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?

The reason why people feel it is unfair is because (a) it penalises those that save rather than spend their money (or give it away to children before it can be used on care home fees) and (b) those that end up paying are disproportionately those that have paid higher taxes all their lives which have subsidised everyone else's care, when do those higher earners ever get anything back, if not at the end of their lives?

I think the amount should be capped at either an amount (eg £50-100k) or as a percentage of someone's estate that is fair,i don't think it should all go.

Or what has been recommended for years is an insurance / pension type scheme that everyone pays into during the if working life which then funds end of life care.

But the current system is very unfair in my opinion.

Having now read the other responses I agree with this:

"care homes should be nationalised and run on a not for profit basis so that any surplus can be reinvested in training and resources. There is no place for profit in a system of care"

Regarding dementia and parkinsons not being covered when cancer is, why shouldn't they be? You can't say it's due to the length of time care will be needed for. If you used that rationale then anyone born with conditions requiring life-long, expensive medical care should have to be funded by their families, and I would hope that anyone in this country would be appalled at that suggestion.

As the saying goes, 'money doesn't buy you happiness but it does allow you to be miserable in comfort' and I think this should apply to end of life care as well, it should be like NHS v private healthcare, if you have money you should be free to choose what to spend it on, not forced to spend it in a particular way.

It could all be paid for by the state, but we need a radical overhaul of taxation and expenses. I'd love to move to a Scandinavian model where we all pay more in tax and everyone has all of their education and health and social care needs taken care of. Of course this also allows for more affordable housing, so people's wages aren't swallowed up by rent etc
The idea that we can't afford to look after people properly here when we've already spent £70 bn on Brexit is ludicrous. We have had successive governments who've made very deliberate choices about pushing expenses onto taxpayers and offering us very little return indeed for the taxes that we pay.

In total agreement with you, particularly the point about choice. Having seen the kind of shithole deemed appropriate for people who can’t afford their own care, I’d sooner walk under a bus than live like that.

Money saved over a lifetime for a rainy day should be used for exactly that.

I think it depends on the reason why a person goes into care.

After FIL died MIL, who was 93 at the time, decided she didn't want to live on her own and she most certainly didn't want to live with any of her children (she was very emphatic about that). She chose her own residential home, moved in and the rest of us cleared and sold her house so all she had to do was take whatever she wanted with her. She paid full costs and we were all happy for her to do so. We just wanted her happy and she loved her new home.

My Dad (90), however, had Alzhiemers and when it became untenable to look after him at home, it broke our hearts, but he also had to move into care. He had a house which we sold and he had to pay nearly £4,500 a month. He was in this situation for just over 2 years, so well over £100k. I know there were people in the same home (because I knew them) who were paid for by the LA and I know that Dad was subsidizing the LA residents.

The trouble with dementia sufferers is that they are regarded as needing social but not medical care, as would be the case with someone who had, for example, cancer. BUT Dad also had a disease that was destroying his brain. It wasn't just old age.

I would never have expected Dad to live in the home for nothing. After all, at home he still had to pay for heating, lighting, food, etc. Care home fees are split into accommodation costs and personal care/nursing costs. I would have been more than happy for Dad to pay the accommodation costs but, he was ILL. He was not there by choice, his or ours, and I certainly don't believe he should have been subsidizing others. And, I don't mean this because of any inheritance that would have come to me. I just felt it was unfair he had to pay for himself and others, through no fault of his own.

Anyway, my very best wishes to anyone who is dealing with a relative suffering from this cruel affliction. We had 10 years of it and I know my brother and I are scarred and will never be the same people.

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

The thing is, though, that relatively few people are in that situation. Many will reach a point where they have paid off their mortgage, but few will also have "vast savings" on top.

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.

That's all I am saying. Is there iant really that much difference in the impacts of illness. For one to come under the NHS and the other not, isnt fair.

I agree how to fund it is an issue. But costing money is the qualifier for the NHS. Or it shouldn't be.

The NHS is a mess. Government is to blame. But so is the NHS itself. There ridiculous amounts of waste and things they spend money on, that shouldn't be happening.

@ConcernedAuntie, that's an interesting point about paying accommodation costs if you would be paying those if still at home. Yes, I could see that it would be fair to charge everyone something towards their living costs, but not charge for care costs which should be classed as medical costs.

