo’s permission, if they mortgage their unit, or put a tenant in or allow somebody to stay in the resident’s unit without permission."

So yes, you're right, with these companies it is an absolute rip off. I actually remember watching an investigative news program about this particular company and the residents were getting charged exorbitant fees for things like, needing the handy man to unlock their door as they locked their keys inside. It would all be itemised on a monthly bill and most of them were saying they wouldn't be able to afford to stay on until the end anyway as it was costing too much but they couldn't get out of their contracts without losing everything.

Aus84 · 04/09/2018 12:05

'excerpt' (typo)

Lucisky · 04/09/2018 13:16

Your parents would have major visa/immigration problems. I don't think the fact that they have family here will count for anything. The fact that they have means themselves would count for little, as two people needing round the clock care would soon whittle away any capital sum and income. One of the concerns would be that they could become a burden, albeit unwittingly, to the NHS, although there is currently no intention for them to use it. You also mention their health insurance. Can they receive the benefits from this if they are not resident in the US.?
I think you need to do more investigation before raising expectations.

Lucisky · 04/09/2018 13:19

Sorry, your in laws, not your parents.

annandale · 04/09/2018 13:34

The retirement places i looked at with my mum had an exit fee of 1% of the value. It's not all a rip off.

IrmaFayLear · 04/09/2018 13:41

I think some of these places sound marvellous for the inhabitants. No worries about cooking, maintenance of property, companionship, future care etc etc.

It is the heirs who are none too happy about "exit fees". Frankly "exit fee" means that the resident has died and couldn't care less about charges incurred.

Of course accommodation has lost value after a period of habitation by someone. It would have started off all shiny and new and over the years become shabby and cluttered. The company will need to refurbish and also, as I read recently, most of these "posher" places start up with active residents in their 70s. Over time new residents come to look around and see decrepit people of 90 to 100, and don't fancy it, so the value goes down.

LeftRightCentre · 04/09/2018 16:01

There's zero way it's 'not that hard to retire to the UK' if you are not a UK or EU citizen (that's up in the air now, too, thanks to Brexit) and links count for nothing (the past 10 years of policy has been intent on stamping out chain migration, which was abused in the past, as were the independent means methods). You seriously think it's going to be possible for two people who are so very elderly, one with already severe dementia, who've never contributed to the system, are going to ever be eligible to use the NHS or services here (bar emergencies and now some places will charge for that)? Honestly? Or that their health insurance (which will be supplementary to Medicare) will pay out for private healthcare in the UK? As pointed out, it's now next to impossible, has been for a long time. Their health insurance is going to cover, at a max, emergency treatment.

Dementia care is expensive for a reason - the person ends up needing round the clock care, sometimes for a very, very long time. Those who have funds can afford much better quality care, and any loving child's goal should be to access that for them in the nearest location (moving can be terribly stressful on people with dementia) possible rather than worrying about their inheritance.

Hmm
BengalGal · 04/09/2018 16:58

Thanks for updating me on the Visa issue. The web is very out of date and you can't tell the date. There out to be a simple way to see the publication date of any site or post. SO it's definitely not an option for my MIL and FIL, unless perhaps she got a work visa to come to Oxford (she has been invited in the not too distant past), but apart from us they do not have a real interest in moving at all. They would like US to move to them of course, but my children say no way and we are stuck in a house we can't sell easily anyway and it's not clear what kind of work
either of us could get.

They really haven't thought about it anyway. The plan is to do this move to the state my SIL lives in. It was just my idea because I think my MIL will be happier and my father-in-law is such a sweet social guy that as long as people are kind he is mister easy going. Until he won't know where he is. Hopefully he will exit before that stage. And hopefully they can get care at home and stay at home for a long time.

