Not my parents! What happens if an elderly person refuses to pay for care?

[Kendodd]

Person has money, just won't spend it, thinks state should pay. Person not coping at all, could do with living in a care home and wants to live in care home, just won't pay for it. What happens if they get admitted to hospital? Do they just stay there forever? Person would be quite happy with that btw. It's a married couple, both refuse to pay a penny.

I've found lots of information online about what to do if refusing care, but none about refusing to pay for it.

I think it would hinge on capacity.

If they have capacity, they can refuse to pay for care - and that will be taken as refusing care. So would be discharged home.

If judged not to have capacity to refuse care they would also not have capacity to make the financial decision not to pay for it. So court of protection would take over, admit.to residential care, and arrange for payment to come from the person's accounts (or share of joint account).

They'll be discharged home.

I imagine that it would become a debt that will be repaid when they die?

My mum has an asset that remains but can't be accessed, after having spent all her savings and the proceeds of her house on care. The council is now paying, and has been for years, but as she's officially a self funder, it's still owed. As I have POA I get an invoice every month. The debt stands at £300,000 so far! The asset is probably worth about £30k.

If social services decide they have to be in a home, they will pay and put a charge on their estate so they will be paid back when the person dies.

Whoever it is whose parents these are, please advise them to not get involved in caring for them at home, because it will be an inevitable nightmare if they do.

Social services have to assess someone's care needs if they appear to need care, under The Care Act. The financial assessment to see what the person can afford to contribute to their care is a separate process. They cannot leave an old person in danger/squalor just because they refuse to pay for care. They will put a lot of pressure on to get payment, or delay assessment because they are very strapped for cash/a lot of councils at risk of bankruptcy. My manager had the ability to waive payment, but these are extreme cases.

As everyone else has said, you don't get to live in a care home for free if you have much money or own a property.

Either your parent will be discharged home or they will have to pay. If the funds are tied up (in a house for example) a bill will accrue until such time as the house is sold.

But as far as I'm aware if they wanted to take the money from (for example) an asset such as a house, the person would need to sign a document to allow this.

For example my parent's house has a lien on it for part payment of my father's care in a nursing home - however my mother had to have Enduring Power of Attorney for him in order to sign the agreement for this on his behalf as the house was jointly owned. Also we needed to send in the deeds of the house etc. It was a whole heap of paperwork.

I'm sure the government could take it from a state pension or something, but it's more difficult to just take it from the estate of a deceased person.

They definitely won't be kept in hospital indefinitely unless they are ill. Why do they think the state, ie taxpayers, should pay but its okay for them to refuse.

What if the house is in Trust for their grown children? I thought this usurps any fee paying?

I'm unsure of the legal side of things re care but they won't be kept in hospital indefinitely, that isn't feasible

If care is denied, there could be eyebrows raised around safeguarding

Is that considered deprivation of assets

Not if it's done before there's any indication that care will be needed. So a fit and healthy 70 test old can do what they like with their money. Someone whose just become disabled by a stroke, cannot.

Or that's my understanding anyway. My mum had intended giving her grandchildren a significant amount towards house deposits. Unfortunately she didn't put the money in accounts in their names, so when she had her stroke she was no longer able to give that money as it would be deprivation of assets.

That can be considered deprivation of assets and is illegal.

They are going to come a cropper here and they just have to be left to find that out for themselves. The debt for their care will be registered as a charge against their estate and is likely to mean that as it accrues they leave little or nothing to their children anyway. So they might as well use the money to fund care. Hospitals are not long term care homes or hotels.

Adult social services are likely to become involved as safeguarding becomes more and more of an issue so these people might well find that their hand is forced.

Ideally, they should see a decent Independent Financial Adviser, but I doubt somehow that they will.

Yes, there's truth in that but OP does say that the people concerned are barely (if at all) coping. So just refusing to spend money. She even says that they want to live in a care home but won't pay for it as they think that the state should be funding them.

I know a neighbour who was not coping at home, repeated falls etc, where the ambulance service was called out at least 3 times in as many weeks.

I think once the system is aware of an individual they’ll be assigned a social worker who will explain their options. Then it’s a question of capacity, but also what kind of needs they have. Certain health conditions will be funded by the local health board, particularly nursing care.

If they have capacity they do have the right to refuse care, but it does become a catch 22 where if someone continues to not meet their basic needs and refuses to cooperate, do they really have the capacity?

They could pay for private carer.

I'm sure the government could take it from a state pension or something, but it's more difficult to just take it from the estate of a deceased person.

State pension would be nowhere near enough. A debt against the estate wouldn't be that complicated. A debt against the assets of a living person is a little more complex, but if they don't have capacity and.nobody has PoA the court of protection steps in and appoints an attorney who can then dispose of assets. If they do have capacity then it would be treated like any other debt - with it eventually reaching the point of court appointed bailifs being able to seize assets.

This I think.
If option 1 is most likely I wouldn't get involved. Can you see where that will end up, ie at your door indefinitely.
If you're already in that situation it might be advised to step away and let a crisis develop.

They can ask social services for a care needs assessment which is free, home adaptations the council pay up to £1k and claim attendance allowance, if they go into a carehome self funding they may also get a funded nursing contribution which can all go towards the fees.

@BranchGold
If they have capacity they do have the right to refuse care, but it does become a catch 22 where if someone continues to not meet their basic needs and refuses to cooperate, do they really have the capacity?
One of the principles of the mental capacity act is that an individual has the right to make an unwise decision.

This. If both parents have to go into a home. The home gets sold and they pay for their own care.

If they refuse to pay, they won’t get care, and eventually some sort of crisis will probably force the issue.

A home’s value won’t be counted towards care costs if a partner or another adult over 60 lives there, if that’s what they are worried about.
Pensions/investments/savings that provide income are assessed at 50% if the partner not going into care relies on it for living expenses.

They'll be discharged into a care home and the council will as a last resort take a charge on their house and get their money when they die.