Mum wants to move to a care home but money will run out and not sure she even needs it

[Tista]

My mother is 78, has extremely bad arthritis (waiting for hip replacement), frail, anxiety and is a bit muddled but not dementia.

She's become very isolated very quickly (lives alone, miles from anywhere in crap sheltered housing) and wants to move to a care home. When she sells her house, her money would run out in less than 2 years. Does anyone else have experience of someone with quite low care needs actively wanting to go into a care home and also what happens if social services think she can live alone) when the funds run out?

She's 2 hours from me, I do the practical stuff (online shop, car, house stuff) - I work, have young family, and we arent close anyway. She's very cranky now to the point I dread the (5) calls I get a day and tears/ anxiety/ "do this now" ness. I've got her to the doctors (no help and she wont take the meds), care assessment (refused), offered to pay for carer/ home help person (refused x million). She's also got a history of moving every few years. I suppose this would put a stop to that as she cant do it alone and there would be no more £££££!! She's very antisocial though so can almost see another problem of "I hate it here"!

Any help sooo welcome.

If she can pay for it herself then it seems a potential solution. When the money runs out she would have to sell her property (assuming that the current situation is that she is a home owner with savings).
When that money is gone then unless she has below a certain threshold there is no "top up" of fees from the local authority, and depending on the care home, it may be that the LA won't pay fees to one home of there is a less expensive option.

It is worth speaking with the person at the care home who is in charge of fees to see what options there are. Some of them do a "pay a lump sum and live out your days here" which, depending on age and infirmity can be a useful albeit morbid approach.

Can she move nearer to you, in another sheltered housing scheme. At least keep her out of a care home for longer.
Is respite an option for a couple of weeks to try it out?

Also if you don't have already, and you are next of kin, look into power of attorney for both finance and health.

@WeatherwaxOn
Thank you - yes getting poa now for finance and then health. There isnt any top up money so its a bit of a worry if she gets moved again - and just seemed a bit extreme to go care home route. I suppose if that is what she wants.

She hasnt got any money at all, just the house.

My grandfather sold his house and bought a flat in a sheltered accommodation block. He's in his 90s and is totally with it but is a bit frail and shaky on his feet. There's a warden on site all the time and various other medical staff accessible plus there's a communal lounge and activities but he also has his own flat and facilities. It's a very good compromise for him as he doesn't have any substantial needs.

Some care homes will allow her to stay for a trial period. Would this help her decide if it really was necessary?

Would she be happier in extra needs sheltered housing, will it be easy to sell her flat if its sheltered accommodation or does she have to sell it back to the company. If she has no money at the moment how would she pay to move to a carehome, she could try extra housing or a residential home but if she is privately funding then social services wont get involved until the money runs out.

Pay for a new hip and see if her mood improves?

Plenty of card homes accept LA funded people. If you can find a lovely care home (your nose will tell you) that will allow her to pay initially and does not charge a top up once her money runs out, why wouldn't you encourage her to go for that?

The staff will absolutely be used to dealing with the elderly anxious. It would also take quite a load off your shoulders.

Ex hospital social worker here.
I would go the extra care route. I don't think she'd like a care home if she doesn't yet need it.
Finance wise, she would have to sell her home to pay for a care home privately. When her finances get down to 23,500 she is entitled to ask for support from her LA. However, if they feel that she initially went in to a care home unnecessarily, they may well refuse to fund her care. Their argument would be that by going into a care home without first receiving care in her own home, she has spent her money too quickly. Basically, if she had asked them for help, it would have been cheaper initially.
The other possible problem is that when her money gets down to 23,500, the LA may only pay part of her fees, leaving her with a top up payment. I appreciate that may well be a long way in the future.
I would look at extra care flats.

First you and your mum need to visit some care homes. Would it be nice for her to be near you or near her friends? Get weekly costs and get a list from the local council as to whether the home is on it.

Don't get taken in by bells and whistles! If your mum can take advantage of them, all well and good but otherwise they could easily bump up the cost for nothing. A lovely home we looked at had a bar, cinema, workshop, hairdresser, 3 dining rooms etc for 1500 a week but my mum has Alzheimer's and would have been confined to the first floor most of the day. The best option was homely and loving and is only half that.

Unless you are in a position to fund the fees from the off the council/social services need to be involved. If they consider the home to be the right option for your mum (play up the lonely aspect, confusion etc) and there is a space then it's time for their finance talk. It's possible it will be funded for 12 weeks called a 'disregard'. During that time they will consider a deferment on he property where they will stump up most of the costs going forward and will reclaim it on her death, when funds run out or it's sold. After all funds are exhausted, if she has been in the home for more than 2 years they will possibly carrying on funding her themselves. All things to clarify when you first talk. I suggest LPOA first snd then you will always be in the loop.

Remember that her pension will be taken into consideration. This ekes the money out a bit further. Eg. My mum's fees are c. 3000 a month. The LA take 1000 from my mum's account (covered by her pension) and fund the rest. I receive a bill every quarter detailing how much they have paid and how much, with interest, will be repayable from her property.

I stress this is my own experience and other LAs might be different. Hope it all works out.

