To worry about where the money for dementia care will come from

[Potatoduster]

If the NHS is already stretched how on earth will it cope with a huge surge of the baby boomers needing dementia care and wanting the NHS to fully fund it?

@SnuggyBuggy and others who don't want to go through this themselves. Fill in this form today to decline treatment in future. I've done one, it doesn't take long. You can give copies to GP and family members.
Oops! I forgot the link!
compassionindying.org.uk/wp/wp-content/uploads/2018/07/Advance-Decision-Pack-v2.1.pdf

www.theguardian.com/lifeandstyle/2013/may/18/never-wanted-parents-in-care-home

I never wanted my parents to go into a care home – then I had to face reality. Louise Smith was adamant that her mother and father would never have to go into a nursing home. But one day the unthinkable happened and they could no longer look after themselves

when looking after a 90 year old with advanced dementia, requires a great deal of skill and experience.

Really? Apart from the experienced qualified carers, many care homes employ young inexperienced teenagers, often not even checking their credentials. That’s why I made the point about my grandmother. As that other poster said, good care can be provided at home for less than £1.400, obviously depending on the type of dementia. Why line care homes pockets, who won’t pay their staff a decent wage.

Someone may have every intention of being someone's carer and not be fit or even alive to do so when the time comes. We can have all the plans in the world and then life happens. My mother really only had my sister to care for her (they live thousands of miles from me and immigration means I cannot join them). My sister sadly sustained a brain injury in her 50s and now cannot live alone, let alone care for my mother. The best laid plans...

@flirtygirl we always thought (and said) we wouldn’t put my grandparents in to a home. But when the time came, we had no other choice. When we worked out how much care in her own/our home would cost, it very quickly mounted up. If you are employing a career, You would need to cover three shifts of 8 hours and you would have to cover their breaks. Even at £10 per hour, that’s £240 per day x 7 days = £1680 and that doesn’t include paying national insurance contributions/pension costs or any of the other expenses of employing someone. You would also have to pay for holiday cover when one of your carers went on holiday. You could cover some of those hours yourself, but if you also have to work to pay your own mortgage and bills, then what?
However you look at it, care is just really expensive.

At least your sister tried.If circumstances change then a nursing home would be the answer. But it doesn’t always have to be the first port if call.

But it doesn’t always have to be the first port if call.

A nursing home is never the first port of call. No one is saying it ever will be. No one is diagnosed with dementia and stuck into full time care. It happens when it becomes necessary. Some people don't have family who have can care for them and go into care earlier but many are cared for by spouses, children, neighbours etc until they cannot do it any longer.

@Idontwanttotalk

I work in adult social care, have worked for 3 local authorities. Yes, some are cutting down healthy trees (ones on roads, which could cause an issue if not properly maintained) to prevent the maintenance costs for them.

I can almost guarantee you that councils where you still have lots of council maintained trees, flowers pots and weekly bin collections have a crisis in social care and only fund those in dire need.

Thank you Charley50 that's really useful.

If I get it, at the first sign I'm taking myself to Dignitas in Switzerland.

jamoncrumpet
It's not funded if there are assets. My 90yo grandmother is in f/t dementia care costing £1400 a WEEK. Her pensions pay part of it and the rest is the money from her savings and the sale of her house. Before she became ill my aunt suggested she gift some of her considerable savings to her grandchildren when we were all in university and she said 'Of course not, they will get ALL of it when I die'

Errr. Nope!

Shame if you don't inherit anything but if you had been given money from the sale of her home, the Council would come after you for deprivation of assets. Nightmare for you to pay it back, especially if you've spent it all.

I believe being self sufficient should be the default for all adults who are able and if I'm unfortunate enough to not get to Switzerland in time, then my house will pay for the best care available, not a local council funded home smelling of pee.

Much appreciated Charley50

Dementia can often be cared for at home. It usually works best if the person with dementia lives alone. As a PP said, the main reason people end up in care is due to carer (informal carer e.g. relative) breakdown. The vast majority of older adults are cared for in the home, until they die. This the preferred option for those funded by the LA due to it being cheaper.

I would never ever recommend a relatives moves someone with dementia in to their home, for many reasons, but the change of location can cause a seeming deterioration of the dementia symptoms due to loss of familiarity with their surroundings. It is also not something you can simply just "do" unless the person with dementia has capacity to make the decision for themselves or you have LPA. Often times, if they do not have capacity to consent to the move, a Best Interest meeting is needed and the Social Worker or Mental Health specialist will make the decision and as I said above, we don't like moving people in with family.

There is a strict criteria for those entering care homes under LA funding, the main ones being night needs and inability to maintain safety (e.g. those who try to leave their property but have lost road safety or sense of direction and frequently get lost, or those who fall frequently and refuse to remain seated.

They don't all need nursing care - some need simply "residential care". The difference between residnetial and nursing care, is that n nursing homes they have at least one registered nurse on each shift in addition to trained carers. The NHS pays for the nursing element of care (around £130 per week).

REGARDING FUNDING:
Currently those with less than £14500 in savings or assets have their care funded by the LA (whether at home in residential care). The problem is that each LA has a set amount they will fund per week, and often this bears no relation to the cost care homes in that area charge. Since the vast majority of care homes are now private, the LA have no say over how much they charge. This results in people having to move area which can then result in loss of visitors and links with family. Even someone with savings, who needs some support with fees from the LA wouldn't be able to go in to a care home that costs more than the LA rate as they would require a '3rd party top up agreement' to be signed, which cannot be signed by the person themselves.

Care homes are expensive, but care homes are not massively profitable, BUPA recently sold most of their care homes due to the profit margin not being enough.

