AIBU to put mum in care home

[Cantaffordthecost]

So my 85-year-old mum, who is widowed, has become doubly incontinent and confused. We are in the process of getting a dementia diagnosis. We’ve recently had to start carers (sourced by social services) as she can no longer manage her personal hygiene and can’t make herself meals or clean herself properly when she is left in a mess from her incontinence. We’ve just had the finance assessment from the council and we have been told we need to pay £142 a week and we just don’t have it. She has a monthly income of £1,143 in pension but our costs for heating alone last year - which they don’t take into account - were £350 and that’s without the rise. We pay for a stairlift and spend best part of £100 a month on incontinence pants - not counting the numerous washing machine loads etc we are doing daily. That is in addition to travel costs to hospital appointments on a weekly basis plus general living costs. We expected to pay some but we just haven’t got the money to pay this much. But she can go and live in a nursing /residential home and have £34.75 a week pocket money with the rest of the costs met. It will leave us financially better off but obviously cost the council far more. Where is the logic in that? Am I being unreasonable to think we have no choice but to find her a residential home or does anyone have any suggestions? The one thing we can’t do is find that much money.

What’s her current living situation? Does she own a house?
Unfortunately the care system in this country is a mess and can be extremely unfair. Putting her in a home could be the best (or only) option for everyone.

I’m confused does she live with you? Is she getting all her benefits entitlement including Attendance allowance? Council finance team can do a benefits check (sometimes called income maximisation)

pads will be provided free of charge from continence team via district nursing but not the disposable pants. Might be worth seeing if she can manage pads especially with the home care coming in.

Following as I can see us being in a similar situation soon.

the elderly parent in our case has just sold her house for £700000 so I assume she will be expected to pay for a care home?

YANBU I'm sorry you and your Mum are in this situation, your Mum needs specialist care and she will get that and company and stimulation in a nice care home. It's heartbreaking but necessary. You will be permanently exhausted, stressed and your own health will be impacted. This way you can conserve energy for visits, trips out and treats that both you and your Mum will enjoy. Agree with pp the care system in this country is shambolic.

Do you have poa?
What does she want to do? It should be up to her as gar as practical. You cant simply "put her in a home".
Is she living with you in your house? If so, her pension should cover her costs only. If youre in her house then that'd be sold for carehome fees anyway... and you need to consider what a fair rent etc would be. If she's renting then I dont get the means testing figures; surely rent must be £500 minimum, leaving her nothing at all after carers have been paid.

I agree that funding us crazy. But her pension would be swallowed up by care home fees anyway.

I fully sympathise with you OP. My poor 91 yer old gran had wonderful NHS carers for 6 months, free of charge after a massive deterioration to her heart condition, when she was put on an end of life pathway, only for us to get a phonemail from SS to say that they were going to do a 3 hour assessment to see whether she still qualified (she didn't have dementia but she couldn't prepare food, take care of her personal hygiene or walk 5 paces without wheezing). We were so so worried about the strain this assessment would put on her, and whether they would consider her 'not ill enough', even though her GP and carers all stated she was. Sadly (or maybe not), she died before the assessment took place. It was scheduled for the Tuesday but she got so unwell tat the community nurse put her foot down and told them to give us as a family some respect, and she passed away the following day.
I hope you find the best possible solution for your mum. Excuse my rambling.

Yes she will be expected to pay for her own care until her money runs out - or at least reduces to around £23,000 when the council will pay.

If there is a spouse living in the house, then the value of the house is disregarded.

I work in finance for a local authority, your Mum's finances should be assessed completely separately from yours. Your own income and expenditure is nothing to do with your mums ability to pay for care.

Were you there for the assessment, are you sure your mum has no other savings? The final amount would have been calculated taking out all necessary costs to live on.

Are you claiming Attendance Allowance or any disability related benefits? Can you get incontinence pants on prescription?

You're not 'putting her in a care home'. She might have to move into a care home as she can no longer look after herself. Big difference

Sorry for your mum's situation. If she doesn't own her home, as you know, you will be relying on social services to agree a care home placement. If your mum can't make decision as to her care because she doesn't have the mental capacity, then the social worker, usually, will have to make that assessment as to what is in her best interests. They will have to consider the least restrictive option so may want to look at increasing her care package at home in the first instance, for example.

As previous poster said, your mum should be entitled to a continence assessment, often via DN, and they should provide pads. It varies in different areas though. Any financial assessment should take into account disability related expenses. Have they done so? Age UK has very good information on their website. Also, make sure you look up NHS Continuing Care funding so you are aware of what she might become entitled to

Thank you.

no she’s moved in with one of her children. However that child is not a “carer”- good at sorting logistics, but I can’t see them wiping bums etc.

they seem to think £200k will be enough to pay for any care needed for the remainder of relatives life. I disagree. Especially if a care home is needed, or a 1:1 carer which is apparently their plan.

would they have to pay 100% of care home fees until the money is gone, or just “top up” over LA contributions?

Do you not think she should have to with 700k in the bank?

Absolutely.

Your fears were well grounded - I fought and fought for NHS Continuing Health care for my grand father which he was 100% entitled to.

It was so stressful, i was successful in getting him a fast track assessment while he was in a care home (sent there by hospital) and they said he wasn't poorly enough.