I hope I never have to go into a care home but, if I do, I think it only right that any money or property I have is used to fund my care.
We spend money throughout our lives taking care of ourselves - on heating, clothing, food, toiletries, cosmetics, holidays and experiences that feed the soul. Paying for care is just continuing that personal responsibility of looking after ourselves with our own money.

Inheritance is not and should not be seen as an entitlement. I would much rather never inherit money and know my parents/ grandparents spent their money on having the best life possible.

🤔 It’s not a straight forward situation.

Unfortunately we do live in a society where those who work hard (FT workers on average+ salaries) - pay hard! Taxes, NI, student loans, dental, childcare, care homes...whilst those who don’t really contribute to the system in the same way (unemployed/Very low income) are simply provided it for free!

Now there’s a very thin line between ‘kindness/morality in society’ and ‘Demotivating people who try’!

If I didn’t have DH, I could keep working FT when baby comes, pay almost all my wage in childcare and receive only child benefit in help (due to my wage).
I could also drop to 2/3 days per week, spend more time with my child, pay basically no tax and get the rest of my wage topped up by UC...to the tune of approx £700 per month!

• ^ I worked this out as I was interested but was really shocked at the results. If I were in this situation I’d be quite pleased tbh as working PT and coming out with more at the end of the month is ace! But is it fair to society to lose out on my taxes and give me £700 per month?!?! 🙄 not really!

As it stands DH and I come out of each month with the same as friends of ours who earn £20k (combined) less! Due to the split of how this is earn’t and the tax applied! That’s not fair either, why should our household income be penalised due to our family choices?

Paying for care is very much the same. Should we also be paying for NHS? (Serious question) I mean those who ‘have it’ why shouldn’t they pay? But equally if one person is paying and the person next to them isn’t- why shouldn’t that person expect better/priority over a freeloader?

^these are not my opinions - but they’re questions that are posed every time some one raises a thread like this.

Short answer- No it’s not really fair, care is part of the NHS and saying elderly should pay is the same as saying any ‘non life threatening’ treatment should be paid for.
However, it’s the tip of the ice berg in terms of injustices/inequalities in the U.K. benefit/NHS system!

Elderly parents can avoid paying by signing over their homes/assets to their kids well in advance of needing FT care- I know several people who have done this and I don’t judge

Care homes aren’t ‘free’ for people on benefits - they are paid for entirely by the person’s benefits / state pension. Depending on the care option these people can often end up paying out more over a lifetime than people who fully fund their care. Probably not a problem when you’re old and grey but this reduction of benefits is a huge deal if you need to he put into care while younger or you have kids.

Honestly I think the best way around this is to increase competition and have a two or even three tier service based on cost. People on benefits get the basic care home that provides all of their necessary basic needs. People who pay should be able to buy something a bit more special Be that in the UK / overseas (including the option to buy a five star suite and have a team of nurses and doctors based there) - currently that option is only available for the very, very rich. It should be available to everyone when you consider the costs.

If only hard work equalled more money though, that's not true at all is it.

DishingOutDone this says in a sentence what it took a whole post for me to say!

Spot on.

The reason for the care home is the key issue. If it required for social care then places shpuld where possible be self funded.

If a care/nursing home is required due to needs arising from a clinical disease such as alzheimers then the care should be state funded.

Cancer care, a clinical disease is funded. Arbitrary differences between different but equally serious clinical diseases are unacceptable.

If a person dies from cancer their care is paid; if a person dies from alzheimers their families pay. It is morally wrong. Disease does not discriminate and neither should the providers of care arising from clinical need.

I think it's unfair that if you have dementia or Parkinsons you have to pay for your care and if you have cancer you don't.

I 100% agree with this.

I also think that there's a lot of institutionalised ageism in play here as, if dementia were mainly a younger person's illness, sufferers needing 24-hour professional residential care would likely still have living family members occupying their former home; whereas most older folk will live with one other (also elderly) person at most in a house that they now own outright.

Many will disagree, but to me, it seems much less like the government deciding it inherently fair for this particular kind of health care to be funded by the recipient and much more like they're circling and seeing what assets the person has accumulated over a lifetime and are simply thinking "We could take that if they won't be needing it any more."

