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.

Only if they are assessed as needing to be in a care home. It's more likely they will be discharged to their home with a package of care.

They won't get to decide what happened financially.

Thank you for all the advice. I'll tell my friend about the assessment her parents could request. I suspect that as long as the assessment is free, they'll have it.

If it’s just the one asset that stops her being funded, should you not ask for a reassessment to stop the debt building up? And present an up to date valuation of the asset.

Funded nursing allowance and Attendance Allowance between them will still leave them at least £800 a week short of nursing home fees, not sure how easy it us to get funded nursing allowance if your needs aren’t sufficient to require a nursing home rather than a care home.

Do they have to rely on it for living expenses? I thought 50% of shared savings were regarded as belonging to them, not their partner. There wasn’t a requirement to be spending it, they could still continue to save for their elderly needs

My mother had repeated falls and hospital admissions, incapable of doing anything unaided yet my father refused to fund carers, he held the purse strings. If the hospital set up a care package on discharge he would cancel it once fees became payable.
He had capacity, so did my mother. Absolutely sweet fa anyone can do about it. I instigated safeguarding and he lied to the social workers about how he could do everything to care for her. He definitely didn’t do a thing.
Nothing anyone can do. Eventually he was unwell so the situation changed and he couldn’t stop them going into a residential home.

Yes, sometimes there is nothing you can do except wait for things to come to a head which is very stressful, epecially if they have been assessed as having capacity to make the decision to refuse care. There has to be a specific question to decide upon when making a capacity decision, e.g. 'is mr x able to understand the risks he is putting himself under'.

going through similar with PILs, how did you manage to actually get them in the care home?

It's so situation dependent it would be impossible to give a general answer as it depends on capacity and all sorts, but in answer to the question about if they could stay in hospital indefinitely the answer is no.

If they refuse to pay for care but also refuse to leave hospital (or the family refuse to make arrangements for them to move) because they know they need the care then eventually the hospital will take legal action and start to charge them the daily cost of an acute hospital bed which is more than you would pay per day in a care home!

Has that ever happened though? A hospital taking legal action against an elderly patient needing care and charging them a daily rate? Can you imagine the bad publicity for the hospital and 'worked all their life' headlines. Even if they hadn't worked all their life at all.

It's threatened regularly, mostly to relatives who think if they keep delaying choosing a care home they might be able to run down the clock without having to pay for care.

In reality most people get a shift on and get something organised once they get the first legal notice letter from the hospital.

I've seen the hospital follow through on the threat three times and on one occasion the police were called when the person refused to leave after all the legal processes to 'evict' them were complete.

It happens less frequently these days as the discharge to assess process used in many hospitals means that hospitals ship people out to care homes 'for recuperation / assessment' and pay for the first 4 weeks of care there without involving social care/families in that decision. It sorts the bedblocking issue but just pushes the difficult conversations further down the line.

@SafeguardingSocialWorker on reflection I can see my mother was delaying making a decision for my father. He was discharged originally from hospital to a ‘reablement’ facility which was lovely but a very unsuitable setting for him. He got lucky because the lead nurse was amazingly compassionate and could see we had unresolved issues with our mother. Eventually though she had to sit us (well me and sister) down and explain the setting was completely inappropriate and we needed to find a home. DoLs invoked multi disciplinary meeting etc. Thankfully she gave us about a week to find somewhere and get his room sorted etc….BUT that was mainly because she had worked with and knew the manager of the home very well over many years so they did seem to understand my sister and I had taken control and stopped mother and brother kicking the can down the road to avoid making a proper decision. Incredibly stressful time. You think you can narrow down a series of homes you might prefer but once you start ringing round and explain the nursing requirements rejection after rejection, or they have no space. We rang upwards of 50 establishments in the area and only one came back prepared to take our father. Thankfully it is the right place for his needs - not all singing all dancing but the right number of staff and a pleasant environment. On reflection if we had been firmer with ur mother about the recommendations of nursing care being needed months earlier we might have had more options.

We also got lucky and secured CHC which shut up my mother and brother who seemed more concerned about hiding money and working out what they would ‘allow Dad” out of a very healthy bank balance. Frankly his care seemed secondary to this. Appalling time to see the reality of our mother and brother. Anyway she is now utterly miserable but her bank balance is in tact so she can’t moan….but she does and lets people think she is paying because she’s wanting to be the victim and tell them she wanted him home but BlueLegume put him in a home. Bonkers…if you are still allowed to say that.