MIL care costs

[NoHaudinMaWheest]

As the title says this is about paying care costs for my MIL.

I feel the need to give a fair bit of background in order for the situation to be understood and also to get things clear in my own mind. That will make it quite long so advance warning if you are short of time or capacity.

MIL is now 90. She was widowed 30+ years ago and has lived alone in her own owned home since. Until she was 79 she was pretty independent, driving, doing voluntary work, visiting friends etc.
She then had to have a fairly minor operation to remove a melanoma from her leg. She was assured that it was the type that doesn't spread systematically and that it had all been removed so once her leg had healed she could go back to normal. However she developed a severe reactive depression and stopped eating and drinking and caring for herself. She ended up very ill in hospital. After a period in acute and rehab hospitals she was discharged home, physically fine but still very depressed.
When FIL died she had taken out an insurance policy which would provide care at home and so that was used to hire a live-in carer to persuade her to eat, drink, wash etc. She had quite a lot of psychiatric input but never improved.
A few years later she had a fall which resulted in much reduced mobility. Since then she has lived in one room - bed and commode in the sitting room, just moving to the kitchen for some meals. She doesn't do anything -watch TV, read, knit, sew or engage in conversation. She just worries endlessly and repetitively about eg if the heating is working properly.
She has had the live in carers all this time funded by the insurance policy and her savings. About 5 years ago her savings ran out. BIL has POA and does all her financial stuff as well as managing the carers and practial stuff for the house though no hands on care. He managed to get social services to agree to some financial support and that was enough for things to continue until about 2 years ago.
At that point the care company massively increased their fees which meant that there was a considerable shortfall. Again BIL did the negotiations which meant some increase in SS contributions but there was still not enough so he decided that he and SIL and DH and I would top up - £125 a week for each couple (increased to £150 from this month).
He and DH are adamant that their mother should not go into a home. They feel that as they will ultimately inherit her house they will get their money back.
Some years ago (at least 15) MIL sold a field adjacent to her house. BIL had done quite a lot to negotiate with the council and developers so she got quite a good amount for it, some of which she gave to us and to BIL and SIL. DH and BIL feel that that means that it is only fair for them to fund MIL now.

MIL is not exactly healthy but she doesn't have any life threatening conditions and this situation could go on for many years. DH and I are both in our later 60s and both have disabilities which we manage independently now but may not be able to in the future. In addition we have two children in their 20s with disabilities which require additional support and limit their earning capacity.

I feel that although we may inherit there is no guarantee. If MIL was to require 2 to 1 or overnight care in the future she would have to go into residential care and the house be sold anyway. We are paying this out of income and even if we don't absolutely need it for day to day living now, we have good reason to want to save what we can as well as living reasonably comfortably now.

I really resent being given no choice about this funding. I am not sure that living in isolation like this is really in MIL's best interests. And all this is skewed but the fact that I have never really liked MIL - the feeling is entirely mutual.

DH is quite passive and happy to go along with what BIL says. We live a lot further away and have the DCs to be responsible for while BIL and SIL are a bit younger, in good health and don't have children.

I don't even know what the figures are and am not sure that DH does either. Nor do I know for certain what MIL's will contains.

Saying no would cause a huge family rift but it is what I really want to do.

Any advice welcome (if you have managed to get to the end of this screed).

care homes are used to coaxing people to eat

Yes exactly. This also struck me as an odd objection to a home. My dad ate much better there as proper meals were cooked and served, and residents could eat in their rooms but were very much encouraged to come to the dining room and eat at the table with others at mealtimes other than breakfast. They may be thinking of something more like hospital where food is plonked down and just removed later with no care for if the patient has tried it, can eat it, or whatever. A care home environment would be different. Staff are specifically there to make sure residents eat, get washed and dressed etc.