A few assumptions you've made there @SilverySurfer

Firstly, the conversation about gifting the grandchildren money was about ten years prior to the first signs of dementia, and we are now ten years past them. So twenty years ago.

Secondly, grandmother was in her own home until it became obviously unsafe for her to remain - she would leave the gas on, not eat, hide food under cushions etc.

Finally, we have always, always ensured the best care package for grandmother regardless of price. In her first home and the one she is in now that cares for people with advanced dementia.

That's interesting about that it's best if the person with dementia having care lives alone. One of my well-meaning siblings moved in with a parent showing signs of cognitive decline and who was getting more ill and needy. Unfortunately sibling pretty much took over, got rid of carers and changed routines and disrupted simple tasks that the parent did for them-self. Even imposed a new diet on the parent to an extent. My parent declined and kept declining.
So although they had more company, it didn't really work out at all.

I don't think there's a 'best way' because each person with dementia is different with a different personality to start with and dementia affects each person differently as it depends on where in the brain is affected. You have to do the best for each individual person with their own individual circumstances.

Least worst is probably more accurate

"I never understand why people object to paying for their own care. All our lives we pay for ourselves" Most people don't find their living costs and food bills suddenly leaping to £1000 per week.

If dementia sufferers have to cover all the costs of their illness themselves, then sufferers from other diseases should pay all their living costs themselves too. After all, if they're in hospital etc with an end-of life condition, they don't need their home, do they? (the argument put forward about dementia sufferers).

It's the unfairness I object to - that one set of children may inherit and another may not, on the basis of pure chance. We've got insurance for such things as your house burning down, but no realistic insurance for care costs,

Well the way things are going i will still be working when dementia hits me I hope I dont hurt anyone

If you have to go in a home, as opposed to having care in the home (which often becomes inappropriate), then it is not funded at all really - you have to sell home to pay. My grandma died in a home last year - her four kids tried caring for her in their homes by passing her around, but that became untenable as she became more confused and none of them had a house or schedule that could meet her needs. She was in a home for 10 years!!! Initially, renting her home and using savings and widow's pension covered care but as her health deteriorated costs were £700/week, with council charge against her house. As a result there was little equity left in the house for her 4 kids. None of them object to that really - what matters is that she had the best care they could give her so that she was as comfortable as possible. It would be possible to put in place an insurance scheme where house equity is used up to, say, the lesser of 50% of value or £100k or whatever and the govt covers the rest, provided that the relevant care providers provide care in line with the relevant fee schedule and an agreed care plan - perhaps to be fair this should also cover care in your home too so that you pay up to the relevant ceiling even if you stay in your home and have care there, so that people are treated equally regardless of their type of decline and there is less incentive for old people to be pressured into staying in a home where they aren't managing and try to get by on 30 minutes of free council care where that has become far too little for them so that their children can inherit more. A level playing field for everyone.

I should also say that the £700/week was the top up above what the council would fund, as I think my post was unclear

• Fill in this form today to decline treatment in future. I've done one, it doesn't take long. You can give copies to GP and family members. Oops! I forgot the link! compassionindying.org.uk/wp/wp-content/uploads/2018/07/Advance-Decision-Pack-v2.1.pdf*

Thank you for that link I've downloaded it for safe keeping.
I work in a Dementia nursing home so it's end of life care. It's a dam well cruel way to live the end of your life. Ours is apprently less expensive I was in the office when admin was telling someone the cost. A steal at only £650 a week, who knew. We aren't one of those fancy looking places, the residents have dented the skirting boards and often tip drinks and food on the carpets, but we clean it well and give the best care The decor is a bit dated, but works well for the age group. We love our residents and respect the families.
Some self fund, others are social services partial pay, others have a combo of Social services, CHC and top up from family. On top of the weekly fee, they pay for haircuts, dentist, chiropodist who come into the facility. We cover soap and shampoo, deoderant and family bring in extras sometimes. Best part is the food is plentiful and delicious. Many gain weight once they come to us (weight loss is a problem in Dementia), lots of comfort food from their childhood is served.
I and most the the other nurses have said they will be visiting Dignitas should they get a Dementia diagnosis for themselves.

We are paying £6022.00 per month for fil. It certainly isn’t as easy as saying you could do the care yourself. We cared for him at his home the best we could, then had outside carers come in then after 2 falls and him becoming non verbal and violent, social services told us he had to go into care whether we liked it or not. They also informed us that because he and mil had given us money towards our house 3 years earlier they viewed our home as his asset so the care costs had to come from us and his flat sale. We are currently trying (unsuccessfully) to sell his flat and have had to take out a second mortgage to pay his care fees (and of course have the extra mortgage repayments on top of that so this is decreasing fast).

Mil died of cancer 4 years ago and got all her care for free. Fil has no quality of life and death for him is going to be a blessed release, and sadly it will also be a relief for us too.

How much would it cost to live in a hotel long term, with all meals and hot drinks provided, all the laundry done, and gentle entertainment ( bingo etc). Then add the cost of personal care including medication and it can easily add up to quite a few hundred per week. And don't forget the bit extra you have to pay for residents whose bills are paid by the local authority (who insist on about a 30-40% price reduction)

I and most the the other nurses have said they will be visiting Dignitas should they get a Dementia diagnosis for themselves.

It costs a fortune to do that and IIRC, they won't take dementia patients. Far better off joining Exit International, get the Peaceful Pill handbook and try to get hold of pentobarbital yourself. I think it should be an option to get pento here if you have a condition like this, but the Nanny says no.

The real problem will come when the generation which has never owned their own home and does not have decent pensions requires dementia care and will not have the assets to meet their own (and others) costs

Like the care workers working in the homes..