How does it work - paying for care?

[GilligansKitchenIsland]

I should preface this by saying that my parents don't currently need care. But I'm aware that they probably will at some point in the future. Currently 68 and 72, and in more or less good health.

They're both self employed in the charity sector and still working F/T. It's not a well-paying field and they're on a very low income, jointly earning around £25-30k (but they find their work fulfilling so have stuck with it). They've never been able to afford their own home so have always "rented" privately. I use inverted commas because in reality its more like guardianship or house-sitting; they live in people's second homes or in the homes of people who are stationed overseas for years at a time, paying very low rent on exchange for looking after the place. It's good financially but quite unstable; they move house every few years. They have been paying what they can into private pensions and also have probably £30k in savings. These savings is their only asset.

I have a sibling who lives overseas, so realistically I will be responsible for arranging/providing their care when they need it. DH and I have a mortgage on our home which is just big enough for our family, lots of stairs, wonky floors. We are on a combined income of about £60k.

Reading another thread about care homes costing £1200/week has really opened my eyes and terrified me a little. What happens to elderly people who don't have that kind of money?? My parents have alluded to being worried about the future but I naively didn't realise just how much their financial situation puts them in the shit. There must be many other elderly people who were on a low income all their life and don't have assets, but what do they do?? I will do everything I can, but I have young DC and won't be able to provide F/T care or housing for them!

[TwoThousandZeroZeroPartyOverOopsFoundMoreTime]

When you say "they have" £30k in savings you mean £15k each. That's below £23.250 local authority threshold

Your parents will get care support from the local authority they are resident in, after a needs assessment.
They don't own their property
Lots of people don't
They will have a financial assessment of what they pay towards their care package, or their care home place.

The local authority will find a placement if they require a care home, nearest to their local rates that can meet their needs.
Not all care homes cost £1200 a week. Infact cost of placement is not a good predictor of quality of care. Some of the best care homes I know cost far less

[Knotaknitter]

The short answer is that it won't be on you to provide care or housing.

Google is your friend here. The care responsibility falls on their local social services department (may be different in Scotland) who will pick up the bill. They will do a needs assessment and arrange what they deem to be needed. It's "care" and not cleaning or gardening. Your parents will pay until their savings fall below whatever the level is at that time.

When they finish house sitting they will need to be paying market rent or be applying to their local housing authority for support. I don't know enough about it to say whether they will be technically homeless. If you want to set your mind at rest then you have years to do some research on this. Consider that in ten or fifteen years time, when they might actually need care, everything might have changed (or not). I'm all for planning but this is not something you need to be worried about so far in advance.

[belikejeff]

As PP said threshold currently for paying for your own care is £23,250 (each) so if they have £15k each they qualify but may have to pay some contribution based on the savings above £14,250 also on their income.

They'd need to be eligible under the care act (England and Wales).

If they're both still working then sounds like this is a long way off. They may never need it, most people don't!

Essentially you don't need to worry. If they have the money they pay until they don't, if they don't have the money then the council pays.

[hatgirl]

Not everyone needs care. I know many people in their late 80s who have never had any care, just e.g a weekly cleaner.

They do however need to start thinking about where they intend to live in retirement as many local authorities allocate social housing based on having a connection to the area.

They will continue to get the state pension that they are currently getting and probably housing benefit if they remain in rented.

If either of them meet the threshold for residential care then the local authority will financially assess them depending on their circumstances at the time.

[Xrays]

To throw in a different angle… my Mum was 71 and owned her own home outright when she developed terminal bowel cancer. She had copd and Crohn’s as well. She needed care but there was no room in any hospice for her so she had a continuing healthcare assessment under the nhs and was given a fully funded place in a high needs nursing home where she lived until she died. They didn’t touch a penny of her own money and she wouldn’t have been able to sell the house quick enough to use funds from that. (She didn’t owe anything from her estate when she died either). You don’t always have to pay for care; completely depends on circumstances.

[Xrays]

https://www.nhs.uk/conditions/social-care-and-support-guide/money-work-and-benefits/nhs-continuing-healthcare/

[hatgirl]

@Xrays

To throw in a different angle… my Mum was 71 and owned her own home outright when she developed terminal bowel cancer. She had copd and Crohn’s as well. She needed care but there was no room in any hospice for her so she had a continuing healthcare assessment under the nhs and was given a fully funded place in a high needs nursing home where she lived until she died. They didn’t touch a penny of her own money and she wouldn’t have been able to sell the house quick enough to use funds from that. (She didn’t owe anything from her estate when she died either). You don’t always have to pay for care; completely depends on circumstances.

The vast majority of people won't be eligible for Fully Funded Continuing Healthcare though, it has a very specific set of criteria that have to be met around the nature, complexity, intensity and unpredictability of the presenting health conditions.

From what you have posted it sounds like your mum actually got fast track continuing healthcare which is slightly different and doesn't need to meet the four criteria. The criteria for fast track CHC funding is that the person has a rapidly deteriorating condition and have entered the terminal phase of their life. The expectation for fast track funding is that the person is most likely to have less than 12 weeks left to live.

Most people don't need residential care and only a small percentage of those who do are eligible for fully funded NHS care.

[Xrays]

@hatgirl

The vast majority of people won't be eligible for Fully Funded Continuing Healthcare though, it has a very specific set of criteria that have to be met around the nature, complexity, intensity and unpredictability of the presenting health conditions.

From what you have posted it sounds like your mum actually got fast track continuing healthcare which is slightly different and doesn't need to meet the four criteria. The criteria for fast track CHC funding is that the person has a rapidly deteriorating condition and have entered the terminal phase of their life. The expectation for fast track funding is that the person is most likely to have less than 12 weeks left to live.

Most people don't need residential care and only a small percentage of those who do are eligible for fully funded NHS care.

Possibly. It was a complex situation. But I still think it’s worth mentioning as so many people just aren’t aware of any of it at all.

[Xrays]

(She actually lived for 8 months after she was given the assessment/ moved into the home).

[Enterthewolves]

Have you considered supporting your Mum and Dad to look at applying for sheltered housing? This is council or housing association properties with wardens specifically for people aged 55+. I live in a very high demand area (South East) where it can take a decade to access council housing but sheltered is often made available to low priority people in as little as 6-12 months. Properties are on fixed rents that would be fully covered by housing benefit when your parents working income stops. If you tell me your parents’ local authority area I’ll happily find the application process for you.

[Thesharkradar]

I have young DC and won't be able to provide F/T care or housing for them!
Of course you can't provide care or housing for them nor should you, they are adults who have made their own choices in life.
It sounds as if they've lived their lives in a way that suits them, made plans and choices according to their own needs/priorities and presumably they will continue to do so.

[Mosaic123]

The 55+ housing sounds like a great idea for them to pursue.

Perhaps you can help them look for one close to your house?

[GilligansKitchenIsland]

Thanks for these responses, all! I realise I'm worrying about something that may never happen / may not happen for a decade or more, but if it was going to be something that would cost tens of thousands if it did happen then I'd have needed to start thinking about it now! Reassuring to know that it won't (necessarily!) bankrupt us.

It sounds stupid but I don't know any elderly people except in passing - all our extended family is overseas. I sort of assumed everyone ends up very ill or needing lots of care for a prolonged period unless they die relatively young.

The 55+ housing does sound like just the ticket, thanks for that @Enterthewolves. I had seen some housing for >55s when we were looking for our current home but it was all for sale (obviously, because we were looking to buy!) and I didn't realise similar schemes existed for renters. I'll DM you re the local authority.