Elderly care options in England 101

[MrsC09]

Hello, we’re at the early stages of looking into options for my mother-in-law who currently lives in London. We live in Australia which is obviously very difficult as our parents back home are starting to age. My MIL has lived alone for 40 years and owns her own flat in London (maybe worth around £500k). She has a pension but not a lot of other funds. She’s starting to get a bit batty and needs to drive everywhere where she currently lives, which won’t be sustainable for much longer. She has 2 other children in the uk, however relationships and finances are a bit fraught on that side on the family so we’re trying to find options that won’t put a burden on them.

We haven’t lived in England for so long (or had to deal with this scenario) so are clueless to what options are available.

MIL is still mentally “ok” and can live on her own but is probably a couple of years away from not coping. She’s really struggling with organising trades to fix things in her flat etc. Her flat is very old & everything is coming to the end of its life at the same time. She’s also starting to get a bit muddled with appointment times etc.

Physically she has issues which means she can’t walk far so relies on her car to do everything. She also has a lot of drs / hospital appointments that she needs to get to.

She’s very sociable.

She’s not ready for a full-on care home (and wouldn’t be open to that anyway).

Are retirement villages a thing in the UK? It would be great if she could sell her flat and buy something where all the facilities are easily accessible and some social life. Or are they just insanely expensive? Happy for all of her capital to go towards her future and just want to find something nice for her. She has family in London, Cornwall & Devon so she would probably be happy in any of those (as long as the health care facilities are accessible).

All my research just shows how dire the situation is in England so I’d be very appreciative of any guidance on where to start. My husband is going back in May for a visit so it would be great if we can set it up so we can help her move whilst he’s there.

Thanks in advance for any advice!

First of all 500k buys you practically nothing in London.
There are groups like these who do sheltered housing flats but I gather there are issues when you come to sell.

https://www.mccarthyandstone.co.uk/retirement-properties-for-sale/?q=London%2C+England

https://www.retiremove.co.uk/a-property/?department=residential-sales&address_keyword=London&radius=50

Be very careful about retirement flats. It can be similar to the new timeshare con.

Ask about the service charges, (these can be frightening and go up in time ) other fees(a lot of facilities are not part of service charge but you cannot always opt out) , restrictions etc etc.

What if you want to sell up ? Often you may have to wait years as restrictions mean not anyone can buy it. Worse, if the company buys it they will want a discount between 25 and 40%. If it’s a sale as part of your estate, terms can be considerably worst.

Whatever you do don’t act in haste, despite salespeople offering you all kinds of inducement or putting pressure. Collect all the paperwork and consult your family and friends but most of all a lawyer specialising in property.

There's a great nursing home near me (1,500 to 1,900 per week). They don't chuck residents out if the money dries up. Care if you want it, or live independently with lots of people to keep an eye out.

I think you need residential care homes, with one moving to nursing if needed .
Alternative rent somewhere? Buy in services as needed
As others say avoid mc Carthy and stone

I think the issue with retirement properties are that they are only suitable for a short period in time. If she does have dementia, then it will only be a stop gap for a couple of years maximum.
If she is amenable to the idea of moving, I would focus on finding somewhere close to the centre of somewhere with good amenities that doesn’t need a car. Ideally somewhere without a garden to reduce maintenance, and - I hate saying this - but best location is one close to relatives who might be willing to take an interest.

101:

there are basically two systems, one for people with money “self funding” one for people without,

she has money so is self funding.

there are schemes where you can buy a flat and there is a warden and some communal facilities on site. Google over 55 housing. The services vary.

other alternatives:
carers coming in. This is a standard option and there are many care agencies that offer these packages,

live in carers. Less standard and very expensive.

finally care homes.

You can now rent these properties, which saves the hassle

You dont need to jump straight to a care home because she's 'muddled'. There can be years of carers coming before a care home.

I agree with the other posters about being cautious about ‘retirement villages’. In MIL's case it would be a short term stop gap, there can be difficulties selling, and you need to check the terms very carefully.