Also, it often depends on relatively minor differences in personal needs. I have a very elderly relative who has a number of serious mental health issues as well as being bed-bound and, because of her circumstances (she shows a lot of signs of autism, which seems to run in the family, but is of an age where it would never have been diagnosed, and she would not cope socially in an environment living alongside other folk) she receives multiple daily visits from carers in her own home, which must cost the council a lot of money. When she dies, her house will go to her family; but if she had gone into residential care, it would be sold and most of the money gone to the council/government.

To those who think it fair that a older person unfortunate enough to suffer from dementia should rightly have their home sold to pay for their care: would you also believe that the children of an elderly person who is lucky enough not to get dementia and who is able to live at home before eventually dying of another health condition or just of old age should also be expected to automatically donate the proceeds of the sale of their parents' house to the NHS, so that it can be used for those who do need it but don't have any assets of their own to pay for it? If not, why not? Isn't that the basic premise of the NHS - that those who can pay do pay and those in need get what they need?

The point here is that if you are 'self-funded' (ie have a house that you have to sell), then you actually pay MORE than the resident who is funded by social services. This is because social services do not pay the true cost and have a maximum amount they will pay. Therefore the residential home have to make this up by cross-subsidising with those who are self-funded. This is apparantly legal.
I know this because my mother was in residential care for many years.
You are also expected to provide money for all toiletries, which is very annoying, because if another resident runs out, the staff will obviously use someone else's. (I think they should provide basic soap, etc).
This goes on until the resident is down to their last £23,500.
A previous government (cant remember which one) wanted to change this so there was a maximum spend of around £75,000.
I am against this, because this will obviously benefit those whose homes are in the millions.
However, I do think the £23,500 has not been raised for some time, and I think it could be raised to, say, £30,000. However, this is unlikely to happen, because they need the money.

The simple fact is there isn't the money to pay for quality care in later life. I intend to go to Switzerland when I'm old and decrepit. I don't want to live in pain and unable to care for myself. My home will pay for that and the left rest for my children. If I was happy to die in care then my home should go to pay for it because there just isn't the money in the system to pay for it, sadly.

I do not think we can have a sensible conversation about funding long term care without a rational discussion about assisted dying.

My Dad lives in a place with no state-funded care. If he needs it, he pays. He is adamant that whatever wealth he has spent a lifetime amassing will not be used to keep him "existing" just for the sake of providing an opportunity to redistribute that wealth to people other than his kids. His oft-stated preference is to dispatch himself with a firearm when the time comes, but we're planning to take him to Switzerland or another more enlightened country if necessary.

Yanbu at all.

Of all the Tory policies in 2017, the one I thought sounded quite sensible was the one that drew almost universal anger, and it was very interesting. You get lots of support for the "people should pay their way and not get hand outs from the state" bilge the Tories like- until it comes to this, where apparently "people should pay their way and not get hand outs from the state unless their paying their way means I get less inheritance".

Unfortunately we do live in a society where those who work hard (FT workers on average+ salaries) - pay hard! Taxes, NI, student loans, dental, childcare, care homes...whilst those who don’t really contribute to the system in the same way (unemployed/Very low income) are simply provided it for free!

Please tell me you don't think only those on "average+" salaries work hard.

Elderly parents can avoid paying by signing over their homes/assets to their kids well in advance of needing FT care- I know several people who have done this and I don’t judge

Neither would I, but it's a very complicated set-up in order not to fall foul of the official rules.

You can't usually just sign your home over to your children and keep on living there without paying rent - and then the taxman will of course be wanting to take his share of that rent that they receive from them.

Normally, if you sign your home or other significant assets over to somebody else but then continue to live there and/or benefit from them just as much as you were when you technically still owned them, it's considered a deliberate attempted tax dodge and you will be deemed NOT to have actually made the gift in the first place.

I don't know, Bernardette; only had one elderly relative who spent a couple of years in a nursing home and she funded it herself. It was a very good place and nice to visit, went to see her there often. She had no children - what was left when she died was divided between me and her other niece (my cousin), and it wasn't a great amount - that didn't matter but it shows that most of her house money was used up fairly quickly. I have to say she was always very generous to us before that, she often gave me money and also treated my son.

