Cautionary Tale re Top Up

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PeggySmith

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Apr 16, 2012
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I bumped into a friend a few days ago and she was in a bit of a state. Think she's a bit younger than me and still works. Her husband has Parkinson's and it's getting worse leaving her with a very difficult personal situation and making her wonder how long she'll be able to live with him. In short, his 95 year old mother is in a care home and he pays £200 a week top up fees so is desperate to stay at work for as long as possible.

I've been doing a bit of research and will pass the information on to her, the best case scenario is that the CH will keep mum even if the top up fees have to stop but in the meanwhile she is living in a situation where her husband is becoming increasingly abusive and paranoid and she has to ring the specialist Parkinson's nurse in secret.

DON'T ever agree to pay a top up fee.
 

AlsoConfused

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Sep 17, 2010
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Thanks for the cautionary tale. The whole process of finding a suitable home and a place at that home is such a struggle for so many it's easy to see why families feel they have to agree to top-ups.
 

mely

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Nov 12, 2016
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Thanks for the cautionary tale. The whole process of finding a suitable home and a place at that home is such a struggle for so many it's easy to see why families feel they have to agree to top-ups.
I'm just about to start the whole process of looking into care homes for my MIL and it really is daunting and scary. I really don't know where to start!
 

CCGcrusher

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Aug 24, 2016
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I bumped into a friend a few days ago and she was in a bit of a state. Think she's a bit younger than me and still works. Her husband has Parkinson's and it's getting worse leaving her with a very difficult personal situation and making her wonder how long she'll be able to live with him. In short, his 95 year old mother is in a care home and he pays £200 a week top up fees so is desperate to stay at work for as long as possible.

I've been doing a bit of research and will pass the information on to her, the best case scenario is that the CH will keep mum even if the top up fees have to stop but in the meanwhile she is living in a situation where her husband is becoming increasingly abusive and paranoid and she has to ring the specialist Parkinson's nurse in secret.

DON'T ever agree to pay a top up fee.

I second this advice. I refused to pay a top-up for my mother. After 6 months the care home wanted to negotiate. Guess what no top up fee.
Be aggressive in your defence.
 

realist1234

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Oct 30, 2014
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Given that just about all homes are now privately run, the top-up is a reality for most families. Thankfully before our dad died, on the advice from our solicitor he was able to change the ownership of their home from joint to tenants-in-common, and changed his will to leave his share of the property to his children. When he died, his half of the house became the children's share, and when the house was sold to pay towards our mum's nursing home fees, we could use our share to pay the top-up amount. Without that we would have struggled to pay it.
 

realist1234

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Oct 30, 2014
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What are top up fees? We haven't quite reached nursing home stage.
Thanks

Your local authority will deem a certain amount of weekly fees for a home to charge as reasonable. If the home you want your parent to live in charges more than that maximum amount, a 3rd party (typically family) are required to pay the difference. Of course if the person is self-funding, they can pay the total fees themselves including the top-up - it is only when the LA starts to make a contribution (eg once the resident's savings reduce to a certain level) that a 3rd party is required to step in.

If a property is waiting to be sold, the top-fee can usually be included in the 'deferred payments agreement' so that it will also be paid from the proceeds from the sale of the property.

But, depending on how long your relative lives and how long her own money will last to continue to be self-funding, this will determine if a top-up will be payable by family at some point. Thankfully my own mum's home only charge £42 per week top-up (about £2000 a year), I know of other homes charging £200 per week!
 

oilovlam

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Aug 2, 2015
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South East
Given that just about all homes are now privately run, the top-up is a reality for most families. Thankfully before our dad died, on the advice from our solicitor he was able to change the ownership of their home from joint to tenants-in-common, and changed his will to leave his share of the property to his children. When he died, his half of the house became the children's share, and when the house was sold to pay towards our mum's nursing home fees, we could use our share to pay the top-up amount. Without that we would have struggled to pay it.

Realist1234, I don't understand how only having half the property would have helped your mother. Presumably she was self-funding until her assets ran out, then the LA took over and the children topped-up (if necessary...most likely). If your mother had the entire worth of the house she would just self fund for longer. Could you explain a little more?

