You and Yours, Radio 4

[MereDintofPandiculation]

You and Yours on radio 4 at the moment is on funding social care for the elderly - a phone in. I'm not listening at the moment because I'm wrestling with the final invoice from the nursing home which does not accord with my expectation.

I’m listening. It’s utterly disgusting that this is the state of so-called social care in the UK.

https://www.bbc.co.uk/sounds/play/live/bbc^radio^fourfm

Makes me change my view on assisted dying.

I was concerned about the slippery slope of having a sister dying when I look at what’s happened in Canada and talk to my friends who are doctors there.

However listening to this radio program makes me think that I would very much go for that option if I required a care home in my old age to save my DC, the emotional and physical, heartache and complete loss of any inheritance.

Otherwise, what is the alternative? All of my income saved up over the years, going to a private equity fund owning a chain of care homes whilst the workers making minimum wage. Few are talking about that latter point but which seems the greatest injustice to me.

In Canada the state pays the provider and pays for it by taking 80% of the persons income in retirement, leaving all of their assets. If it’s possible there, why is that not possible here?

Having worked in a couple of homes donkeys years ago before I trained ,earning minimum wage and no skills to speak of, hearing from the cook about the miniscule budget she had to provide food for residents …I agree about how on earth can it be so costly when residents can receive so little for that money?

Nursing homes are battery farms for our elderly. The good ones are few and far between. If it stinks of piss don't put your relative in there unless you hate them.
I would rather be put down than stuck in one of those places. Death is inevitable so why prolong it in a nursing home. (Not talking about residential homes, they tend to much less regimented, sometimes more of a stop gap between hospital and home, and generally have residents who are largely independent, and staff who aren't completely overwhelmed or under qualified.)

Even on a very low wage, staffing costs are going to be high at care home surely? So even for a minimal service, the fees will be high because you need a high staff to resident ratio? I get the complaints about them but I don't know what the alternative is.

I don't think that the dwindling number of working-age people, many of whom are struggling themselves, should fund the huge cost of care homes from taxes in order that others get an intact inheritance.

I also see the argument that why should someone have physical ailments treated free at the point of need, but something like dementia will cost them 100,000s.

My parents' care is already well over six figures. Yet I have friends whose parents' care has cost them nothing because they've been struck with different ailments. I fully expect to inherit nothing despite my parents having inherited a lot. I'm not complaining, merely observing. I don't begrudge this and I'm not offering to care for the remaining parent myself, but it's also sad that one year of care home fees would make a life-changing difference to the lives of my 20something nieces, for example.

And even if I were to offer myself up to be my mother's carer, I couldn't without giving up my job, giving up my family, giving up my sleep etc.

I just don't know what the answer is. And it seems like nobody else does either.

@Sittingontheporch there is no minimum staffing number unfortunately…you might often only have 1 registered nurse on duty, the rest are low paid staff who may or may not have a care qualification. It’s interesting comparing eu countries…it’s compulsory to have long term care insurance on Germany for eg. It’s got to change as many councils will become bankrupt as their budgets are being swallowed up by care costs for the elderly/ disabled and providing care for children and young people.

Death is inevitable so why prolong it in a nursing home

Because we can't just kill people?

@istheheatingonyet I think pp was considering what they would choose for themselves.

I would choose assisted dying for myself based on what I’ve seen and learned in the course of my life (both with terminal illness and long term frailty). It is socially acceptable for pets to be put down, and I want that option for myself and to be able to document that, so my DC know it is respecting my wishes not to prolong my life in similar circumstances to those I have witnessed.

I didn’t just kill my father, who was going to die living independently. We arranged self-funding in a nursing home and fully expect his care to take every penny he has. The nursing home is nice, does not smell, food is good. But there is no doubt it is prolonging his life. And no doubt that he hates me. Incidentally, he was costing the NHS a fortune in daily nursing care and emergency services.