Since she died, a good few years ago, the law changed a bit and if someone needed a nursing home - as opposed to a retirement home - it should be government funded. I don't know if it has changed since then.

My auntie had a lovely room with en suite, the food was great and the place didn't smell.

I have known other elderly people who have gone into council funded homes and some of them were pretty grim, frankly.

Actually I had two aunts who went into nursing homes but the other one wasn't in there long, she was 90+ and died. She would not have been in a home had she not become senile and wandered out in her nightie at all times. It was sad but her daughter ensured she had good care, even moving her from one nursing home with which she was not happy, to another which was far better. As I said, she wasn't 'in care' long, maybe six months. The last time I saw her she had been taken to hospital (would you believe the poor old dear had breast cancer at the end, quite a big lump that you could see, but no suffering, obviously no treatment), and died shortly after that diagnosis.

I will be able to fund any care that I need (am nearly seventy and a widow), hope to stay in my own home but you never know what might happen. For example, if I became senile I would have to go away. Not a pleasant thought, like most of us I want to 'go off' peacefully in my sleep. I'm OK at the moment though so must seize the moment :-), the future can take care of itself.

Certainly I want to leave something to my son but I may give him money before I become very old.

It’s a difficult one,

While on one hand government should not be responsible for paying for your care. On the other I hate the thought of handing over my money to the government.

I had to sell my mother’s home to fund her fees when she went into a care home - it was a nice, friendly, well run place with an excellent local reputation where she was happy and had expressed her preference for. That would not have necessarily been the case if she had not had the funds - the council could have allocated her somewhere else.

I didn’t resent the other people in the home who were funded by the local authority - l could have no idea about all of their circumstances that led to them having less assets at the later stages of their lives.

Her cash assets were below the limit until the property was sold, so the council did fund her short term until the house sale went through - but they had a lien on the property and that advance money had to repaid before the sale funds were released. As her representative, under POA, I could not then have spent all the cash and then tried to claim funding - I was legally responsible.

I worked out how many years her money would last ( not taking into account possible higher level of care ) anxious that she would be able to remain there .

But most people are already at an extreme age or frail when they go into care homes now and I was given statistics then, and later when dealing with my MIL, about how long people, on average live in care. Something like 2 years.

My mother had 3 happy years there and I don’t resent for one moment that the asset earned through my parents work and planning, with some coming down from her parents decades before, had funded that.

My brother and I did inherit a bit, less than if her care had been free, but I don’t think it should have been entirely free - she wasn’t paying for running a house any more or supplying food. As for the ‘family house ‘ attachment - most inheritors will sell, rather than move in to the family home.

If we want free at point of use social care ( there is a problem defining where the demarcation is between social and nursing ) then it has to be funded from somewhere - either by higher general tax or an insurance based system. I would limited money went to the NHS - and maybe elder social care being far more integrated into the NHS to stop expensive revolving door admissions, but that is another subject .

Otherwise if you, or your assets, can pay you should - and no side eying at the person in the next room who can’t ( not that you should be able tell )

I agree but in the UK inheritance and property ownership are sacrosanct.

I don't know what the solution should be but I find it equally unfair if person A spent their lives saving nothing and spending every penny they had on themselves and therefore gets everything funded while person B saved very carefully by denying themselves luxuries but now have to fund their own care. Living carefully is penalised while being irresponsible gives you everything for free.

Tbh I just think that the UK really, really needs to raise it's income tax by 10% or more if it wants to keep the NHS, the same benefits system, free childcare hours and long maternity leaves...

The system is a mess. We should all be paying more tax: we want Scandinavian levels of service but US levels of tax. Successive governments have bottled it because (as this thread shows) there are high levels of expectations over levels of care and inheritance and changing the system would be even more unpopular. A long term strategy of national government dumping costs and responsibilities onto councils and then blaming them when there isn't enough money in the system. My net salary each pcm is c£4K, yet I'd struggle to pay for my care on that - let alone what happens when I eventually retire and am living off a pension. There are little incentives to save for care either, and although there was talk of insurance companies developing some products, none have because its probably not enough money in it for them. Never mind faffing about with tv licenses for older people-stuff like that is a red herring.