I am interested because I have the option of doing what you did but am undecided.
 

lemonjuice

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Jun 15, 2016
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Realist1234, I don't understand how only having half the property would have helped your mother. Presumably she was self-funding until her assets ran out, then the LA took over and the children topped-up (if necessary...most likely). If your mother had the entire worth of the house she would just self fund for longer. Could you explain a little more?

I am interested because I have the option of doing what you did but am undecided.

You know this is an interesting question.
My father died intestate (his reasoning being I have oone wife and one child it's obvious who to pass it on to) and so his share of the house was automatically transferred to my mother. Initially when my mother went into her NH I wished we'd transferred his share to me, as he'd mentioned at some point in the past.( At the time he suggested it he did point out that in the event of my being privately sued, say in an accident or other scenario, I could be pursued for my share in their house and I couldn't bear the thought that I could be responsible for my mother having to sell her home because of me, and so we never pursued that option. )

For a years I used to feel slightly resentful that his 'share' was being used to subsidize my mother's care, ensuring his grandchildren would have no inheritance, as he'd always assumed they would. I didn't mind my mother's share being used, but it seemed to me unfair that his would also get swallowed up.

However now, after she has been in the NH for 5 years I'm grateful. I realize that my father would have wanted his wife to be cared for in the best possible way and having that 'extra' means she can stay longer in my choice of Home, as opposed to where SS could afford. There's no chance of affording any top up from us, so it does mean our options are better for longer.
 
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Pickles53

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Feb 25, 2014
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However now, after she has been in the NH for 5 years I'm grateful. I realize that my father would have wanted his wife to be cared for in the best possible way and having that 'extra' means she can stay longer in my choice of Home, as opposed to where SS could afford. There's no chance of affording any top up from us, so it does mean our options are better for longer.

Well said Lemonjuice. I was grateful that mum's savings meant we didn't have to argue with SS about her choice of home and that's definitely what dad would have wanted. She needed that money much more than her children or grandchildren did.
 

realist1234

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Oct 30, 2014
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Realist1234, I don't understand how only having half the property would have helped your mother. Presumably she was self-funding until her assets ran out, then the LA took over and the children topped-up (if necessary...most likely). If your mother had the entire worth of the house she would just self fund for longer. Could you explain a little more?

I am interested because I have the option of doing what you did but am undecided.


Just to be clear, this was not about ensuring an inheritance for the children etc. It was about trying to enable our mum to stay in a good NH as long as possible. We sold our parents' home for around £65k (NI housing prices are not good). Our mum was staying in a NH charging £670 per week (we subsequently moved her to a different one as we werent happy about the care she was receiving, thankfully the new one is better). At the time, the max the LA deemed reasonable was £550/week incl the £100 NHS nursing element. So 670 - 100 nursing - 200 pension = £370/week from sale of house. Based on about £60k after costs, the £370/week would reduce to the upper limit of £24k in under 2 years. Then she would no longer have been self-funding and her family would have been required to pay the £6240 per year top-up, which we couldnt afford. But as we had about £30k from the house proceeds, this would last nearly 5 years. Thankfully her new home charges considerably less than the previous one, but ironically is a better home. So far she has been in a NH for 4 years, and God willing will live for a few more years. We would have struggled to pay the top up without the money from the house. Hopefully that explains it.

Everyone has their own circumstances, but I would encourage you to do your sums to decide which is best for your loved one, long term.
 

oilovlam

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Aug 2, 2015
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South East
Just to be clear, this was not about ensuring an inheritance for the children etc. It was about trying to enable our mum to stay in a good NH as long as possible. We sold our parents' home for around £65k (NI housing prices are not good). Our mum was staying in a NH charging £670 per week (we subsequently moved her to a different one as we werent happy about the care she was receiving, thankfully the new one is better). At the time, the max the LA deemed reasonable was £550/week incl the £100 NHS nursing element. So 670 - 100 nursing - 200 pension = £370/week from sale of house. Based on about £60k after costs, the £370/week would reduce to the upper limit of £24k in under 2 years. Then she would no longer have been self-funding and her family would have been required to pay the £6240 per year top-up, which we couldnt afford. But as we had about £30k from the house proceeds, this would last nearly 5 years. Thankfully her new home charges considerably less than the previous one, but ironically is a better home. So far she has been in a NH for 4 years, and God willing will live for a few more years. We would have struggled to pay the top up without the money from the house. Hopefully that explains it.