My Aunt spent several years in a care home in Canada with dementia. The fees were paid by two of her children as my Uncle couldn’t afford it, despite being reasonably well off. So I’m not sure things are better in Canada.

The fees are extortionate because the self funders are also subsidising at least one non paying resident. An elderly friend was paying nearly £5k per month for her dh while the local authority block buys beds in the same home for around £1k per month. It isn't sustainable. Her husband has been in there for nearly 2 years and his savings are gone. He has no quality of life at all. It is really grim. Now the LA will have to fund his care too. She is in her 80s and very unwell herself but she still has to go in every day to feed him and get him to drink. She has to organise transport and accompany him to every single hospital appointment, including every time there is a catheter issue as only the hospital deals with that now. She is exhausted. Then there is the constant lost spectacles/ teeth/ hearing aid/ clothes. Wrong medication. And this is a "very good" home.

@Sittingontheporch You put the two sides very clearly.

Two solutions have been suggested, both of which spread the cost across the whole of-the better off elderly population, not just those unfortunate enough to need care:

Compulsory state insurance scheme paid into by elderly. This was labelled “dementia tax” by the opposing party and killed.

Compulsory levy on death from whatever cause, whether care had been needed or not. This was labelled a “death tax” by the opposing party and killed.

Either would have been better than the “cap on care costs” nearly implemented by the last government, which didnt cover “board and lodging” and was set at a level where it would take three years to reach the limit, when the average care home stay was 3 years and the average nursing home stay 1 year.

My friend’s mother went into care there. Also with dementia. This is what she told us but also that you didn’t have a free choice about where. Your name went on a list, you’d be told this place take or leave it. If you left it, then back to the bottom of the list. You can self fund if you want to choose where ie closer to family etc. But I’ll go ask for further details. It’s the exploitation by the private equity funds owning homes that is offensive.

https://www.chpi.org.uk/blog/investors-are-making-a-fortune-from-uk-healthcare-why-is-nobody-holding-private-equity-to-account/

https://www.ft.com/content/952317a6-36c1-11ea-a6d3-9a26f8c3c

https://www.bbc.co.uk/news/uk-59504521

@DrBlackbird I know about the private equity ‘profiteering’ and also listened to Mo Gawdat’s last 4 podcasts (I had a lot of long drives when caring at a distance).

No one seems able to solve the system and it is too depressing when you start to see that pension funds are invested in private equity that milks the NHS and the care system and keeps rents high… like we’re all in a huge precarious pyramid scheme.

Exactly. It does beggar belief that the govt can’t step in with some reforms. I believe more than a few Tory MPs were involved in the care industry but Labour could step in here.

Watching MIL decline then pass away in a nursing home over the last 5 years has had a profound impact on me personally. She’s the first ‘oldie’ in our family to decline this way.

She followed a very well worn path. Began to decline in her late 70s, diagnosed with Parkinson’s, dementia and severe osteoporosis in her early 80s. Poor care at home by FIL resulted in a fall & delirium then a prolonged hospital stay, by the end of which she was doubly incontinent, immobile, and unable to speak. For me, that should have been the end for her, so old, frail and ill - if there was any ‘natural’ end point for her, that should have been it.

But instead a place in a nursing home was found. She died in the end anyway, after 4.5 years and nearly £500,000 taxpayer money. Her physical condition never improved, not one iota. She was kept alive - vaccinated every year against Covid and flu, given abs for every chest infection, fed liquid food - and for what?

i would absolutely support a population wide tax to provide a basic level of social and nursing care for anyone who needs it, irrespective of the exact nature of their illness - and dementia is an illness!! As are Parkinson’s and osteoporosis.

But unless we are also willing to stop prolonging life at any cost, the costs will swallow us whole. That’s how I see the whole private nursing / care home industry - like a giant monster charging endlessly forward, gobbling up inheritances and pensions and savings and assets, just to feed itself and churn out the profits.

I understand @rickyrickygrimes . 5 years of your life gone by. It's terribly sad.