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?

My parents didn't have to look after their parents because people didn't live that long. People are living up to 40 years longer, with very complex conditions that require 24/7 one to one care. Nowadays it is usual for both partners to work FT and pay for child care. Which family members are going to do all this caring? The answer is that it usually falls to the women and very often the woman who ends up in that position is likely to end up with no job, no pension, no home of her own, no marriage or children.
Times have changed.
It is no longer a question of moving granny in for a couple of years.

Isn't it more of an issue, that we're just keeping people alive for too long? Most residential homes (considerably cheaper than nursing homes) are fine, but if a person needs to go into a nursing home then I can't help thinking its kinder to stop meds and let nature take its course. I'm not talking euthanasia, but so many people in nursing homes are being kept alive by medication, and often have a very poor quality of life. Absolutely give full pain relief, keep them comfortable and give them dignity, and the 'best death' possible. A few months of excellent care would be so much kinder than years of lingering misery.

There’s a massive difference to paid for care and state funded really, even if the homes themselves don’t intentionally cause it. Self funding people come in quicker so are more mobile, more continent, more able to go on outings and do nice activities. By the time some LA placements arrive they’re completely gone, possibly even violent with more hidden issues after being left in their beds at home waiting on a place. Self funders can often pick a room so instead of a shared room or one with no en-suite you get a nicer room where if they can they have their own facilities.. not a neighbour in the bed across who’s deaf screaming volume only, doubly incontient or violent and up half the night.

Nationalising it would mean we’d all need to wait for assessments, we’d all lose choices and we’d all need to take what we got.. just so a greedy child can have their (your) money.

I’d rather live as I am than scrimp on end of life care for those who brought me into this world and cared for me when I couldn’t do it myself.

I agree with you Op.
You can’t take it with you. You want to give your kids money,give it to them.
Of course we will all need a carer, a care home or hospital towards the end. How us that any different to needing a house or whatever - except less glamorous and you can’t make money on it I guess.

Perhaps that’s the solution. If people can make money on being in a care home they won’t mind doing it. How could it make money? Buy it like time share and rent it out to other people in the meantime?

Where is the line?

No NHS treatment for those who can afford private?
No state funded education for those who could afford private?

We already have a two tier system for those who can afford better and those who can’t, in care homes and all these areas. Is that acceptable? Not to me.

It’s the people in the middle, just scraping past the threshold who get screwed by all of these ideas.

I think all care needs - whether residential homes, carers attending, general healthcare - should be funded by the state, but I’m happy to pay the tax required for this. Unfortunately our society is littered with wealthier people who’d rather pay more than the tax increase to make sure they’re okay personally.

I'm on the fence about this. I agree the system is shockingly underfunded but we don't ask people to pay for healthcare if they can afford it. I don't want to end up like the US where people are forced to sell their homes to pay for medical bills.

I think for some reason care homes aren't perceived as medical care when in my mind they very much are. Everyone who is in one is there because they are sufficiently unwell in one sense or another that they cannot live independently. Especially as in many cases care homes are often providing end of life care.

Yes, the subsidising makes me cross especially when the self funders have been paying council tax for donkeys years'.

You know, I do wonder about the cost of some of these so called ‘care’ homes where the care is absolutely appalling.

My gran went into a lovely home, which was paid for by the sale of her home. The cost, if I remember correctly, was in the region of £1200 a week. They cared for her properly. She was only there for three months before she passed away, so not all the money was used up.

However, you hear and see some awful accounts of where the elderly are paying ridiculous fees, left to lie in squalid conditions and sometimes are abused by staff.

Then, of course, you pay for the sometimes lovely but totally incompetent care workers, who come to your home. Staff who are paid peanuts, have had no training and often can’t speak much English. The agencies must be making a fortune.

The system is a mess.

I remember a couple of stories about two old ladies. One who lived out her life on a cruise ship and another who went to stay in a very plush hotel. They both paid similar amounts to care home fees and they were much better looked after!

My job is in a care home in the finance department.
I understand both sides of the argument however you get what you pay for in the care world. Government funded beds in really good care homes are few and far between and often are only available to people who have a very short life expectancy and qualify for the grant (I’m talking weeks/a few months).
I have been on the side where I had to sell my grandmothers home (£400k) to cover her care needs, she had severe dementia and was in the home for 7 years @ £1700 a week. She and my grandfather were considered very affluent and well off in their day and my grandad died thinking he had set his wife up for the rest of her life, which in effect he did.

So people pay taxes to help fund others care homes.
They pay their own fees.
When they are paying for their care homes they are paying a lot more than state funded people therefore again subsidising others.

Surely this means they are in effect, paying three times?

In the meantime whilst they've been saving all this money to provide for their own old age, probably forgoing holidays and luxuries, Joe Bloggs down the street had been spending all of his spare income or benefits, on said holidays and luxuries. In some cases these two people might have had exactly the same income.

It does sound very unfair to me. I feel that everyone should be entitled to a basic care package through taxation. If people want to then upgrade on this because they have saved, then they can.

My mum has dementia and is in a care home. She is doubly incontinent, has violent outbursts and needs 24 hour care. People who say 'kids should look after their parents in old age' have no idea of the intensity of what this would really be like for dementia patients.

