Are you meant to get into debt to fund a care home?

[Carla]

Hello

I have not posted since January of this year when I was looking into care homes for my mother as my father had decided he was unable to care for her much longer. She is 65 and he is 70 in 3 weeks. He's been caring for her for 7 years, when she started with symptoms of Alzheimers. She still knows us and others but is unable to look after herself at all, is now doubly incontinent and in nappies. Dad kept changing his mind up until July when my sister (who is due to have her first baby in 2 weeks) and I said enough was enough, his health was starting to suffer. Since July I have been negotiating with social services on the funding for care homes. Both my sister and I live in London, my parents in Yorkshire, so I am trying to go back every other weekend to give him respite and am starting to get exhausted myself, as I travel with my job most weeks. I would appreciate any advice or info around the dilemma of funding.

The care homes my Dad has been given as an option in the local area are all around £650 a week. There are only really 3 at that price, the rest are higher. Of those 3, 2 are full. Social services have offered to fund £373 a week leaving a top up amount that would leave Dad in a few hundred pounds debt a month, as he is on a pension. He is very anxious about this, it is causing him almost as much distress as caring for Mum. Social services have said they will review this but Dad is convinced they will only offer a little more, still leaving him with a few hundred pounds a month to find. I will contribute also but have very little left at the end of the month as it is. Is this what has to happen when you can no longer care for your parent? do we have to send her to a home in another town in order not to pay this much? is it normal to have to get into debt to do this? We know half of the house will be taken, but they can't take that until after Dad dies apparently?

Any advice would be great, I fear for Dad's health greatly and need to resolve this for him as soon as possible. Dealing with Mum going into care is an emotional area I haven't allowed to go into yet, I can't do that until this is sorted.

With best wishes to you all dealing with this tragic illness.

Carla

 

[jenniferpa]

Dear Carla

Firstly have you checked that the price you have been quoted by these homes (I assume the "list" price for want of a better term) is actually what the homes would expect SS to pay, or might it be that they would accept less as she is a LA placement. I ask, because the NH my mother was in charged us £600, but LA placed residents £450.

Secondly, is this the full amount that the LA claims they would pay for anyone? Because if so, and the only homes that meet your mother's needs are that much more, they "have" to pay for them. I've put "have" in inverted commas because it's not quite so straightforward as that. Do your parents have any other savings, so the amount you have quoted is the reduced amount?

Regarding your parent's home, not only is it disregarded for the purposes of these calculations, the only way it would be even considered is if your father predeceased your mother. In other words, they can't claw back any money from the house when your mother dies, assuming your father is still living in the property.

 

[Cate]

Hi Carla

I am so sorry that the time has come to move your mum to a NH, but I appreciate all too well, when enough is enough.

On the issue of funding, I am not too hot on this area because when my mum moved last year, as dad had died 25 years ago it was a case of selling mums home to fund the NH.

I do know with mum's NH there are two levels of charging, one is the Social Services rate, the other private funding rate, and because mum had her own home to sell, she falls into the latter. However I do know the Social Services rate is set at the rate Social Services will pay. I would ask the question at the NH of your choice if they adopt the same system.

In any event, I am sure there are other TP friends who have been in your situation and who will be sharing their experiences with you.

Isnt it bad enough that these heart rendering decisions have to be made without the additional finacial worry on top.

Hope you get it all sorted out soon.

Love
Cate

 

[Helena]

Social Services have NO RIGHT to ask you to top up the fees or your father find it from his pension

Firstly your Mother is entitled to 100% Fully Funded Continuing Care see www.************

2nd Unless your Mother has income or savings of her own they cant ask her to pay

You will also find that many homes charge SS £450 a week but Privately funded people pay £600 in order to subsidise the others

This is an iniquitous situation which is totally unfair on all those who dared to save for their old age

Go back to SS and demand that they find a place for your Mother and put in writing that she is entitled to Fully Funded Continuous Care

Then get help from the experts on www.************

 

[noelphobic]

The info on this factsheet may be of some help, especially the following:

The local authority will tell you what their usual price limits are for places in care homes offering residential or nursing care. However, if a home that meets the person with dementia’s assessed needs and is in the local authority’s price range cannot be found, the local authority should fund the person in a more expensive home

http://www.alzheimers.org.uk/Caring...idential_and_nursing_care/info_payingfees.htm

I would also suggest phoning the AS helpline on 0845 300 0336.

 

[Sandy]

Hi Carla,

You might also want to take a look at an earlier thread that had some useful information on top-up fees and local authority funding:

http://www.alzheimers.org.uk/TalkingPoint/discuss/showthread.php?t=7300

It seems as if establishing the reasons why one home is more suitable than another (cheaper) one is key to making your case.

Calling the Alzheimer's Society Helpline as noelphobic suggested is probably the best way to go.

Take care,

Sandy

 

[Margaret W]

Hi Carla,

What a sad situation for you, I feel for you.

It is a difficult issue, and one on which I am no expert, but your Social Worker should be able to advise you.

