To think that if you have the funds to pay for your care home needs then you absoloutley should?

[BernadetteRostankowskiWolowitz]

Interesting chat with a friend the other day about the extortionate costs of care homes and how if you live in social housing/rental and are on benefits then the government will pay for your care yet if you have "worked hard all your life and want to leave something for your kids" you are made to sell your home / use savings to pay for your care.

Friend is of the opinion that everyone who requires a care home should have it paid for by the government. So essentially a "hand out" yet also is of the opinion that those on benefits are getting "hand outs" and looks on them with scorn.

My personal opinion is that if you have the means to fund your own care home needs then yes; you absoloutley should pay for some or all of that. Why should the government fork out millions for every care home resident in the country so that a vast amount of them can then hand their properties and extensive savings down to their children?

It's simply not viable to fund 100% of care home needs across the country and if you are the kind of person who gets smug about "paying my way all my life" to the tune of living mortgage free in a 300k plus home with vast savings then you should be happy to continue "paying your way" til the end.

I also pointed out to her that as she will be funding her own care she will likely have more say in where she goes.

The end result was we both agreed the best solution was to swerve the care home altogether but I wondered whether I was BU to expect someone who can afford to pay for their care to actually pay for their care?

I don’t think there was any deceit or string putting involved but there was definitely advice about what to highlight and which hcp was most likely to complete the forms in a way that would increase the application’s chance of success.

It is true that the form itself would likely deter many people from being successful. It's not for the faint-hearted and you need to know which aspects of need to highlight and which to steer clear of.

Been through all of this with the pil. Sadly they trudged through over £500k of care home fees.

Several points: money does not give you choice. It may do if you are a millionaire, but for the average person with just a house and a bit of savings, that would soon run out in a "naice" care home. The pil were in the same care home as those who were not paying. Mil's advanced dementia (and particularly the fact that she was a "screamer") meant that only one home in the area was prepared to take her.

Dementia is a problem, because it is a disease (mainly) of the old who years ago wouldn't have lived to the age people do now. It is also not wholly life limiting, so people can need extensive care for years, decades even. The pil's final years were absolutely awful. Unfortunately the hippocratic oath is not compatible with modern medicine. In spite of having a DNR, mil was repeatedly carted off to hospital for various infections, which had to be treated with antibiotics. I saw people in hospital having x-rays, being put in plaster, even given hip replacements when they were clearly absolutely past knowing what day it was or their own name.

As for a solution, it seems to me that there should be "state homes" which are free to all but very good, with dormitory-style accommodation. Anyone can qualify for these, no means testing. People could pay for go to "better" homes with fancier food and accommodation if they so wished. Two-tier system, maybe, but at least you would get what you paid or didn't pay for.

As for a solution, it seems to me that there should be "state homes" which are free to all but very good, with dormitory-style accommodation.

That’s the most appalling, inhumane suggestion I’ve ever heard. Why don’t we just open workhouses? Everyone is entitled to privacy and dignity in old age and I’m happy to subsidise someone else to ensure they get it.

irma that was my mum’s experience too. She was DNR yet we lost count of the number of times she was carted off to hospital in an ambulance. The worst thing was the 24 hour nature of hospital care - so she (aged 82, severe vascular dementia) was wheeled off for eg scans of her tummy at 1am - not because she urgently needed care but because that was when the machine was free. The doctor would have arrived on the ward to examine her at, say, 11pm.

Always she was discharged after one night, but then there would be no ambulance to take her back to her nursing home - so another wait of 8, 10, 12+ hours sitting next to her hospital bed, periodically calling out. Nobody to help her use the toilet. The nurses expected family members to sit next to her waiting for the ambulance and if none of us were in the hospital they used to phone to say she was being a nuisance annoying the other patients and could someone please come and sit next to her. I remember once it took so long to be picked up from the hospital ward after being discharged that she was finally transported back to the nursing home long after midnight.

I’m not allowed to drive but even if I could I’m not sure I would have wanted to drive my wheelchair bound, demented and dying mum in those days.

Actually I can't help thinking that dormitories would be better in some cases as it could prevent neglect/abuse.

Having seen the pil, honestly if I were doubly incontinent, not aware of anything around me, no memory of my children or my own name, I'd rather be dead and certainly wouldn't care if I were in my own room. Dignity and dementia are completely at odds with each other.

