To think we have to accept that we need to use savings to fund care in old age

[LastDuchessFerrara]

My parents died before reaching old age but I'm now watching family and friends caring - in one form or another - for older relatives.

Many seem to be in denial about the fact that savings, pensions and, in some cases equity in their home, needs to be used to enable their relatives to continue to stay in their homes or go into care.

"But they've worked all their lives!" they cry in protest. Well, yes - and now that money needs to be used in their old age.

It's really focussed my mind on how any money I accumulate might not be spent on amazing holidays but paying for cleaners and carers.

I'd be interested in views but please can this not be a "boomer" bashing thread. I know plenty of impoverished old people and plenty of entitled non-boomers.

The difference with old age care though is that it's also residential. I don't think its unreasonable to expect some 'rent' from the old person

I think the lines between residential and nursing has become very blurred.
My mum was double incontinent, bed ridden after a stroke, yet all her care was classed as Social Care, so had she not been on an end of life plan, the costs would have been funded by her.

Relatively well people moving into retirement bungalows is one thing but many care homes offer very good medical facilities and are far from "Homes"
These should be fully funded, just as a long stay in hospital is or is the next step in cutting costs?

[quote countrygirl99]@kendodd it's the same old problem. People think the state should fund care along as they don't have to pay more tax. And if "yuppies" move into their parents area and push prices up then they truly believe they deserve every penny of that unearned wealth as an inheritance.
There are only 2 options ' more tax and Scandinavian style social services or pay yourself. You cannot have fully state funded car in our current low tax system. Anf as for care homes raking it in, the sector has a really high bankruptcy rate. My MIL has occasional respite care and the last 2 homes she has been in have both closed due to bankruptcy.[/quote]
I agree. No one wants to pay more tax but they want the state to pay for everything.

I still don’t see why people think the state should pay for care homes so they get to inherit large amounts. Care for your elderly family yourself or accept that their money will go on care.

@FrankButchersDickieBow, nursing homes are for people who need a qualified nurse in attendance.
That’s why they’re more expensive than ordinary residential care homes.

A lot of people in ordinary residential care homes are in need of general care and supervision- help with washing, dressing, ‘toileting’ as they like to call it, and feeding.
These needs are often because of dementia.
A person can have dementia for many years and yet not need actual nursing care.
I wish people would stop referring to all care homes as ‘nursing homes’ when most of them are not.

Incidentally it’s unfair to say that all care homes are rubbish. Over many years I’ve experienced several that were very good and doing their best for the residents.
The only one I truly thought awful was the very expensive, swanky one on the seafront, where an aunt of dh put herself for a month while her helper was away.

Surly, miserable, unhelpful staff - she couldn’t wait to get out of there.

A person can have dementia for many years and yet not need actual nursing care
I wish people would stop referring to all care homes as ‘nursing homes’ when most of them are not

I think most people would assume that close personal care such as feeding, mobility, changing pads or toileting, dealing with dementia, administering medicines etc would be classed as "nursing"

All the govt did was re class nursing care as social care and boom! we can all pay for our own treatments... quite a trick really!

People with less issues, can and often are, helped in the community.

People do care for their elderly parents for years but many end up in residential care because it becomes too much for them.
This is fine to do if you have the space and can afford it and prepared to give up your job and your life to do this for your loved ones, but many just can't. It is shit and makes you feel guilty that you can't do these things or have them living next door in a granny / grandad flat or whatever. I worry endlessly about becoming a burden to my own children ( might not happen but who knows? )
I suppose more people might do this in order to get the house ( if this is the case) but years of looking after a dementia patient ( or whatever is wrong with them) but it has its toll. It's a double edged sword really and depends how dedicated you are to your parents. I know people that have done it but it's hard. Also ok if you can afford it.
My friends family are doing this and have bought a bigger place to house her parents but it's the woman that is doing 99 percent of the hard graft. No surprises there!

Old age care should be fully funded.
Every other illness or medical need is free at point of use. Why should old age care be different.
We get free cancer treatment, free treatment for every manner of avoidable lifestyle related illness, free maternity care. There is free care and treatment available for people with disabilities.

Again, it's the scale of what's needed and the cost of it - we absolutely could fully fund all care for the elderly, but the cost of it to the taxpayer is unlikely to be acceptable to the electorate. It's the number of people needing it and the length of time for which it is needed that make it hard to compare to any of the other things you listed.

