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Question(s) regarding funding someone in a care home?
Hi there,
I'll try and keep this short and sweet and to the point. Basically, nearly two weeks ago my Grandmother had a really nasty fall within her home, it's left her in hospital and after nearly two years of what we may think be dementia, the hospital (and myself) agree that going back to her home may not be a good idea because the facilities are just not up to scratch and are very dated. My nan is 81 years old and even today admitted she couldn't live back there unless she had someone there 24/7 to assist her (which is obviously impossible).
So my question is (and I have looked online but didn't get much luck), my nan's house was what she was to leave to me in her will when she passed away, however now is for the time of the living and if she needs good care etc then that money will have to go on her for a possible care home. I have no problem with that at all. However what I wanted to know is, whatever the house makes (sorry if I'm wording this wrong), does the whole amount go straight to the home for upkeep etc?
I ask because me and my mum were saying earlier about what if someone's house sold for bucket loads, surely one single care home couldn't take every penny? That seems a bit wrong somehow.
Like I said, sorry if I worded this wrong, all this has literally been thrown at us this past fortnight since my nan's fall and some big decisions lay ahead in the future. Thanks guys
I'll try and keep this short and sweet and to the point. Basically, nearly two weeks ago my Grandmother had a really nasty fall within her home, it's left her in hospital and after nearly two years of what we may think be dementia, the hospital (and myself) agree that going back to her home may not be a good idea because the facilities are just not up to scratch and are very dated. My nan is 81 years old and even today admitted she couldn't live back there unless she had someone there 24/7 to assist her (which is obviously impossible).
So my question is (and I have looked online but didn't get much luck), my nan's house was what she was to leave to me in her will when she passed away, however now is for the time of the living and if she needs good care etc then that money will have to go on her for a possible care home. I have no problem with that at all. However what I wanted to know is, whatever the house makes (sorry if I'm wording this wrong), does the whole amount go straight to the home for upkeep etc?
I ask because me and my mum were saying earlier about what if someone's house sold for bucket loads, surely one single care home couldn't take every penny? That seems a bit wrong somehow.
Like I said, sorry if I worded this wrong, all this has literally been thrown at us this past fortnight since my nan's fall and some big decisions lay ahead in the future. Thanks guys
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You need to know if the care required is medically based or not as medical care is paid for by the NHS.
Social Services usually make an assessment.
If you feel your Nan requires medical care then push hard to get it officially registered as medical care....they will try very hard to avoid this!
Regarding the property or assets, anything over £23,000 (they can't touch the first £23,000} is taken into account in assessing the payment for care.
My MIL's local authority have put a charge on her house which means that when the house is sold they will take back what they have paid out for the care home fees.
My MIL's pension pays for part of the monthly cost.
My MIL has been in a care home with Dementia for 3 years now and the amount owing to the local authority is currently £56,000.
Get some good advice!
Good luck with everything, this is not easy to sort out.
I think I heard about a scheme where it may not be necessary to sell an elderly persons house to fund care. I can't remember any more though. Age U.K. are really good for advice about these matters.
A care home usually bill people on a monthly basis. Obviously if you sell your grandmother's house, one would assume her savings will then be above the threshold for support from SS. If she doesn't sell the house, a charge may be put on it and when it is eventually sold, the money will be recovered then. Your local council website should have information about local savings thresholds etc.
Looking on line, if you have savings (including house) worth more then £23,250 then you will be expected to fully fund care home and average cost of care home is around £28k per year.
As mentioned, you really need to contact somebody like ageuk who will be able to give better advice.
Based on those homes, the cost per annum is between £36k and £45k. Pension is, as someone said upthread, still paid but there are ongoing costs for the person
- spending money for hair, chiropody, etc appointments
- clothes - both because they can wear out faster (or get lost) and also because if laundry is done centrally in the home, clothes need to be machine-washable, tumble-dryerable and ideally needing no ironing
- gifts for friends and family
- perhaps their own phone
- continuing any hobbies and interests
OP, there are at least two ways of funding care - but check with care home and local council practices. One is by selling the person's home (and this doesn't happen if a partner is still living there - they're not made homeless) and investing the money to enable the care home fees to be paid monthly or by having a 'charge' made against the property (via a solicitor and the Land registry) so that the council (social services) or the care home itself can have what is owed when the person dies and the property passes into their estate. This means that if (being blunt) the person only lives for a comparitively short period, a family could choose to pay a manageable total bill (say £30,000) by a loan or a mortgage rather than sell the house.
There is a possible benefit to doing it that way is that a rising property market may eventually realise a larger sum on the sale of the property in 3 years time (say) compared to the sale in 2014's spring market.