In our area, extra care flats can be rented from £700- 800/month marketed for the over 55s who need independent living but with a warden who is there 9-5 weekdays. These are not McCarthy Stone type of living but via a private landlord. Communal laundry, big lounge but everyone has own flat with front door, hallway, a bedroom and kitchen/ bathroom. If she allows carers eventually, they pop in and out. Might be a halfway house for a year or so?

It sounds like your Mum needs some advice. Age concern might be a good place to start as they will know the rules around care funding. Your Mum can't just decide to live in a care home in the knowledge that she can only afford it for 2 years. Worst case scenario is that she could be evicted and made homeless. Care homes aren't obliged to house people and if the Council refused to fund it she could find herself in a very uncomfortable position.
She's being very unreasonable to refuse all help but expect you to pick everything up. For your own sanity and health you need to negotiate a different split of responsibility and accepting outside help is part of that.

Thanks all, so helpful. She has the funding from the sale of the house so could go straight away - would get her closer whatever (not too close!) but am worried that she can only afford for two years expecially if she isnt that bad. She wont get financial help for a home but am confident she would for carers to come in. Sigh! Its convincing her that its not sensible to go to a home just yet- and yest on other hand am also worried that shes just going to sit and look at four walls again if she goes into very sheltered or sheltered closer to me (is already in sheltered but they are crap). It would be about £20k to pay for the hip op and associated care if she went private. Not an option.

Yes Age UK is a good idea. I would be wary of a private carehome who took on a resident who previously refused all care, refuses meds, has no real care needs or enough money to last, when the cash runs out she may need to move out. Why does she want to move into a carehome at the moment, you say she is anti social so she will just be sitting in her room all day spending money that she doesnt need to spend.

She may not get funding for carers, if she refuses to have a care needs assessment that cannot happen anyway. She could apply for attendance allowance and may get a spell in a rehab unit or a few weeks home care and equipment after her operation.

I suspect your Mum has quite unrealistic expectations around funding. My Mum was terminally ill and it still took weeks for emergency funding for a nursing home to be approved. She actually died before it happened.
Care homes will ask these questions before offering her a place. It sounds like she's unhappy where she is though. Maybe something nearer you would make sense?

When money runs out the LA would assess her. If they assess that her needs can be met in the community they would support her to move out of the care home and in to sheltered accomodation or private rented or Local authority rented, though she'd need to register and bid for suitable properties.

To be honest, it's quite rare that someone in a care home for 2 years would be assessed as being able to live in the community but it does happen.

I'd recommend extra care sheltered housing as an option. Would give your mum the social aspect she is craving. It's rented, so no need to buy anything.

If you were to refuse to do any practical stuff in two years though, she'd likely not manage? So could stay.
If she's asking to go into a care home I'd think long term and seize the opportunity with both hands. New hip or not, people can go downhill very sharply between late 70's and early 80's.

Definitely speak to Age UK. They are the experts and will give good advice. I would favour paying for the hip replacement and finding better sheltered/ assisted living. That could make all the difference.

@cptartapp

If you were to refuse to do any practical stuff in two years though, she'd likely not manage? So could stay. If she's asking to go into a care home I'd think long term and seize the opportunity with both hands. New hip or not, people can go downhill very sharply between late 70's and early 80's.

People without family, friends or friendly/ helpful neighbours manage to remain living in the community. The assessment of mum's needs would be done on mum, not on the support daughter can/ will offer. The only time that would be the case is if SS thinks mum should be in a home and mum wants to live independently and says it'll be possible because of daughters help.

SS can put care in for cleaning, shopping, hospital appointments, meds collection etc. Having family to support is not a requirement for independent living.

Organise a social services assessment, state you are doing all these things for her because she lacks capacity, they have to take mental health into account too. They may say that they will take over the fees once money is below £23k. Care home fees vary dramatically and are much more reasonable if they don't have personal care needs. We were paying £500 a week a year ago (when he died) for bed, board and washing basically, this wasn't that much more than household bills, food, cleaner l, gardener and home help - Midlands

Once her funds call below the threshold of £24K, and she has a care assessment
Social services could say she doesn’t strictly need 24 hour care and would be ok at home with carers.
However if she’s already sold her home, has been in a care home for 2 years and doesn’t have a home to go to then in my experience they are extremely unlikely to say that.
Also with her arthritis etc her care needs may well increase in that time so that they would agree she needs the care.

They may of course say that she has to move to a care home that accepts the local authority rate so ideally she’d move to one the local authority use too so that she’s less likely to have to move when her money runs out.

Is a live in care an alternative option? For self funders it can be a comparable cost and enable someone to stay at home.

What happens if you tell her she can't afford it or needs to wait until Covid blows over and she has had her hip operation.? I take it that a move won't happen if you don't organise it. She may just be saying these things for attention and to vent how unhappy she is . Lock-down with bad arthritis would make most people crotchety. Step back. I would refer her to speak to Social Services about her plans as they will be able to give her details of what accommodation would suit and assist her. This is not something you know enough about. Infuriatingly, it's common for folks who won't accept help at home when family discuss it, to become sweet reasonableness when a third party talks to them. I would also ask the GP about the hip op and if she is ever likely to be fit for it. Point out how low her mental condition has become.

In my local authority if you’re 2 years away from threshold you could insist on a care assessment but there’s not much point really.
I wouldn’t involve social services at this point other than to perhaps find out which homes they might fund in future.