As you can already tell she is struggling I strongly suspect she will need care sooner than you think. People with dementia tend to mask problems in short term interactions, it is only if you spend a lot of time with them you see the real extent.

Personally I would either wait until a care home becomes inevitable, or sell her flat and so she can move into a rental. That would then be easy to leave when she needs a care home. Of course a rental will deplete her funds but she may not be there very long. And once her funds go down to £23k, the local authority will take over paying for her care.

My mother paid for her own care, but when her funds ran out the local authority continued to fund her in the the care home I'd originally chosen. Although things in England sound bad, they may not be as bad as you fear.

Before I answer these questions, where does MIL want to live? And what is her financial situation?

also wondering about your definition of "needs to drive everywhere" as that can vary quite a lot.

And how old is she? She might have years and years ahead of her.

Age U.K. is a good source of advice
https://www.ageuk.org.uk/information-advice/care/housing-options/

Thank you, great advice

Thank you, will look into carers coming to the home. I just worry about her feeling lonely when she stops driving.

i didn’t realise carers coming to the home was an option. Will definitely look into this.

her financial situation is not a lot of cash but owns her flat outright ca £400k-500k

She would probably prefer to stay where she is in London but there is family in Devon and Cornwall.

She currently drives herself to dr/hospital appointments, grocery store etc. She can’t walk very far and not near public transportation. Would feel very lonely once the freedom of having a car comes to an end.

She is 83.

I'm an Older Peoples Social worker. It's a few years since I've been frontline as I'm now in strategic management but I still work closely with operational teams

I wouldn't touch schemes like McCarthy and Stone with a bargepole. There are so many pitfalls.

No matter what her financial situation your mum should qualify for a social care assessment from her local Adult Social Care team. They will be able to advise her re care options. Having visiting care workers is definitely an option. If she was going to arrange this via her LA then she would need to hit certain eligibility criteria, and it's not clear if she would. But if she's privately funding care, she can sort it out herself (with your help) if that's what she wants.

Id also suggest looking into the possibility of Extra Care housing. This is where you have your own (rented) flat - kitchen, bedroom, bathroom, living room - but shared communal facilities including a dining room providing a hot lunch every day. There is a building manager who ensures upkeep of the main property. They are purpose built so accessible bathroom etc. There are care workers on site 24/7 so there is always support available BUT it is not a care home. Your MIL would need to be assessed and meet the criteria. It works really well for lots of people.

My MIL recently died aged 93. Despite almost total sight loss and a lot of memory loss/ possible dementia she was able to remain at home until the end - she was adamant she didn't want to move into an extra care flat or a care home. We arranged for two private care workers to visit her every morning, more for a welfare /social call than anything else. It wasn't cheap but MIL had the money to pay. They were brilliant, kept up with appointments, letters etc and kept us updated. We live 6 hours drive away. DH took over her finances (with her agreement).

One thing I would stress is that, if she hasn't already done so, she needs to set up Power of Attorney whilst she has capacity to do so. It's not complicated but it saves a huge amount of hassle if she develops dementia.

Good luck

You can buy properties in independent living housing. Basically 24 hrs call bell for assistance eg falls, normally a lunchtime restaurant and some social activities organised by staff. You can get care from them or bring in outside care if needed. As people say service fees are high. Radis is one provider. They are not terrible, but are out to make money IME.

This is an Extra Care scheme near my Mum, she has a friend who moved in here and who loves it. I've never been there (not my area) but it looks similar to schemes in my LA that I do know.

Sheltered House in Ipswich | Paddy Geere House | IP1 6QB https://share.google/1nYzaNSGG4Mqfzkeq

Staying in London sounds the more practical option on the face of it.

