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?

scarlet sorry your mum has dementia it's an absolute bastard of a disease . Care will often be funded for cancer because once someone needs full time care it's weeks, at most a few months so funding is short term. As you've said dementia is long term so ££££££. What we really need to do is fund dementia research....properly fund research, and look for the cause so that we can find a cure.

The current model of health and social care needs a major re-think to meet the needs of an ageing population and the consequent complex health needs. There just quite simply isn't enough money to go around as it is. I can see that's galling when you've grown up and grown old thinking things will be a certain way - but what other options are there?

Sure. But how will it be funded?

And that's the issue with the NHS, in general. Which everyone is aware of.

And that doesnt validate your point.

You want to call people infantile for pointing out the lack of fairness, that's up to you. If that's the only way to try and make a point, go ahead.

The NHS is on its knees. That doesnt mean people cant point out the lack of fairness on inequity of it. It's like the IVF debate. Some people get it, some people dont. Some people think it should be in the NHS remit. That doesnt pointing out the u fairness of who can have it, infantile.

What is the difference between cancer and dementia that means one in entitled to care and the other isnt?

What is the difference between cancer and dementia that means one in entitled to care and the other isnt?

I’ve said this about 4 times, the difference is that one falls into the original remit of the nhs, the other doesnt.

It’s a political and structural difference, not an integral difference, but that’s how the world works.

I think this is a hugely important issue and needs debate, but we have to actually engage with the complex detail.

I’m lefty. I’m inclined to believe the government should cover this stuff. But then we need to talk about increased taxation.

Exactly

Well put Greentulips

I do agree that those who can afford it should pay for care. What I have difficulty with is that this penalises those who have been careful with their money. If two people earn exactly the same throughout their life and one chooses to rent and spent their money on new cars, the latest gadget and expensive holidays so has no savings their care home will be funded by the state The other has been careful and bought a house, had modest cars and holidays, because they have capital in their home and savings they have to pay for their care. Options of a one off lump sum payment or a cap for care home costs would be fairer as the person who has been careful doesn't lose everything.

When (if) the time comes I intend to send my cash t those who would inherit before I need to spend it on care. I've worked and saved so why should my inheritors lose out. The government might try to claw it back but the inheritors mostly live abroad.

I’ve said this about 4 times, the difference is that one falls into the original remit of the nhs, the other doesnt.

That's not what I am asking.

What is the differences in the illnesses?

My mum has had several strokes over the last ten years and up until recently was paying for carers at home. She has stroke induced dementia, double incontinence and her formerly polite and lovely self has been completely lost. Sadly the latest stroke has rendered care at home unsafe and she is now paying for a care home herself.

I so agree with other posters that dementia care is hugely neglected, it feels like once you have a diagnosis of dementia the system washes its hands and you’re on your own, whereas with other terminal illnesses the help and finance on offer is huge in comparison. This is where the discrepancy is rather than the blanket “all care homes should be free/paid for” thinking.

Dementia IS a terminal illness, it’s no less devastating than a cancer diagnosis, and there have been times over the last twelve months that I have wished my mum would die (and so has she when she’s in a lucid phase) - and I’m not being over dramatic here, I really have both for her sake and ours felt this. We need to balance the scales. Sorry, bit of a rant and derail but I feel abandoned by the system and it gets to me....

I haven't read the replies yet, I'm going to go back and do that after posting, but in my opinion everyone should have basic care provided as part of the NHS cradle to grave remit. Any savings should be able to buy you extras.

After all, you can have people on the same salaries - one blows it all on holidays and parties, the other has some holidays, some parties but saves the rest. The first person can't pay for care so gets it paid for, the other has to fund their own. How is that fair? Assuming both have been in private rental so no property to sell.

Many people are not aware of the higher rates charged to patients paying privately. A self funding patient will becharged £65k a year whereas for exactly the same level of care the NHS/local authourity will only be charged £40k a year for their patients. So not only are the better off expected to self fund their care but they are also subsidise the care costs of other patients by way of what is effectively an extra tax on them for suffering from dementia. That is a disgrace but only those families paying for care are aware that it happens.

Meanwhile In Scotland and NI (not sure about Wales) all care is funded.

Hmm. I agree the government shouldn't fund everyone. That said, your friend is entirely right that people having to sell their homes to go into care homes is totally unfair. You can't even pass the home to another family member because the lawyers will prevent you from doing so if they think it's because you're planning to move to a care home. It's crap.

@cakeisalwaystheanswer , not all care in Scotland is funded. Local authorities expect a person to self fund care homes and care fees until their estate has been reduced to £23k (exact figure might slightly vary from that).

I got my my parents to do their will a few years ago when my mum was given six weeks to live so that the house is owned owned 50 /50 and when one dies their 50 percent goes to my sister and my son and the surviving spouse has the right to live in the house till they die .

This means that my parents can leave something to my sister and my son even if it’s not the whole lot should my Dad need a care home later in life

As my mum is now getting palliative care for cancer and is 84 I don’t think she will see Christmas sadly but she is happy that she is leaving something to her kids / grandkids
There are lots of way people can protect their property for inheritance even if it’s not the whole lot but most people don’t like thinking about death and what it entails . While this is always foolproof if both need care at the same time it helps that if that isn’t the case something can be left to kids and grandkids if a persons wants to .