Everyone has their own circumstances, but I would encourage you to do your sums to decide which is best for your loved one, long term.

Thanks for the explanation. Sounds like your dad did a very financially astute thing.

In the UK the care home fees are a lot higher - but so are the house prices - but the LA funding is similar, so the benefit may not be as positive as it is for you. As you suggest I will have to do the sums. Thanks again.
 

realist1234

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Oct 30, 2014
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Well said Lemonjuice. I was grateful that mum's savings meant we didn't have to argue with SS about her choice of home and that's definitely what dad would have wanted. She needed that money much more than her children or grandchildren did.


See my response to Oilovlom. Hopefully that explains my position.
 

oilovlam

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Aug 2, 2015
386
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South East
See my response to Oilovlom. Hopefully that explains my position.

Realist1234, I can see why some people think what you did is strange. It is basically 'playing' the system....because the system is basically unfair (self funders subsidise LA funded residents in care homes). The biggest weakness in what you did is the matter of trust.....your father trusted you but some children would not do the 'right thing'. Once the money is in their bank they could (quite legally) refuse to top-up the care.

So what you and your father did is very clever but it does have potential problems. The money has to be ring-fenced so that it is for the parents care but I don't think that can be done (perhaps a solicitor could do it). So it goes back to trust and not all people are as trustworthy as they say they are....especially when money is short.

But you seem to know what you are doing. I hope things go well for you and your mother.
 

realist1234

Registered User
Oct 30, 2014
108
0
Realist1234, I can see why some people think what you did is strange. It is basically 'playing' the system....because the system is basically unfair (self funders subsidise LA funded residents in care homes). The biggest weakness in what you did is the matter of trust.....your father trusted you but some children would not do the 'right thing'. Once the money is in their bank they could (quite legally) refuse to top-up the care.

So what you and your father did is very clever but it does have potential problems. The money has to be ring-fenced so that it is for the parents care but I don't think that can be done (perhaps a solicitor could do it). So it goes back to trust and not all people are as trustworthy as they say they are....especially when money is short.

But you seem to know what you are doing. I hope things go well for you and your mother.


Indeed, it is sad when there is no trust between parents and children, and between siblings, particularly when it comes to looking after elderly parents in need.

Whilst family could refuse to top-up the fees, the NH would be at liberty to demand the resident is moved, so family would have to deal with that and the possibility their parent would receive worse care elsewhere.

The system is indeed unfair, but not just because in some homes self-funders subsidise LA funded residents - thats what happens when just about every care home is privately run (it also shouldnt be forgotten that at some point, many self-funders become LA funded residents because their funds have reduced). The whole principle is perverted - people who have worked all their lives, in my parents case from the age of 14, paid tax and NI contributions (they were literally never unemployed), and just when they need care at the end of their lives they and their families are told they have to pay for it themselves, because the care they need, without which they would die, is suddenly deemed to be 'social' rather than 'health'. But successive governments in this country have perverted priorities, large companies make excessive profits and pay little tax, individuals dont want to pay a fair level of tax so that public services are properly funded etc etc. I could go on but rant over.
 

Pickles53

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Feb 25, 2014
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Radcliffe on Trent
But successive governments in this country have perverted priorities, large companies make excessive profits and pay little tax, individuals dont want to pay a fair level of tax so that public services are properly funded etc etc. I could go on but rant over.

No argument from me on that point, especially that too many folk are unwilling to pay the level of tax needed to fund these services properly and are then shocked to find that services are inadequate when they do need them. This is not rocket science! Wish we had a government willing to be honest about the reality that you can't vote for a low tax economy and expect top quality service provision. My rant over too!
 

Lets_Stop_Time

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Aug 23, 2015
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we had the top up fee added into our deferred payment scheme so we had it taken from the value of mother in laws property
 
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