Unless you're very clear that the family in Devon or Cornwall would be up for taking on some kind of responsibility, I wouldn't look to move her there, particularly as you think she'd likely prefer to stay put. I personally wouldn't be at all impressed with a relative on the other side of the globe moving a family member with dementia hundreds of miles to be close to me, unless I'd explicitly volunteered.

There can be issues getting sufficient carers in more rural areas too. Well, there's issues everywhere really but the SW is a double whammy of expensive and sparsely populated. London at least has a large pool of workers.

Good advice on POA too. Needs sorting while she has capacity.

@MrsC09 If she's in London, her driving could be replaced by minicabs. I'm actually wondering where in London she is because driving and parking is such a pain.

Also, I'm wondering how often she's driving but if it's a couple of times a week and small local journeys then mini cabs would cancel out much the same as the cost of running a car - especially as insurance will go up with age.

other than that, a good care agency will be helpful. I have an elderly mother not in London - but when I did live in London, I had a couple of elderly neighbours who had some lovely (student) carers coming in to help them with cooking and stuff. They were basically students who were looking to fund their way through their courses but I met a couple of them and they were really nice.

Mum has carers now and they are very sweet.

I do worry because there is a shortage of carers, but on the other hand, I think they like going to mum because it's not like going to a more challenging patient and they do seem to be fond of her.

I would definitely take that route before you think about anything else. Unless she really wants to move, but that's a hell of a faff.

Could you support her with finding tradespeople? That could all be done on a platform like taskrabbit? Age UK also has a programme where someone visits for a couple of hours a week, just for a chat. Perhaps also look into the care and repair programme, where repairs can be organised and done for the elderly, but I am not sure if that is run by the various councils.

@AnnaQuayInTheUkgreat info for OP and the rest of us on this position. Could you enlighten us with a little more re the pitfalls of McCarthy and Stone? I’ve just had a marketing card through my door for a local M&S and was seriously considering it for my DM who is 85 and has failing sight. What bounces out at me was the service charge fees? Is this big standard across the board for this type of thing? Or is the main pitfall not being able to sell?
OP I really feel for you being so far away trying to sort this - it’s hard enough when you are nearby. My DM sounds very similar to yours-sociable, wants to stay in own home, but I’m pre-empting the next few years and her possible blindness. You are so right regarding stopping driving. It has had a huge impact on DM’s happiness, - now loneliness - she doesn’t mind using public transport but struggles to see- the other is the continual loss of mobility or deaths, of friends. It’s a horrible age.

This might be of interest. A full time live in carer will cost approximately £1,115 per week, or;

Share my Home Homeshare;

a provider that matches older people with compatible companions for mutual benefits of shared living. The companion pledges 10-15 hours of help per week.
The older persons provides them with a room and place to call home.

@abracadabra1980 the main issue is about the service charge. If you end up having to go into a care home, you still have to pay the service charge until the flat is sold. If you die, whoever inherits the flat has to pay the service charge until the flat is sold. The flats usually lose a huge amount of value. People end up selling them very cheaply to get out of paying the service charge.

Extra Care flats are built and owned by a Housing Association or other not-for-profit organisation and then rented out. The service charge tends to be less, and if the tenant moves on or dies, the service charges stop.

Some people don't like the idea of selling their house and moving into a rented flat. Some people want to move into somewhere with a sense of community, lunches provided, etc before they have care needs so wouldn't be eligible for Extra Care Housing even if they wanted it - you usually need to have some personal care needs - help with washing, medications, meal prep etc.

But there are different models and options in different parts of the country. That's why getting a social care assessment is valuable, because the social worker should be able to advise what's available locally.

I hadn’t appreciated from OP ( my bad for not reading properly) that MIL lives in London. I would be loath to uproot her from there to less central location for many reasons. Unfortunately most elderly DPs are resistant to change until it’s more or less forced on them, so it would be very lucky if you could get her to work to her DHs timetable.

It might be better getting her set up as best she can in her current home. Contact a minicab company and see if you can set up an account for her and a local company for trades. There should be some sort of service that will manage most things at a cost.