He was doubly incontinent, had open weeping bedsores, kidney failure and dementia.

36 hours after they said he wasn't ill enough, he died.

The care home sent me a bill for £14000+, I told them they can continue to ask via my solicitor (I didn't have one) as I knew the assessment was incorrect. I never heard back!

They're all in it together- the care homes get more money if you're paying as a private person than if NHS CHC is awarded. So the care homes, during the CHC assessment, will make out the patient is better than they are.

So many people are paying who shouldnt be. Income and savings DON'T matter, I a relative needs ongoing care then they don't need to sell their homes.

YANBU

My mum, also widowed, was struggling with personal hygiene and taking care of herself with cooking, cleaning etc. We paid for someone to help with her shopping, cleaning and bits around her retirement flat, but other than that let her get on with it. Until she had a fall. In hospital the occupational therapist, physiotherapist, nutritionist, social worker and doctor all recommended she move to a care home, which is what we did (not that she thanked us for it!). We're lucky the decision was essentially taken out of our hands, but I'd say don't leave it.

@Cantaffordthecost
You should be able to get someone from your local adult services to do a financial assessment as well as an assessment of needs for your mum. A couple of things - one, as others have mentioned your mum needs to claim for attendance allowance, if she isn't already. Secondly she should be able to get free incontinence pads though the district nurses and also some support in respect of making her home safer for her - through occupational health services - either the GP or memory (dementia) centre should be able to support with referral .

However - unless either you or your siblings are in a position to provide a lot more support to her yourselves (as in being there and helping rather than financial) then at some point it is likely your mum may need to move into a care home . It would probably be a good idea to start looking round now - seeing which local homes have availability and which ones will accept local authority funding referrals (i.e. where you won't be expected to pay top up). It sounds at the moment that your mum would be OK with residential care (as opposed to full nursing) and a decent home should be able to give support in respect of dementia including activities to help her mentally active ).

@Lastnamedidntstick yes if your mum (MIL?) has just sold her home for £700,000 then that sum will need to be used to pay for her ongoing care costs. Care home fees are likely to be around £6,000 per month - depending on where you live. You are still entitled to claim for attendance allowance as this isn't means dependent .

Sometimes going to live in a care home where a relative can get the care they need is the right decision to make. It sounds as though your mum might need that and while finances shouldn't drive things, sometimes they do and that's just life. I'm not sure if you and your mum are getting all the benefits eg attendance allowance, help with continence pads? Maybe citizens advice could help if you are thinking to keep your mum at home if possible.

Agree with this. We all need to move on from thinking "putting in a care home"
Is the least good solution, many times it is entirely the right and best thing to do for everyone concerned.

Thank you for all your suggestions.
My mum has her own home but doesn’t own it thanks to an equity release mortgage from years ago. Unfortunately this bans anyone from living with her although my brother stays there most nights so she isn’t on her own as she can’t manage overnight.
She gets attendance allowance but this is used for someone to come in and see once a week and clean/ do the washing etc. My brother and I do the bulk of this though as it’s needed daily along with daily carpet washing as a result of numerous accidents!
She has to wear absorbent pants rather than pads as she can’t manage the pads. She doesn’t really understand wearing pads and just never put them in no matter how often we asked her and checked up on it. We had to resort to hiding her normal pants and only giving her the absorbent ones. Unfortunately we’ve been told only pads can be supplied and we can’t face the mess that goes with that or risk mam sitting in wet or soiled underwear which was what was happening before we switched.
We got the council finance assessment today and we had thought we might have to find about £60-80 a week or so but never thought it would be almost twice that.
She hasn’t got a dementia diagnosis yet but to be honest the more I think about it and reading these suggestions I think a home might be best. She’s lonely and hates being on her own and really struggles with the constant incontinence issues so being looked after somewhere there is company might work.
I looked at a care home I thought would be nice earlier this week with a view to respite but it was soul destroying - and that was one with good reviews and reports from families I know who used it.
Time to look at some others and see if they are better I suppose.

Of course YANBU. In view of her care needs, a care home is clearly the most appropriate place for her. You and your brother are already doing far too much and she needs to be somewhere with proper professional support.

This can't be right. She doesn't live with you so why are you having to fund anything?!?!

Is this the case of the council trying to pass the care costs on to someone else and guilt trip them into paying when it is not your responsibility? It happens a lot...

FWIW, I remember my parents being told something similar (going back 15 years ago) with my gran who lived alone. She needed had to go into an assisted home and the council were trying to get my parents to pay the extra which wasn't right - my gran had no assets, only a state pension as she was widowed aged 32 and never remarried). In the end they didn't have to pay anything, and my gran finally ended up in a residential home with around £20 a week left over to spend on newspapers and a pedicure or something!

@Cantaffordthecost Are you sure of the calculations? If on the basis of her income they’ve calculated she needs to contribute £142,then they’ll come to the same conclusion if she’s in a care home, or more if she owns her current home.

The “pocket money” you refer to isn’t so that she’s given, it’s the amount they’ll let her keep out of her pension if they’re contributing to the funding of the care home.

You can only get AA in a care home if you are a self funder, with no LA contribution