I know BIL is keen on the house but as his wife has made it abundantly clear that she is not prepared to live there, I think he has accepted that it will have to be sold in the end.
I don't think BIL is being in any way fraudulent but I not so confident that things are being managed as well as they could be. It would be possible to make adaptations to make things more comfortable for MIL for example and that hasn't been done.
My hands are tied because no one listens to me. For example when MIL first became ill I suggested they applied for AA. I even offered to do it as I have experience of applying for disability benefits. They did do it in the end but resisted for much longer than necessary.

As for the will I don't know for sure what is in it. DH and BIL seem to be assuming an even split between them but I don't know if that is based on certain knowledge. BIL is executor but that doesn't necessarily mean he has seen it.

@NoHaudinMaWheest It’s 100% clear that an attorney MUST act in the sole interest of the donor. Your MIL. No will beneficiaries are relevant or anything else. He should be guided by health professionals if he has health and welfare POA. If just finance, he has to manage her money for her needs. It is not acceptable to ask you. This is too much money every month and it sounds like a care home is best. I assume you know the costs but an attorney cannot hold onto a house belonging to the donor because they want the money from it. Your MIL’s needs come first.

TizerorFizz thanks for that clear message.

It's her husband and his brother. The OP is the DIL it's not her siblings.

@NoHaudinMaWheest You are welcome and I hope family members understand their roles and responsibilities. DH and me are your age and my DM had a property to sell. She died before much of the proceeds were used but as Attorney I never asked anyone else for money. I also knew what was in DMs will and it was fair to all that she self funded when living at home became impossible. Just remind everyone of the rules.

My mum went into care last year. It was her decision. It is a really good home and she is much happier. There is company, plenty to do and she is really well looked after. It is absolutely the right thing for her. She has enough money for a limited number of years from the sale of her flat, so we are looking into insurance to fund it for life.

Honestly the relief that she is in the right place, that we are doing a lot less running around, makes all of us kids a lot happier and the impact on any possible future inheritance is utterly irrelevant.

Some others new to the home having been isolated before, but they seem to end up much happier, provided they still see plenty of their friends and family. You have to find the right home though.

Yes I agree with some of that - but atleast it may push them to sell the house or get her more suitable care. Or have the council fund it now but reclaim the money later out of the estate. It seems madness to rely on getting it back for the OP.

they are convinced that if MIL goes into a home no-one will ensure that she eats

This is nonsense. They will regularly monitor both her weight and her food intake. She'll probably eat better than she does now.

I agree with this my DM moved into a care home just before Christmas after an extended hospital stay. Without a doubt she has been far better cared for in the care home than in hospital.

In 'cared for' I mean the whole person. Not just the physical. The care home encouraged DM to get out of her room, to sit in the lounge with others, to eat with others. Eating is discretely monitored. Drinking is regularly encouraged.

Being self funding meant that there was a choice in where to go. We were able to choose somewhere that worked both for DM and also for us, her family. The atmosphere is akin to a golf or spa hotel without the golf course or swimming pool.

It does help that DBs and I do not benefit from DM's will. We are cheerfully spending our kids' inheritance.

What an absolute mess.

I'm with @TizerorFizz. You have very few things you can control here, but what you do have is your own money. I think you absolutely should not contribute your own income, for which you have definite needs, to someone else's care setup when they have FAR more resources than you and where you also think the current setup is actively damaging (fwiw I agree with you).

Your dh's income is much more difficult as obviously it's not yours, but you have an interest. I would focus on any joint financial goals that you have as a couple and how not having this money now will impact those goals.

Thinking about future money takes you into areas you have no control over - the will, the care setup, the value of the house, ultimate care costs, the length of MIL's life. I'd stop taking account of any of that as it will drive you mad.

This isnt easy and I'm guessing that there is a genuine risk to your marriage if you down tools and refuse to pay any more. But doing it from the basis that your MILs current care setup has demonstrably resulted in a terrible quality of life for her should give you some certainty here. Stop worrying about whether you like her or not, if the love of her children has resulted in this outcome.