The Australians are following the US model that was developed at the end of the 1990s. It is very exploitative. We are talking 75% of the money they put in the for apartment as an "exit fee," or a return to their heirs --of course they don't call it that. It's all a written in like "guaranteed rate of return" so you feel like your flat would depreciate greatly and this is just a fair return.... of course none of the fees you paid for housekeeping, food, or nursing care are really mentioned much (again, the place or bed assured, the actual care is not, and so it will be in addition to whatever monthly "condo fee" you pay is. In the states you pay a monthly fee for gardening, maintenance, etc. of a condo. in these places that fee is much higher). It sounds like the UK is trying to take the sensible part of these places and make it profitable but not fleece everyone. Round the clock care at home is definitely cheaper in the US, but the demand is high and the pay is low (but higher than here) so it is very hard to find good carers. Agencies get minimally educated immigrants and pay them minimum wage but charge 3 times the price. They pass background checks because they are brand new to the USA but often there are real problems as there is no one around to supervise, they are paid little, and they don't really want to be carers at all
.
My MIL wants to keep working but recognizes she now must retire to supervise his care at least. Her plan is to retire next year and to try to hire people for her husband until then. He still helps at home as he always has with dishes laundry etc.(he retired long before she did and never was so ambitious) but is increasingly likely to forget what he is doing.

Apart from pensions my inlaws have retirement accounts that would more than cover their medical needs. It's possible to get health insurance even at their age privately. It's just expensive. But what else are they going to spend on? They can't travel anymore much, they don't care about status items, they soon can't drive and they have no wish to own more property. So it was never about becoming a burden to UK tax payers. Indeed people like them would be a boon because any assets remaining I assume would be going to the UK government in the form of death duties. But in their case it sounds like they are stuck in the USA.

OP posts:
LeftRightCentre · 04/09/2018 17:10

Health insurance is very limited in what it provides to such people even in the US as it is assumed Medicare will take on the bulk of it and as such is usually supplementary. Do they use Medicare? If so, research needs to be done in the state where they plan to move. But in general, it's not too difficult to change states in such cases. I do know a couple in the US who are in their 70s with no health issues who use private health insurance instead of Medicare but they are vastly, immensely wealthy and again, have no healthcare issues. Moving here, the chances of that in their present state is nigh on zero.

BengalGal · 04/09/2018 17:42

well they can't move here anyway because of visa issues. But the cost of just paying all yourself is still not that high here, not compared to the USA. Look at memory care for Ramsey Medical System which has a self pay option for example. It's not that high and would be much higher in the states where malpractice insurance and other crazy things have driven costs way way up. Cost of a night at a hospital in the states if it were self pay would be something like 10 times the cost here. Blood tests are just as high, but everything else seems to be a lot less here.

Because they both were professors they have good private insurance in addition to medicare. I am pretty sure doesn't move if they move though.

But it's all moot in their case. Hopefully this thread can help others and keep us all aware in case these exploitative health care companies make their way here. I'm seeing more and more companies with names that sound just like the big baddies of the USA (in the mortgage industry, education industry, etc), and I suspect they will be here soon. Hopefully they will not be allowed to thrive. To have to lose 75% of the value of your flat just because you get too broke or want to leave is not OK ever I think. Better to have that money go to charity or taxes then to line the pockets of whoever decided this was an acceptable way to provide "security" to the elderly.

OP posts:
Jux · 04/09/2018 18:19

Something did exist, as my aunt lived in one. She bought a ground floor flat, with a small garden (about 15'x15', so tiny) in a managed care facility. It was a nursing home, with medical staff and fac, though pretty basic ones. They also had some sort of 'deal' with the nearest private hospital so that anything that couldn't be dealt with at the home was given preferential treatment there.

There was cleaning, communal dining but also your own kitchen in your own flat if you preferred (daily choices), shopping could be got, there were classes like painting etc, amusiments, trips. You could curl up alone at home in your flat or go out and party.

She paid an enormous amount for it, but could afford it.

They didn't take alzheimer's patients though. It wouldn't surprise me at all if something exist for dementia patients with the money to pay for it, but it might be quite a lot more than 90k pa.

Swipe left for the next trending thread