Dignity and dementia are completely at odds with each other

I couldn’t disagree more. My mum’s excellent care home helped her maintain her dignity to her last breath. She would have been so distressed to be surrounded by other people every minute of every day. It’s a cruel, heartless and demeaning suggestion. I’m genuinely shocked that it would ever occur to anyone.

I want the option of euthanasia for myself!
I can't talk for others of course, but keeping people alive when they don't want to is wrong.
The whole system needs a shake up but nobody will do it. The bills are voted down every time.

Re dormitories, I think it depends on each person’s condition. My mum’s first residential care home (advertised as suitable for people with dementia) looked wonderful - plush carpets, lovely furniture (although not your own though), lawns viewed through bay windows, TV in each room etc .... but the staff ratio was so poor that none of the residents ever sat in their own rooms, or used their own TV. Frankly you had wedged every door permanently open and designed it like a panopticon, it would be impossible to watch everyone at the same time, and anyway it was inconceivable to imagine one of these residents using their own TV remote, at least for its intended purpose. It was all for show, to make the families feel better. The residents spent their day sitting in a circle in a communal lounge.

A nice clean dormitory would at least have been honest! My mum lasted 5 weeks before she moved to a nursing home.

When my father developed a complication towards the end of his life, we 'children' were consulted and asked if we were in favour of him being taken to hospital. We discussed the pros and cons with the GP and all agreed there was little to be gained. My dad was also asked (although he was quite confused at the time due to the complex medication regime he was on) and he said he preferred to stay where he was.
So he stayed. Ironically, I think that helped prolong his life, as he was happy and comfortable at the home, with all his things around him and 5* service and care. He would have rapidly declined with misery in hospital.

Quite agree, Figment. The pil's care home looked like a third-rate Butlins, but the staff were very kind.

Bil insisted fil was moved to a nicer home after mil died, but frankly it didn't matter. The decor may have been sprucer and there were vases of flowers on the dining tables, but the residents were still sitting in nappies with one poor fellow shouting "Fuck off!" at anyone who passed by .

I want to be able to sign something now which would give whoever the right to stop treatment that I didn't even know I was having if dementia sets in. MIL used to visit her neighbour in a nursing home as there were no known living relatives and she used to come out so upset as they had her friend being fed by tube, pretty much unconscious. She went on like that for a few years. Wouldn't let that happen to my dog. There should be something you can sign while you still have your faculties that is stronger than DNR.

A legal right to refuse antibiotics would be a start.

Living wills are an excellent idea.

A living will is essential for anyone who thinks they’re at risk of dementia.

I probably am as my mum had Parkinson's and my dad has vascular/ mixed dementia.
Not much to look forwards to!

100% get why doctors might not agree. It's not what they signed up for to make decisions on whether you shouldn't get treatment but if it's clear and it's a legal requirement that you're allowed to pass on, would that make it easier?

Or worse?

Easier. An advance directive or living will leaves doctors in absolutely no doubt as does a signed DNAR declaration.

@CallmeAngelina sorry about your dad. That's a nice example of GP working with the patient and their family.

I agree people should pay for their own care but i don't agree they shoulfd bankrupt themselves and go into debt and spend their last days worrying about the bills all because some greedy care home owner wants to line their pockets. Care homes should be a lot cheaper than what they are for the abysmal care they provide and the staff should also be paid a better wage but i doubt things will change its clear the money all goes straight to the owner and not the staff or residents

Thank you, RedPanda.

https://mydecisions.org.uk/?utmsource=cidwebsite&utmm_medium=infolibrary
'Living will.'

It is sickening to think that some care home owners are raking it in. It's not a sector you hear much about on tv ; maybe panorama or some other investigative journalist could have a look into the running of these places.
I'm sure that not all are very rich and may even be struggling , but I bet a lot are not.
I know they are checked regularly and have standards , but it's justifying the fees that's hard.

Justifying the fees.

Our local, lovely nursing home charges self funders £49,200 per annum (plus extras such as hairdressing and chiropody). We are glad to be sure that DM is safe, warm and well cared for 24/7.

Interesting comparison with fees at leading public schools, including Eton which I understand is currently around £30k/annum plus extras.

Is it possible that the additional care staff required cost so much more than a full staff of Eton masters? I am quite sure that individually they are not paid more.