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.

We've been expecting to lose DMIL, 92 this year, with vascular dementia and multiple other chronic conditions, for several years. She hasn't enjoyed life for years and pre-dementia, she asked if I'd accompany her to Switzerland when the time came. Of course now that she lacks capacity, the option is no longer open. However, as she is well fed and cared for, her medication is better monitored, her pain managed, and she's not exposed to every cold and bug the great-grandchildren bring home from school and nursery because of the pandemic, she's in better fettle than for ages. But all the care in the world is not reconciling her to existence.

The debate over euthanasia and the freedom to decide on one's time of departure is not going away.

My mum made me promise, when my nana died, that I would help her to die if she ever became unwell like my nana was. She does seem to mean it, every so often she brings it up and reminds me that I promised. I seriously doubt I would ever be able to keep that promise. I don't know why I made it other than at the time I just wanted my mum to feel a little better and that was what she wanted from me. It plays on my mind more and more as time passes.

I have worked in several care homes and nursing homes in the past.
At the last nursing home I worked at they had a carer’s forum, to enable all carers and registered nurses to have a say in the running of the home.
The actual owners of the home were very up front and transparent in their discussions with the staff, and tried very hard to ensure all the clients living in the home, had the best care possible.
Pay was a regular feature that was brought up in discussions with the owners, although they paid slightly higher rates than other homes in the area, it wasn’t fantastic wages.
One day the owners brought a break down of all the outgoings and money received by them, to the meeting. It was an eye opener to see exactly how much money received by the local council for payment of care was received, far lower than we all thought. That was the only stream of income received into the home, once all the payments for wages - all care staff, laundry staff, kitchen staff, groundsman was added up, it was a massive chunk of the money received.
Mortgage, insurances, annual fees to CQC, annual service fees for the lifts, fire safety, mandatory training and refresher training for all staff, costs of weekly hazardous waste removal, costs of food, specialist equipment, beds, hoists, pressure relieving mattresses, cleaning products, window cleaning, specialist cleaning of carpets etc, costs of medications to be returned to chemist, medical supplies, PPE, incontinence pads, bedding and towels. 24 hour heating. The costs were absolutely astounding once they were all added up.
The only way the home remained viable was if it was operated at full capacity all the time, these owners were good people who really did put their staff and clients first, but eventually they called it a day and closed the home as it wasn’t viable and certainly not profitable.
It was a shock to the local community who did value the home and did recognise that it was a good, caring home.
The local authority now has to send all new clients many miles away to other homes as this was the only nursing home in the community .
I don’t know what the answer is to this ever growing problem, but I know there are good and caring homes out there, but people must be willing to pay for them, which unfortunately they aren’t at the moment.
My DM had to go into a nursing home after suffering from a stroke, this was about fifteen miles from where she lived and was the most local one to her. The home itself was okay, but rather clinical, she died following a further stroke a few months later, and I was relieved when it happened, I’m ashamed to admit.
Due to how disabled she was following the initial stroke, there was no way I could have looked after her at my home, or hers, as neither had the facilities she required. My DM paid for her care as she had savings, which was the right way to use them, her needs came first. She also needed two carers for everything, and there would have been no one to help me, plus I would have had to leave my job, with no prospects of getting another one later on.
Sometimes we need to look at the wider picture and perhaps re-think the best way forward for everyone. This issue is not going away anytime soon.

I’ve never known anyone face up to or admit they have dementia. There is fierce denial, collusion with spouse to conceal it and anger if anyone dares to mention any memory loss etc

My mum did. She said to me one day “My memory is like a colander, it’s full of holes”.

Yes my DDad also vinyl, we cried and talked together about it after initial diagnosis. But now when he mentions holes in his memory, I don't keep saying it tbh so maybe family can be uncomfortable being forthright too? He originally understood that he had Alzheimer's so he felt lucky when the distinction was made.

I seem to recall reading something about how dementia won't affect the following generations as much because people won't retire as early and do nothing. Most people aren't old before their time anymore and are generally more active and have more hobbies, interests and more likely to carry on doing the things they have always enjoyed if they physically can.
Ime my parents, apart from the odd holiday and scrabble, didn't do much at all once retired in their early 50's. They seemed to age really quickly. They did no physical activity whatsoever just a lot of TV watching, pottering and napping. They are both fortunate to have escaped with their minds so far but a lot of their friends who did similar haven't been so lucky.

It’s a nice idea @Zenithbear, not very realistic though. Dementia is partly genetic. My mum had it, as did lots of her family. My dad lived to be 99, played his last round of golf six months before he died and was sharp as a tack to his last breath. Me? Could go either way.

I seem to recall reading something about how dementia won't affect the following generations as much because people won't retire as early and do nothing. Most people aren't old before their time anymore and are generally more active and have more hobbies, interests and more likely to carry on doing the things they have always enjoyed if they physically can

True, activity levels can ward off dementia to some extent but generally age is the defining cause.