So what's the answers then? Nobody does have the answers , I certainly don't.
Many don't want to live , but keeping people alive is what we do because euthanasia and having a choice in that matter is taken out of our hands if we have a disease that can't be cured ( whole other thread) and paying for care can / is a small fortune. The ones that save and graft are likely to end up paying more for their care and the ones that spend it all might receive the help. It's the usual story about everything in life isn't it? Governments need to address these problems but they don't. They are happy with the status quo I guess?

The problem will come in, say, 40 years time when many people of my generation will need care but will have no savings due to high living costs, no house to sell due to having to rent, no state pension probably, no final salary private pensions, no inheritance due the the previous generation having to spend it all on their care. What happens then? Do we all just work ourselves into the grave?

Funnily enough DH and I were talking about this last night.
DMIL has dementia. She is currently still at home with DFIL with nurses coming in twice a day. We're in France and this is fully funded.
She will probably need to go into a home in the not too distant future. As I understand it, the care aspect will at least be partly funded by the state but the residential side will have to be self-funded. If I have understood correctly this will come to 2000 - 3000 euros per month, depending on the home.
PIL do have aassets thanks to inheriting from MIL's parents 25 years ago. DH and BIL are currently trying to sort things out (FIL seems to be declining fast too and is overwhelmed) so that both will be able to go into a home at some point.
We are very, very grateful that PIL made some sound decisions. BIL got the shock of his life when he realised just how much care for both of them would be ( admittedly far less than in SE England). It wasn't so much that he has been counting on an inheritance, although there is an element of that, but that if/when it falls to he and dh to pick up the tab it will mean we will also be trying to pay our mortgages, put something away for our own old age (we all know that we won't be getting much from the state), and help our children out (sstudies possible small contribution to a deposit). DH and I had already understood this but I think many people like BIL are oblivious.

I am definitely not boomer bashing, but in my circle our parents and their friends did not have to fund elderly parents' care (no one lived long enough to need it), were not still paying mortgages off into their late 50s and even 60s, didn't have to help children with university fees, and none of our friends had any help with a deposit.

It seems that we (late 40s and 50s) are the first generation who will be simultaneously supporting our parents and children to such an extent.

How on earth our children - the current lost generation of 18-25 year-olds - are going to do the same actually frightens me.

I actually have sleepless nights about these issues. Having gone through it with my own late dad it was depressing and hard and made me feel guilty for years. I just wanted to win the lottery so I could care for him myself , but that wasn't going to happen of course.
I agree that today's generation won't be in a position to help their parents at all , they have been screwed over enough already.
It is very depressing. To add to all the other woes.

‘I do think it's odd that if you have cancer (for example) all of your treatment, and care in hospices, can be net from the NHS. But if you have Alzheimer's, although the costs of medical treatment will be met, you have to pay for your own care in homes.’

Modern hospice care does not provide long term placements. People ( including those with dementia and many other non cancer conditions) are admitted for symptom control throughout the palliative phase of the illness and will be discharged again either home or to a nursing home. Patients are generally only admitted from home for end of life care when their prognosis appears to be less than short weeks.
However beds are sometimes blocked in hospice settings by family members refusing to agree to nursing home placements for their family members because of the cost/inheritance implications.

[quote Lockheart]@BigWoollyJumpers

I think if you have means it is not right that you take from the state in order to pass inheritance on. You work to live, and that includes covering provision for old age.

Ok, but by that logic why should those with "means" (which also needs defining) be able to access state education, or the NHS, for example? Will we also start asking those with houses worth over X amount to free up equity in them so they can contribute to the primary their child is attending?

The state is there to help everyone - rich or poor. We don't refuse to treat someone through the NHS because they have a good job or own a big house.[/quote]
We can fund social care for everyone if we raise enough money to pay for it. That could and should involve a significant rise in inheritance tax. The iniquities of inheritance far outweigh the iniquities of social care.

The pandemic has put all these concerns on the back burner again. Any Tax raising by the chancellor will be solely to pay back the huge debts and nothing for adult social care or addressing why dementia is treated so differently to other diseases or conditions. All these things will limp on as they are currently.