Also it means that should my dad remarry at any point at least my mums share would not go to his new wife and possibly to her family .
Mercenary and cold hearted bitch I may be but I’m also realistic in that my father is probably the sort to remarry as he has never been on his own for 52 years and hates being on his own even while my mum is in hospital and after reading the threads on here about children not even being able to access the family home by the new wife I wasn't about to let that happen to my sister myself and our kids . I would probably be up for a murder charge if that happened 😂

My mother would be devastated if she thought another woman had her kids and grandkids inheritance of probably around £400,000

There seems to be an assumption in these discussions that people with money available when they are at the point of needing a care home have "worked hard for it all their life" and so should get to keep it, rather than spend it on their own care.

But it's also the case that people who have no savings to pay for a care home, and which then gets paid for by the council (or whoever) also have worked hard their whole lives, just have been working in the kind of circs which mean you can't build up reserves.

And of course plenty of people have reserves because they've worked hard their whole lives AND have had the kind of social advantages right from the beginning which means they get education, connections, and thus good and lucrative job opportunities handed to them much more than other people.

I don't get to claim, eg housing benefit, just because I would really, really like to save up the money I currently spend on housing to other people. I don't see how this is any different.

It's simple.if you can afford to pay for care you should. Forget inheritance that's a nice bonus.

What needs to be addressed again in the system maybe there should be a tax incentive like pensions to save for.care

What is the differences in the illnesses?

Medically, they’re clearly significantly different, but I don’t have the knowledge to go into details.

In terms of impact (which is what I think you’re asking), they’re different, but impact is significant in both.

Politically and structurally, one falls under the original remit of the NHS, one doesn’t.

That last point is the pertinent point when it comes to funding. If you want to widen the nhs remit, fine, I totally agree. Let’s talk how to fund that.

The world isn’t fair op. I agree with you that we do have to fund ourselves where we can. I do think the small amount left to give to future generations is a derisory amount.

My Ddad sadly spent the last few weeks of his life in a care home earlier this year . He was funded but one care home (Bupa) asked that we pay the difference between what the nhs paid and what the private patients paid (about £500/wk) which would have been afforable for him. In the end for other reasons he went to different one. My family (and he) would have preferred him to live his last days in his own home and he probably would have done if he hadn't been given a course of drugs that extended, but didn't improve, his life but his needs became too great to manage at home.
I don't know what the answer is. Care is a huge expensive (despite carers being paid a pittance) and as people live longer more people are likely to need it. There were 2 100 year olds at the care home and one had lived there 5 years.

I think the crux of the issue is that families can no longer look after their elderly parents. That would be the best situation.

People didn’t used to live as long with complex medical needs which undoubtedly made care at home easier to manage. Now someone with dementia may live five, 10 years. Most families couldn’t manage that sort of 24/7 care on a long term basis.

@PlanDeRaccordement
Whilst I agree with the rest of your theory on how to pay for care costs, I don't agree with:
"Employers should pay higher NI taxes to fund social care just like they have to contribute to pensions.'
This would increase the cost of goods and services, increase inflation and reduce growth in the economy.

If only hard work equalled more money though, that's not true at all is it. In my late 50s/60s I have a number of friends who have inherited money from their partners and parents. Huge amounts of money, £half a million+ They are not particularly worthy or deserving people, they don't work harder than anyone else.

Even if H and I don't need to pay for care, I reckon there wont be much left of the equity in our house so with 2 DCs they might be lucky to get £50k each. I wanted them to have something from our lives, from our work, to benefit in the way that I see those around me now benefitting. But if we had to pay for care, our money would be almost gone, whereas people with the large inheritance will still have plenty left.

I agree there is no easy answer, but we mustn't equate wealth with hard work, its not always the case.

I'm on the fence about this as I can see so many different sides to it. However, I can imagine those with money to pay may well choose to spend that money before the time comes to avoid it all being used for care, whether that be by having fancy holidays or buying nice things for themselves or family members.

@Anotherlongdrive

Care wise? End of life cancer care could be a few weeks to at most a year or two, obviously some people have cancer for years but they’re mostly at home and still fairly able compared to end of life care. They tend not to be having violent psychotic episodes either, unless it’s a side effect from medication/infection/end of life itself which could be addressed for the most part. Most have some ability to communicate or understand which again is helpful for care.

Dementia is being diagnosed as early as 30 and these people can go on to live to 100.. cost alone there is massively different. There’s known behavioural changes, hallucinations etc along with the physical effects which as communication and understand goes become harder to treat.. basic refusal to take drugs/unable to communicate if something’s working or making it/something else worse. And that also works for giving medical staff information on something that’s changed themselves.. constant confusion.

It could simply boil down to funded care for the short term vs funding care for 20+ years. Financially one is a lot easier to provide than the other.

Every person contributes towards the cost of their social care. If they have no assets and no income, they are still - rightly - expected to contribute. It’ll be the majority of their state pension with a small amount left other for basics e.g. toiletries.

NHS and social care funding is assessed by needs and not diagnosis. I have personally dealt with many, many people who have cancer and were social care funded. Terminal conditions are addressed differently.