You need to talk to social services (your grandmother may already have a case worker assigned by the hospital who will pass her on to a local case worker on her discharge).
Something else for you to research is the 12 week property disregard that councils can apply (there are qualifying criteria) to people going into a home to give the person and / or family time to establish the best way forward. Effectively, the first 12 weeks in the care home are funded by the state.
If the 12 week property disregard comes into play, you may be asked for a contribution if there is a shortfall between what the council pay vs what the home costs and you do not have to pay this. You / you grandmother may choose to make a voluntary topup contribution but you do not have to.
Enough (toomuch?!) from me. Good luck to you and your grandmother. It is complex but social services, AgeConcern, the local Citizens' Advice Bureau etc will have a lot of information for you.
PS: you also need to look into Lasting Power of Attorney if one has not already been set up.
Paying care home fees
When does a local authority pay for care
When does the NHS pay for care
In order for you to be able to deal with your Nan's affairs you will need a Lasting Power of Attorney or Deputyship. As you have mentioned that your Nan has been a bit of a recluse for some time you probably wouldn't be able to complete the LPA forms yourself as you need someone (not a relative) who has known her for over 2 years to certify that she understands what she is signing. You should be able to find a solicitor who will visit her in hospital to complete the forms - they will also be able to certify them. If the solicitor doesn't think your Nan understands what she is signing you will have to apply to the Court of Protection to become her Deputy.
Your Nan may qualify for Attendance Allowance which you can apply for on her behalf & at the same time you can apply to be her appointee which means that the DWP will deal with you rather than her. Her pension and any benefits would be paid to you.. You'd need a separate bank account for her money.
Before she leaves hospital you need to ask for a continuing care assessment to see if she qualifies for NHS continuing care. It's difficult to get for someone with dementia as their needs are mainly care based rather than nursing care but she may have other problems which would need nursing care.
It's all very daunting at first but you should be able to get advice from Age UK and Alzheimers.org
At present, the dementia (feels weird saying it) is manageable, it's more confusion and names/times/dates as well as throwing in a couple of odd comments. However some days it's worse than others. Like today for example, we got a call and it was my nan using the hospital phone (the nurses in the ward let her use it) and she was demanding for us to go over and bring her home. My mother then spoke to the nurse and she said not to worry about it, just ignore it. So it's clear the nurses and staff on her particular ward are in the know about what their doing and the signs of my grandmother's behavior.
So if she were to go into a home it would be to keep her safe really. Not to wander about unattended too much etc. Someone to keep an eye on her basically.
Very stressful time
Hospital wards can be very busy and sometimes older people are overlooked, just because someone is getting older doesn't necessarily mean that they will get memory loss or dementia.
If she has deteriorated during her hospital stay then make sure you ask questions about medication and other tests
Hope this helps
At present we may be jumping the gun, we're thinking the worst case scenario atm.
There has been some excellent advice given on this thread, so I won't add to that. I just wanted to say that my mum went into a care home when my dad, her main carer, passed away. My mum could be reasonably 'with it' mentally most of the time, but when she wasn't, she was physically unable to care for herself.
It seemed really strange, confusing, and somewhat upsetting having to sort everything out at the time, but I have to say it was the best decision all round. My brother (who lives abroad) and I lost all the proceeds of the sale of my mum and dad's house apart from around £20,000, but we both felt it was money well spent to make sure our mum was safe and happy. And she was.
The money from her house sale was kept in her building society account and I, as her 'power of attorney' organised by a solicitor, was able to access and use some of that, along with her pension and attendance allowance, to pay the monthly invoice. The balance finally got down to the amount she was allowed to keep about 2 years before she died, at which point the Benefits Agency took over the payments. This meant she no longer received her full pension and attendance allowance, but a small weekly amount enough to cover her needs re toiletries etc.
Going into a care home may not be for everyone, but for my mum it was the perfect solution. And no one said that more than she did! She actually lived in the same care home for 11 years living to the ripe old age of almost 96. She was in hospital for several weeks at the end, but her last wish was to go back to the 'home' to see everybody, and she made it, passing away just a day later. I wish you much luck sorting things out for your nan
Anyway, something they said that puzzled me a bit (though may not be correct?) was that apparently the £23,000 that is rightfully yours (or ours) is apparently held back until the money runs out
So say we have £90,000, when it gets down to £23,000 left, that's when we're entitled to have it. I didn't know it worked like this? I also think in a strange way it's kind of bad to basically be told what to do with the WHOLE sum of the money (i.e. the money her house will make). But if that's how it works, then that's how it works.
It's such a confusing time, me and my mum are constantly rowing and I feel incredibly stressed. Oddly enough my nan seems quite okay, well, content maybe.
