Why is the cost of care so high?

[Truetoself]

I think the average household income in UK is around £33K? I believe the cost of a care home is upwards of £5K a month and that of a live in carer us around £10k. I am trying ro work out how this makes sense because it is not proportionate to the income of an average household in the country.

You do, but that's exactly why finding a nice home for elderly loved ones is not such a bad thing

I think also that because the NHS is free at the point of care, people in the UK are not routinely exposed to the true cost of medical and other care. In France, we get charged-then-reimbursed for many things from surgery / stays in hospitals, to prescription medications to equipment and other supplies. We had a run of small operations in our family last year (broken bones, elective shoulder surgery, uerine polyp removal) all of which involved a hospital overnight, general anaesthetic and surgery. The final bills are detailed, and although we only paid a few hundred (because we went private) the costs of the anaesthetist, the private room, the surgeon's fee, the operating team etc are all detailed on the bill. The anaesthetist alone was €700+ for my last operation. But anyone being treated in the UK doesn't see any of this, so it's a big shock. A friend who was receiving treatment for cancer saw quite clearly that her weekly medication was in the region of €2,000 per dose - though she didn't pay any of that, it was on the paperwork.

True @rickyrickygrimes. We go from free-at-the-point-of -use healthcare to the most ruthlessly privatised elderly care system and it's an absolute shock to the system. We can't even take out insurance to cushion the blow, but I think that's inevitable in the future - as each generation ages, lives longer and there are fewer assets to strip, fewer homeowners.

That makes sense to me.
My parent is in an expensive care home. Her fairly expensive house is paying for it. I am unlikely to inherit anything. My own home is less than half the value of my parent's. My children have as yet been unable to get on the property ladder. I'm not sure that the current system is sustainable for more than a few years.

I’d agree it’s unsustainable. I think lots of prople won’t own houses when they get to the point of needing care homes over the next few decades. Council is already skint, I’m really uncertain how we can support an aging population with a decreasing pool of self funders.

There’s almost an incentive not to save unless you are fairly well off as can get pension credit if no private pension. However even a small private pension can mean you don’t qualify leaving you worse off.

This is so upsetting to read. My parents each spent eight years in a care home before death: one with dementia, one lucid but physically frail (my mum). I cared for her at home first, for almost two years, but it nearly broke me and I had to put her in a home. They weren’t mega wealthy; had a few tens of thousands in the bank as life savings plus a three bed semi in the south east. If they’d died before needing care they might have left half a million including the house. As it was, all the money went on their care, and I spent 16 years as an only child who was therefore solely responsible for making sure they were ok (tbf Mum did a lot of it for Dad, who went first, but then it was her turn). The care homes were decent enough but not perfect, the emotional burden was still huge, and my parents had a pretty terrible quality of life towards the end in both cases. Your post has really hurt.

I have personal experience of friends and family looking after the elderly parents with dementia - no help or support from anyone, and no money to afford a care home, even a cheap one. Its terrible, unfair and soul destroying.

As I said earlier, I worked with later care providers. What I said is literally something I've heard in a meeting. I just highlighted that for these people, its a business, nothing else.

It’s a terrible system, the only winners are those that are so poor they are fully funded from day one, those that are so rich they can afford to self fund anyway, and the private nursing home chains. Asset stripping is the right description and it isn’t sustainable, because the inheritances that used to enable people to purchase a home are now being handed over to private care companies.

Families pay the 'top up'. Social services tell you the elderly person can not pay it themselves even if they have the money.
I know, I've been there.

Families don’t have to top up, do they?

It's really not a good idea to spend the capital of an elderly person with dementia etc, making the assumption that they don't have long left.

My ex's parents had a lot in savings, much of which they've given away to their children; the problem is that the FIL was diagnosed with dementia four years ago and it will be viewed as intentional deprivation.

MIL is 77 and has to look after him, he is incontinent and quite far gone, but he may live years yet - they have dug themselves into a hole when it comes to trying to obtain a care home placement, as the DOC will be flagged up straightaway.

What happens if the the elderly person has no family (but does have the money to pay)?

I too think it's really high, per week, the cost.

Family can be asked to pay a top up, not made to. If they say no - or there is nobody to answer - social services will either (in rough ordernof preference) negotiate a lower rate with the existing home, find another home that will accept the standard local authority rate, or pay the extra themselves.

Because the care sector is now totally privatised with no financial regulation. It’s an utter disgrace the amount of profiteering that now comes from so called “care” sector. The people doing the graft really do not get paid anywhere near enough.

If there is no money then the LA will pay. There may be little choice, but if home care is unsustainable and there is no money then social services do have an obligation to arrange something.

Everything about this situation is unfair, especially for the elderly people trapped in it.

I think for LA to get involved there have to be, literally, nothing. On top of this, the process takes forever... One of my friends have been trying for about two years now.

Yes there will be 4 X shifts of staff, however the ratio of staff to residents isn't 1:1. It's about 1:4. So whilst it will always be very expensive to pay effectively 1 persons wage for care, NMW is only around £25k per annum. Let's add 50% and round up to £40k for antisocial hours. That's still only £800 per week (rounded up). Let's add another £200 per week for employer NI and pension contributions. Where's the other £3-4k per week going? Some of it will be utilities, food, equipment, insurance, salaries for additional staff (managers, caterers etc) but I would imagine a significant proportion is the care home being rinsed by excessive rental costs and private contractors (eg meal providers will charge extortionately for low quality food, agency costs, equipment may be hired at extortionate cost instead of purchased).

We should nationalise social care right down to R&D of equipment as much as possible - seeing as we are all having to pay (through the nose) for it in any case, whether we/our loved ones end up in care or not.

£3-£4k per week? That must be top end of the ridiculously luxurious market. £800pw is about 50% of a typical rate and probably not far off the total labour costs including NI, pension contributions, holidays etc. Add property and equipment costs, food, laundry, insurance etc and £1500-£1800pw is not that eye watering.

Not nothing. The threshold is £23k.

The OP said £5k per month, not per week.

They can charge what they want because people have no choice but to pay and when people run out of money the LA pay. I know two people who own care homes and they are both phenomenally wealthy.

They do if it is a good home and the local authority want to move the person to a cheaper home. Either your relative is moved or you find the money.

Probably... but 23k would not go far in this situation.

But are there good ones and not so good ones? Is it really a binary choice? Because from my own experience and from what many people have said on this website, generally speaking, the self-funders and the people funded by the state are living in the same homes.