My understanding is that if the person has liquid (cash) assets of below £21,500 they are entitled to the maximum contribution from the government for their care in a home. If there is a spouse still living in the home, it will be disregarded, indeed it is disregarded until it is sold anyway (but I won't go into that, cos you are not at that stage). If mum's liquid assets are above £21,500, they DSS will not provide anything, you will have to find the total fees yourself, however you do that is not their concern at all. If liquid assets are below £21,500, as said, the state will pay a fixed sum. In my area it is £352 a week. If you "choose" a home which costs more that that, someone has to fund the extra, and it cannot be the person in the home, so it would have to be you, or your dad, or somebody else. So the answer is, no, your mum would not go into debt, it would be you or your dad. Not nice.

But if the only homes in the area which DSS feel are suitable, are charging more than £352 or whatever, they have to pay the difference. It is only where you have a choice, and you choose the more expensive option, that you have to find the difference. So go back to the DSS and challenge their decision not to pay for what they have said is appropriate care costing £650 a week. By the way, that sounds terribly expensive for Yorkshire, there are plenty of reasonable (not perfect) care homes in Derbyshire for under £500 a week. Yes, there are dearer ones, but remember your mum is not wanting a hotel, but a care home.

If they have some reason for not paying (not an expert on why or what to do about it), you will have to think of some alternative to pay the difference.

It is a horrendous decision financially. There is no easy answer. Your dad is still at home, so you cannot sell the house (or presumably don't want too, and quite right). But could you get some income from the house to help support your mum? There are lots of financial advisers who can assist, and they don't all charge the earth, but they do charge, but unless you know what you are doing by yourself, it might be worth it. Help the Aged have a "partnership" with a firm of Independent Financial Advisers who will come and discuss your situation with you free of charge, and based on the information you give them, will provide you with a range of possibilities that might help. You are under no obligation to accept their advice, but once you do, you will be expected to pay. They will make it clear what you are expected to pay right from the outset. We have just had one visit to us, and found him to be excellent. We didn't think we needed him, thought we could do our own thing, but I think we learnt a lot, and probably will be happy to pay the commission for whatever he comes up with.

Lots of other Independent Financial Advisers can help in the same way, see if there are any in your area. We haven't finalised anything yet with Help the Aged, so I can't recommend them, just that we have found their rep very pleasant and understanding - and knowledgable.

I'd say don't put your mum in a home which is going to need a considerable contribution from yourself for any length of time. You say she is 65. She could live for 30 years, needing financial support from yourself. That isn't a possibility surely? Okay if you feel she might die shortly, you can perhaps pay for a year or two, but then what would you do, having just got her settled somewhere? Move her to where? You are telling me the only homes are £650 a week. Are you sure about that? In my area there are lots of homes charging that amount, but it just isn't feasible to pay the extra in the long term, so the home we have chosen for mum isn't perfect but it is okay. Bear in mind that none are perfect for someone who doesn't want to be there, in my mum's case doesn't see why she NEEDS to be there.

Do get your Social Worker involved, ours was excellent at telling us what we were entitled to, and what not.

I hope you can sort something out. You certainly can't be committing yourself to £300 a week for the next 30 years, or even the next year.

Much love, and please let us know how you go on. I am sure there is help out there that you haven't discovered yet.

Regards

Margaret

 

[jenniferpa]

Just to add to what Margaret said: if you have savings between 13000 and 21500 you will be assumed to have a nominal income of £1 per week per £250 of capital and be expected to contribute that amount (and the LA contribution will be reduced accordingly).

 

[Carla]

Thank you to you all. Social Services are reviewing Mum's case again tomorrow to see if they can increase the funding. All the care homes on the list they have given us that are suitable for her are over £650 a week in our area. Scary.

But thank you, your messages really helped me and gave me some valuable info.

Cx

 

[jenniferpa]

I'm still not certain whether you suitable from a medical/care point of view or suitable (as this is where you would be happy for her to live).

If the former consider this (copied from CARERS (EQUAL OPPORTUNITIES) ACT 2004)

Choice directions guidance


New guidance was issued in October 2004 relating to choice for those assessed as needing to move into a care home. It is issued under s.7 LASSA 1970 as LAC(2004)20.

Under the Choice of Accommodation Directions 1992 local authorities are required to offer individuals a choice of homes providing the level of care they need.

The Guidance states:

at request the council should arrange for care in a home more expensive than it would usually fund, provided a 3rd party or in certain circumstances, the resident is willing and able to top up the fees,
councils should only seek top up payments where an individual has chosen to move into a home that has higher fees than those agreed by the council with local independent care home providers
if a person has to move into a care home whose fees are higher than standard because of the level of care they need, the council should meet the additional costs.

Note the last point. If your mother needs a certain level of care, and all of the homes that provide that level of care in your area are more expensive, the LA should meet the additional costs.

Also note that the figure they quote you (£373) can't be an arbitrary figure: it must be the one that the council have agreed with local independent care home providers - in other words there must be some suitable homes that would accept that payment as full recompense, and the council should be able to provide you with the names of those homes.

Edited to add: this is the link to the actual guidance http://www.dh.gov.uk/en/Publication...ocalauthoritysocialservicesletters/DH_4091152