@Hardbackwriter

Old age care should be fully funded. Every other illness or medical need is free at point of use. Why should old age care be different. We get free cancer treatment, free treatment for every manner of avoidable lifestyle related illness, free maternity care. There is free care and treatment available for people with disabilities.

Again, it's the scale of what's needed and the cost of it - we absolutely could fully fund all care for the elderly, but the cost of it to the taxpayer is unlikely to be acceptable to the electorate. It's the number of people needing it and the length of time for which it is needed that make it hard to compare to any of the other things you listed.

The electorate is happy to fund Trident and HS2/3 ? thats anywhere between 300 and 400 billion.

I think a recent commons report said adult social care can be fully funded for 5 billion per year?

So with some rises in inheritance tax and stopping decreases in corporation tax, the amount raised from general taxation would be reduced.

also, if care was provided by the state in a not for profit basis, savings can be made.

My DD has done part time agency work, on behalf of the council, in the community, the owners have a very expensive house, audi/bmw's and the owners partner has now left their job to become a director & the agency is actually a good employer too!

@catspider

So, all those people who have never paid into the system, have never saved anything, how do they pay for their care? It's a bit unfair that taxpayers who have paid their whole lives and who have been prudent and saved get shafted and those who have never saved will get get their care paid for by taxpayers who have. Not exactly an incentive to save and be responsible is it? Might as well fritter it all away in younger years.

By the same token, its just as ‘unfair’ that their children get handed an inheritance that they’ve done nothing to earn. What about people who have never worked because of disability? Or looking after a child with a disability? Or earned minimum wage so paid minimum tax ‘ national insurance? Most inheritance money comes from property. I bought a house for £25k many years ago. Ive spent maybe £80k in total paying the mortgage and maintenance. It’s now worth £300k. Ive done absolutely nothing to ‘earn’ that extra £220k. Why should the state pay for my care and the equity in my house be handed over to my children?

Taxation on inheritance and intergenerational wealth transfer only amounts to 1% of the total UK tax take. In the 1960's it was 2.5%. There is so much potential to do more there, and then you could have a properly funded state run social care sector, while also tackling some on the entrenched inequalities in society. Roughly a third of the population receive an inheritance from other family members, and those who do have on average twice the wealth of those who do not.

Obviously, I’d rather receive my parents’ property as inheritance than it is sailed to fund them in a care home if that’s required.

However, I accept that funding everyone’s carehome places on a non-means-tested way isn’t viable. As other posters mention, the cost to the tax payer would be vast and the electorate wouldn’t bear it. And to be honest, why should they?

The reality is that support should be means tested....it is a safety net to ensure everyone can have a are home place, but for those who can pay, they need to pay. And why not? It is simply their money being spent in themselves when they are in need. As with everything else, if you’ve saved more, you get more options about homes and style of care....a huge comfort to many elderly to know they will have that choice or their family will have that choice if the need arises. Those who have insufficient income will basically be allocated.

I agree that people should be able to keep a certain level of savings...and they can.

The reason people get agitated about this is that they hoped for a big inheritance or to leave a big inheritance. But crucially, there is no right to these things nor historic percent for them and this is largely the first mass generation to be in a position to even have the assets to even consider leaving an inheritance. It is not the norm and adult children returning to a place where they don’t expect to inherit a property is far more the historic norm.

Yes, the current boomers had a very different life to those before and after them. Far more bought property than ever before. Far more so huge price rises giving them a valuable asset. It wasn’t that they worked harder than previous or later generations. Their adult children aren’t any more deserving of an inheritance than people in the last or future. So if your parents don’t go into a home and get to pass on this valuable asset or you get to receive it, you are extremely fortunate, rather than it being your right or entitlement due to their hard work as lots of people see it.

Consider our children or their children. Many of our children will struggle to buy properties and when they become old will have nothing to sella nd the state will have to fund them in conjunction with family support. Their children won’t inherit and in all likelihood will also struggle with property and debt. It will just be the norm.

No-one likes the idea that a large possible inheritance can’t be given or won’t be received. But that money isn’t wasted when it’s used to pay for a care home. It is going to a good use to look after a needy person and to give them more options or their family more options about their care. We have to accept that as well as saving for pensions (which die with us or or spouse) we are essentially saving for possible care too. We save for all eventualities, one of which is the need for paid care.