Anyone assessed as needing residential care is 'allowed' £23,500 (ish) in total savings, investments, etc. Anything over that figure (potential value of owned property is taken into the assessment) and they are required to pay some or all of their care home costs until capital drops down to £23,500. Then they stop but at this stage, a larger portion of any pension paid may be taken while leaving a sum each week for living and incidentals. Itsy Bitsy's excellent post above refers to this process too.
I think people who've not (yet) got old and ill while living on their own may not be able to appreciate how vulnerable and stressful that can become. Or how long nights can be when you're alone and not feeling well.
Things that we would never worry about - getting a few roof slates replaced after a storm or heating costs increasing - can really play on an older person's mind and the relief of not having to worry about anything any more is very comforting.
If your Nan doesn't have savings over 23k but does have a house that will raise more than that the local authority will 'pay' her care home fees until such time as her property is sold when they will expect to be reimbursed from the proceeds. What's left will still be your Nan's money and she/you will be expected to pay her care home fees from that money until it goes down to 23k. The money will be under her/your control & you will be billed monthly by the care home. While she is paying the fees herself she will be entitled to Attendance Allowance.
Once the money has gone down to 23k she/you will still have to pay a proportion of her care home fees until her savings have dropped to 14k when the LA will pay the full fees.
There are a lot of systems that can enable someone to stay in their own home, local authorities of course will want her in a home, paid for by selling her house, not only do they not have to provide her care but she will pay a large fee which subsidises the cost of residents who the local authority pay a pittance for.
She can have care visits, have a pendant alarm, a fall alarm, worn round her wrist or waist that will alert the security company who provide them, they provide a visit service when the alarm goes off on their system. Alternatively ask about Direct Payments, where the local authority pay money to her, or whoever has power of attorney, she may have to make a contribution, but she can then choose her own care package.
Personally, with an elderly mother with advanced dementia, who I care for, and with my experience as an agency carer, I would see a care home as a very last resort, you cannot trust them.
BIB: that's not true of of my mother's local authority. They did everything they could to enable her to stay in her own home - carers, district nurses, social services themselves, occupational therapists, pendant alarms, mobility equipment - but there came a point where it cannot be enough. In my experience again (having thoroughly investigated the financial aspects of self-funded care home fees vs the standard LA contribution) there was only about £150 in it. The self-funding residents did get the largest rooms though but apart from that, the care and access to facilties was the same.
Especially with dementia patients (and the OP did say her mother has dementia) all of the aids are not necessarily enough to enable someone to continue living independently. There comes a point where living independently actually becomes part of an elderly person's problem - it is not a solution. It won't be the same for everyone but my mother (who does not have dementia but has mobility and eyesight problems) the fact she no longer has to worry about maintaining her own home is an enormous weight off her mind.
Not everyone can care effectively for their elderly relative and providing a care home is chosen carefully, they are certainly not a last resort.
I do trust my mother's care home - not blind trust, I do keep an eye on things - but not all care homes are the horrific places that documentaries and reports would have us believe. There are good ones with carers that genuinely do care for their charges and I don't think it helps anyone to dismiss the entire industry as untrustworthy - though I do take on board that your comments are based on your own personal experience.
But then, in my experience, the agency carers were too often untrustworthy, lying about their attendance times, what they had time to do and when they had been asked to come. I think the carers probably did their best (though I had evidence where some were very slapdash) but the agencies and particularly the schedulers, were very poor.
LIke your mum, Normandie, my mum was like a new woman after being at her care home for just a few months. From being someone who had been extremely frail and totally dependent on my dad and outside carers for her personal care, she suddenly began to do things for herself. She was still physically incapable of doing such things as making a cup of tea as she was not strong enough to hold a kettle, but she walked around the garden unaided something that was unheard of at her own home. I used to joke and tell her she was like 'head girl' as she had her finger on the pulse of the 'home' and made sure all the other residents were kept updated about events.:)
I visited her several times a week, but the 'home' gave her the company and social life she craved when I wasn't able to be with her. She read loads, was always winning at bingo, and was doing crosswords and puzzles until just a couple of months before she passed away.
I know not all 'homes', or carers are as we would wish them to be, but I cannot praise my mum's highly enough. I have to say that when my mum was discharged from hospital for the last time she had to have an oxygen cylinder and I was extremely concerned that her 'home' might feel they couldn't cope with her medical needs as they were not a nursing home as such. But they went out of their way to make sure she had everything she needed even undergoing special training so that she could go back there, as her last wish. The owner was really upset that my mum didn't quite make it to 100. She was planning to hold a big party for her. The fact that many of the other residents in the 11 years my mum was there, also lived to be well into their 90s I think is testamount to the excellent care they received.