When I was having chemo I got very confused and found it hard to think. It was a very frightening experience and I am absolutely clear in my now normal brain I do not want to live that way again. If it’s up to me at all I would choose to die rather than live through that again. And if that means my kids can have some cash too all the better.

True, activity levels can ward off dementia to some extent but generally age is the defining cause

Age is not a the cause of dementia, and is not part of the normal ageing process:

www.cdc.gov/aging/publications/features/dementia-not-normal-aging.html

An upside is that rates of dementia are in decline in western countries:

www.independent.co.uk/life-style/dementia-decline-rates-smoking-tobacco-prevention-study-harvard-school-public-health-a8833136.html

The only way the home remained viable was if it was operated at full capacity all the time, these owners were good people who really did put their staff and clients first, but eventually they called it a day and closed the home as it wasn’t viable and certainly not profitable
that's pretty dismaying to learn.....what are we going to do with the rising numbers of elderly, put them in suspended animation pods until we find a way to pay for them to have lives?

Personally I think that the state could fund more adult social care but chooses not to.

It could also do more to invest in public health which would do a lot to reduce significant costs arising from an ageing population.

Everyone knows there’s not an infinite supply of money. However we are a wealthy country and huge swathes of that wealth are sitting in small concentrated pockets. Tackle that and there’s more for everyone.

Invest in public health
I agree!
I suppose the problem for the government is that they would be asking the cohort of people who vote for them to do things they (and the rest of us) don't much like doing ....like exercise and eating healthily, not drinking etc

Simply put, bullshit. We pay taxes all our lives and it's a total con that we should pay again. PS everyone, without exception pays taxes. Poor people pay more proportionally because of the relative cost of things. Don't believe me? Try having a key meter for electric instead of a direct debit, which you can't get when you're skint.

But taxes cover the bin men, education etc etc - obviously 24 hour care takes 3 people full time so, say, 40,000 a year total , 10-20 years of expensive medication - people don't pay enough tax to cover the costs.

Age is not a the cause of dementia, and is not part of the normal ageing process

Not what the Alzheimer's society says:
Ageing
Age is the strongest known risk factor for dementia

Of course, like all things related to health, lifestyle choices can reduce risk.

I was about to make the same observation JasJas. The older you get, the more the damage accumulates, and the progress of the disease becomes obvious. Lifestyle helps, but probably outweighed by genetic factors. As long as a person lives long enough for the condition to show. Early onset dementia is less well understood AFAIK?

Agree with Xing and Jas.

My experience is also that after a certain point it is very difficult to distinguish one condition from another, and that many diseases of old age contribute towards confusion. Even the hard lines that would distinguish the symptoms of e.g. cancer in a younger person blur with old age.

On the other hand many older people do stay relatively healthy and mentally alert, and relatives have to constantly remind HCPs of what would be normal for this person.

It's difficult.

I seem to recall reading something about how dementia won't affect the following generations as much
Previous generations did not have today's obesity rates

Good point. They're calling it type 3 diabetes..

Mil and fil both had dementia. Physically they were in the best of health, which actually made it worse as they both lasted many years.

I have family members who have lived to their 90s or 100s with no dementia, and didn’t have lives full of activity or hobbies.

I think, like most of health, it’s just genetic. We like to hope we have agency over our lives, but we don’t.

It's starting to look as if dementia is a symptom which can have many different underlying causes, I suppose essentially it is a type of organ failure and as we age our organs become less efficient and start to malfunction

I had to go into A&E recently. The woman in the bed next to me was senile with double incontinence. Utterly distressed. No family. The carer was absolutely wonderful in her efforts to calm her down but very little was getting through to this poor dear.

At what point do we debate life at any cost when a life such as this is simply not a life.

I know of so many family fall outs due to the money issue. Where the grandkids are resentful they lost inheritance as grannys house was sold to fund care. Also know people who beat the system by transferring deeds 7 years prior so government topped up.
My gran lived with my mum most of her life until at age of 97 she had a stroke that meant she needed 24 hour care. My mum had no option but to put her in home. This caused family fall out as my aunt said she should not be in a home. Although she did none of the care.
It was soul destroying to watch until her death 2 years later.
I am all for euthanasia I have seen first hand care of elderly units. My opinion is that if someone has no quality of life what is the point of lying in a bed when you know noone and getting feed and washed like a baby. Its crazy to me that we would not let an animal live like that but have an issue with our relatives.
I have always said i would end my life rather than become a burden to my kids. I have seen the resentment within families when someone lives too long and starts to inconvenience the other person.

could we end up in a situation where people's lives are routinely extended to 150 with decades spent completely dependent on carers😳
It's hard to escape the conclusion that we will eventually have to to have a form of euthanasia, however it seems likely that this will bring with it a whole new set of problems🤔