I used to be a social worker, and when I started in the mid 70's, all local authorities had their own residential and domiciliary care for older people. There was a private sector, but nowhere near as huge as it is today.
I doubt if there are any council residential homes left now.
Things began to change in the 80's. I think it was because the local authorities couldn't/wouldn't pay out to bring them up to a required standard, (residents were often in shared rooms), but also because the (Tory) government of the day wanted a shift to the private sector, and local authorities became able to fund/part fund places in private homes rather than provide their own homes. They could also sell off these homes!
The local authority care homes were nowhere near as comfortable and well-equipped as homes are today, but I remember them as caring places where the staff were kind and motivated, and training was ongoing. (But I'm sure there were not-so-good homes too, maybe I was just fortunate to not come across any).
84% of residential care for older people is provided by private companies. Someone earlier in this thread said they would like to see residential care run by, for example, the NHS, as not-for-profit.
This would be my ideal scenario, but just can't see it happening, and certainly not under a Tory government.
It's a HUGE, expensive issue, but it's a can that keeps getting kicked down the road, because, as other PPs have said, no-one wants to pay for it.

I absolutely agree that if you require care then you should absolutely pay for it, and those who cannot pay for it should be funded by the tax payer - it’s how society in the UK works. Those who are fortunate either by hard work or luck should help via tax or care home fees to fund those who have not been fortunate.

I also think that I should be able to opt out of a care home or paying for my care by choosing death instead.

We can’t ask anyone to bump us off, but one thing we can all do once we’re of an age to think about such things, is to add a section to our Health and Welfare Powers of Attorney to make our wishes clear.

Because we do not want any ‘striving to keep alive’ if our quality of life is poor, dh and I have said roughly this:

‘If I should develop dementia, or any other condition where I am unable both to care for myself and speak (with full mental capacity) for myself, then with the exception of e.g. fractures, I emphatically do not want any life-saving or life-prolonging treatment. I ask for palliative care only.’

Otherwise, regardless of quality of life, there would almost certainly be lots of medication, in and out of hospital, on drips, etc., not to mention badgering and pestering to eat and drink when the person no longer want to.

I have seen too much of all this. It may well be done with the best of intentions, but IMO it would often be so much kinder to let Nature take its course.

@Willyoujustbequiet

But what about all the thousands of people who die having paid into a pension and no one gets the benefit?

My parents worked their whole lives in the NHS....40 years pension. He died shortly after retirement....after 3 months they cut his pension in two for my mum and then both his and hers was lost when she died not long after.

80 years contribution for nothing. Its no wonder people dont want to save for their later years.

Indeed. But that's the luck of the draw. There a thousands of widows, living until they are mid 90's, who's husbands retired at 60, but died shortly after, leaving the bulk of their pension to their widows. That generation of widows probably never worked, and then lived off those pensions, plus state pensions, for a further 30 years. Swings and roundabouts.

84% of residential care for older people is provided by private companies. Someone earlier in this thread said they would like to see residential care run by, for example, the NHS, as not-for-profit

Posted up-thread, but interestingly, most of these private companies, are charities or not-for-profit. I know when we looked for DM, many of the homes we looked at were charitable trusts, and NFP organisations.

jasjas1973 - I'm not happy to fund Trident or HS2, (or the House of Lords daily allowance, or the Royal Family, but don't get me started 😬), but it seems I haven't got a choice.........

@AlwaysCheddar

If I get a stage where I don’t have a clue what planet I’m on, id rather someone put a pillow over my face than pay thousands on a grotty nursing home.

The second that I am unable to use the toilet independently, I'm booking a one-way ticket to Dignitas.

I used to be a social worker, and when I started in the mid 70's, all local authorities had their own residential and domiciliary care for older people. There was a private sector, but nowhere near as huge as it is today.

I worked in the NHS from 1970 - at that time when an elderly person of, say 90, came in they were fussed over as it was so rare!!

It's the opposite case now where the vast majority of patients are old!

So it's not just funding or politics it's sheer numbers - so many more elderly.

@BigWoollyJumpers

84% of residential care for older people is provided by private companies. Someone earlier in this thread said they would like to see residential care run by, for example, the NHS, as not-for-profit

Posted up-thread, but interestingly, most of these private companies, are charities or not-for-profit. I know when we looked for DM, many of the homes we looked at were charitable trusts, and NFP organisations.

BigWoollyJumpers - Ah, I didn't know that, and it surprises me.