As for nursing homes; yes they can be awful (I'm a community therapist working with older people and also have many extremely aged relatives) But often the actual awful impression is the reality of some of the conditions of extreme old age, not the home itself.

@PermanentTemporary DM had a great care home. Self funding gave choice and DM was extremely well cared for. Every member of staff was great and other residents liked DM too and she liked them. They cared for her until the end and they really helped us as a family to feel her care was the best. One great aspect was having access to a GP!! So much better NHS care than when at home. She actually got some!

Thanks PermanentTemporary. My Dad's nursing home was good although it might have looked a bit basic. There are good homes out there though I suspect that MIL will take her 'difficult' nature with her where ever she is.

We need to review the situation. BIL has already said he plans to do this in April (when pension and benefit increases come in) but I will push for earlier. If they won't agree to consider residential care, and I fear that is likely to be the case, then I will push for revisiting equity release.

My main worry in all this is the future of our children. There is a lot of uncertainty there and much that is out of my control but I don't want to do anything which will make their future more difficult if it can be avoided.

Great point. Having access to a dr or nurse is great! We had the same
for my Nan when she was in respite care. She had a UTI and there was no need to try to get a gp appt!

I would look into buying a care annuity policy.

For around £130k plus her pensions all of my mother's care costs are covered. £50k+ a year.

The remainder of her house money has earned around £70k in interest since we took out the annuity.

Had we not done this her current care spend would be £250k+

As an aside mum went into a care home via social services a very undernourished size 0, depressed and lonely she's now size 14/16 and so settled.

With dementia she believes she's either in a very expensive hotel or a monastery (it's the feeling of calm about the place apparently)

@NoHaudinMaWheest Equity release could well leave you seriously out of pocket! It’s a mortgage loan with very high interest rates. You will be liable for repaying it and this could take all her equity in her property. It’s much better to sell and self fund. It’s hard when that might use up funds too but there’s no debt. Unlike equity release!

TizerorFizz yes of course selling is best if she were to go into residential care. However if her sons insist on continuing with the live-in carer, equity release would allow it to be paid for from her resources rather than ours.

A suggestion. Your DH puts something in writing to his brother saying that you've been reviewing your family finances and concluded that from the end of March you will no longer be able to pay the previously agreed contribution to MIL's care. This is for all the reasons given: MIL's own wellbeing, the need to plan for further decline, and the wish to prioritise your own children and their increasing needs. You're open to other ways of supporting MIL and will discuss those but the current arrangement will stop at that date. This gives almost 3 months' notice and allows you to take charge of your own role in this, while allowing time to research the other options. Draw a line.

@NoHaudinMaWheest It might be solely from her resources but the debt is not written off. What happens when the loan needs to be repaid on death? There could be very little left for beneficiaries. The sum payable doubles every 12 years. It’s always better to sell and invest. Or downsize. Read MSEs guide. What beneficiary wants a multiplying debt?

Not necessarily if you just use a chunk of equity for a few years. We have looked into it. The costs of selling up and moving are higher than the costs of taking a bit of equity.

Can BIL put a charge against the house to get your money back if MIL needs to go into a care home and house needs to be sold.

If you borrow £20,000 - in 12 years you owe £40,000. Getting money out from downsizing can make far more sense. At least you can get a return on it. Live in carers are expensive. It won’t be much cheaper than a care home. DM paid £30 an hour. Not live in but if you needed 40 hours a week that’s £1200 a week. So not far off a care home. Equity release is the last resort and only ok if you don’t have dc. If you do, talk to them and familiarize yourself with the problems and solutions to your care without equity release.

I was told it would cost me £60k to move - estate agent fees, removals, stamp duty etc. Then buying new furniture, curtains etc if yours doesn't fit. If you have a house worth quite a bit, it can be much more sensible to borrow a bit on equity release than to move.

@Arran2024 but the person is selling to move into a care home. No stamp duty, no new carpets, furniture etc.