Her home costs over £4K per month and she is only early 70s so she could live another 5-10 years. My dad has had to sell their house to pay for her fees. They both worked hard their whole lives and my dad is facing poverty for the rest of his retirement.

As others have pointed out if she had terminal cancer she would get all her care needs provided + free hospice care at the end. Care of a cancer patient is easier for a family to cope with as the patient has an understanding of what is happening to them.

So no it's not fair that the government has decided one group of elderly patients are worthy of NHS funding and one isn't. If faced with the choice of dementia or cancer in my old age I would choose cancer every time.

But the diagnosis can determine whether or not this is necessary. That is unfair.

I find it very infantile to reduce this argument to ‘fairness’. It’s a hugely complicated issue, there is no way on earth that it’s ‘fair’ to everyone.

The issue is that dementia care falls outside of the remit of the NHS as it was originally set up. Now, as the NHS, under the current funding model, can barely cover its original remit, let alone take on more, there are no easy answers here.

So either we ...

Have a conversation about widening the NHS remit and how to cover the considerable short fall in funding.

Or, address funding models for end of life care more generally.

‘It’s not fair’ doesn’t move the conversation on a jot.

My dad has had to sell their house to pay for her fees. They both worked hard their whole lives and my dad is facing poverty for the rest of his retirement

How has that happened? If the other spouse is living, the home shouldnt be sold.

So people pay taxes to help fund others care homes.
They pay their own fees.
When they are paying for their care homes they are paying a lot more than state funded people therefore again subsidising others.

Surely this means they are in effect, paying three times?

There’s an obvious solution to this, it’s just not one neo-liberals seem to like.

Who pays is in my view not the issue. In actual fact it's the very low quality of care that is the problem. We managed to keep my mum at home until she died despite significant medical needs. But even the quality of at home care is very variable and some
Of what I saw completely shocking. Even if you are self funding you don't get to go into a really nice home unless you have £100's of k to spend (and anecdotally I've heard never choose a nursing home as they can drug more easily). Hospitals are no better - I've seen elderly people left sitting in their own faeces more times than I care to remember. Quality of care is the issue, as if it was excellent people wouldn't mind paying for it.

I thought the state couldn't make the spouse sell their home if the other was still living in it?

This did come up with mil as dfil had dementia but he died at home.

This is a difficult one.

Think at the moment the estate that is left untouched by local authorities is somewhere round the £20k mark (at least in my council area in Scotland, don't know if that varies by area).

Most people don't own much more than their house and some savings and those will quite quickly be eaten up with then the circa £20k left for inheritance & for paying for funeral costs. That just doesn't seem fair.

I perhaps would suggest bringing inheritance tax thresholds lower (two nil rate bands means that if someone's parents are married they're looking at over £700k IHT free, which is just too much IMO). And then perhaps increase value of the personal estate that isn't used towards care costs to around £100k. That would equalise things between families where care is needed with those where it isn't.

The issue is that dementia care falls outside of the remit of the NHS as it was originally set up. Now, as the NHS, under the current funding model, can barely cover its original remit, let alone take on more, there are no easy answers here

Theres lots of things that fall outside that remit because things change. The NHS still funds care. We learn more about illnesses, new illnesses become known or its discovered the cause is something different.

My mum is in her mid 80s, still lives in her owned home. Dad died before a care home was necessary.

Mum has proudly been frugal for years and years, squirreling away for our "inheritances", not huge amounts compared to some, the house is probably worth £90-100k, she has around £80k in savings and there are 5 of us. Doesn't matter how much we tell her to spend it and enjoy it as it will only pay for future care she keeps saving those pennies.

If/when the time comes and she needs to move to a care home should she have to pay for it when she has been so frugal all these years? Absolutely she should! She has the means to pay for care. Paid care is there for those than can't afford it, if they can't afford it because they went on holidays and lived lavishly etc good on them. Mum had the choice to save or spend too, no-one is entitled to an inheritance.

Theres lots of things that fall outside that remit because things change. The NHS still funds care. We learn more about illnesses, new illnesses become known or its discovered the cause is something different.

Sure. But how will it be funded?

I shall take my infantile thinking elsewhere then. Thanks for the walking all over my very recent experience with your enormous boots. Hope is never happens to you.

I shall take my infantile thinking elsewhere then. Thanks for the walking all over my very recent experience with your enormous boots. Hope is never happens to you.

Pretty certain it will happen to me. I just want you to engage with the actual issues, that’s all.

And yet everyone's up in arms about the possibility of a US style healthcare system where those who can afford it, pay.

@Anotherlongdrive when my parents' situation was assessed by SS (which took months) it was decided my 81 year old father was capable of meeting my mum's care needs (he wasn't) so no help was offered.

A home was the only option and as they had more than £20k savings and my mum a decent pension income then they were not eligible for financial help. Of course those savings have all now gone so the only option to keep my mum in the home where she was settled was for my dad to sell their home and move to a tiny cottage to keep paying the fees.

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?

When they forced vast majority of woman into work, increased the house prices so you have to buy as a couple you then reduce the home care that was previously available.
It’s all relevant