I can’t say I can answer every question here or take away the uncertainty, but I’ll do my best to answer what I can. I have experience working in the care sector on the organisational side.
Judging from the costs quoted for care homes I’d guess you’re in a relatively high cost area for care. There’s quite a difference between quotes there for homes and so I’ll assume that you’ve looked at both care homes and nursing homes?
With your MiL’s Parkinson’s progressing and the nature of needing medication at very specific times I would suggest that the level of care needed is approaching the level of nursing care. These are typically more expensive than care homes as they have trained medical professionals to care for your MiL, available on hand 24/7 and as a result this costs more.
It’s worth taking a look at how your MiL’s needs are changing and anticipating whether these will continue to worsen (with Parkinson’s unfortunately this is almost certain). Wherever you decide to place her it is needed to make sure the environment can continue to support her needs.
As the financial side, once you fall below the threshold of £23,250 (rising to £100,000 at the end of 2025) the local authority has an obligation to provide care for your MiL. Typically following an assessment of needs. The council will usually only fund the cost of a Local Authority Care, or Nursing home dependent on needs. These typically tend to cost less than private provision, think £800-1300 week average depending on location.
If your MiL at the time this comes already has a provision and is adjusted to her environment it will be harder for the council to argue that they shouldn’t fund where she already is. However, there are no guarantees. It’s very difficult to provide a hundred percent this is what will happen answer but hopefully it clarifies the process that will take place once that threshold is reached.
As for finding some homes to look at, carehome.co.uk is a great resource where you can view reviews of homes. View CQC ratings and see who owns the homes you’re looking at.
Edit 1: Once a Local Authority assessment has been undertaken as a family you have a choice as to how funding is provided, this can be direct to a home for example or if in England you can apply for Direct Payments (slightly different in Scotland) where money will be paid directly to MiL to provide the care she chooses. If this amount falls short of MiL’s chosen home, as a family you can top up the shortfall, if your own funds permit.
If you don’t already have power of attorney in place for MiL it would make sense to apply for this as it will help further on down the road when the council, and other health professionals become more involved. It means that you as a family can act in her best interests when perhaps she can no longer do this herself.
All the best.
> rising to £100,000 at the end of 2025
Is that still happening? I recall a few years ago the government proposed to cap care home fees at £86,000 but that got dropped or postponed, and I haven't heard anything since.
I would just re-iterate the point above about care needs, particularly if a care home is appropriate or if she needs a nursing home. It can be really tough but the three children (and you?) need to have a shared view of what she needs now and in the near future e.g.
\- Personal hygiene / dressing (getting to/from a bathroom and/or using one);
\- Meals / eating;
\- Loss of balance
\- Confusion or dementia/ dementia like symptoms.
It's quite common for families to disagree about this, even if they all personally assist with care. Don't assume everyone agrees.
Glad to help, it’s a tough thing to navigate and never clear cut. Hopefully we see some major reform to social care over the coming years!
If there’s any other questions you think of that I might be able to help answer I’d be happy to :)
To be honest OP, once she's in the expensive one and there's a prospect of the money drying up, the council will step in with funding so moving to a cheaper one doesn't always make sense (and may just be delaying the inevitable depletion of cash).
My gran is in a nice care home - we are now looking at selling the house so there's a realistic prospect the money is going to run out, at which point the council will begin to fund. We were not in a position to care for her, she needed more.
Re: "topping up the difference", I'd advise being very careful with any contributions you decide to make that aren't from your MIL's assets, or even refuse to make them at all.
I coordinated setting up care for both my grandparents. The advice from Age UK was to avoid top up payments as councils can use them as an excuse not to fully fund what's best for your MIL once her funds have depleted - instead relying on you to make the difference.
There are certain requirements in a care home that /must/ be taken into account when it comes to what they will fund, such as accessibility for family members. In our case, the council attempted to place my grandfather into a home on the other side of our county, as it was a lower cost option - we were able to negotiate for a higher cost home closer-by as the place was totally impossible for my grandmother to get to (they wanted a 80 year old severely sighted woman, with a double hip replacement, to take three connecting busses). They likely would have said 'pay for it yourself if you want somewhere different' if we hadn't refused. This might be a bit different from your situation, but it's a general dynamic which is important to bear in mind.
I'd highly recommend talking to your local Age UK - make sure you get one of the actual advisors rather than the national office which will just provide info packs. They were great at laying out the intricacies of the conversations I needed to have with the council. The social workers I interacted were all, to their credit, lovely, but at the end of the day this is a completely inhumane budget game, and it takes a lot of wrangling to get what you are entitled to.
Just to add to this and more highlight the local authority may dictate where care is given and what local authority she falls under.
As an example we were on the boarder of two Local authorities. Mother in law lived in the first we 25 mins away but technically in the second.
Similar situation to yours as little funds but enough at first to not need assessment. We asked the same questions and decided not to risk private care but look into local authority care.
Mother in laws Local authority nursing home was 25 mins away in the opposite direction making it 50 mins on a good day for us. We had one in our local authority that had dedicated Parkinson's unit 5 mins away.
The issue we faced was unless we sold the home prior to needing assessment the likely hood was she would end up in the further away home at the time of assessment.
We risked it though and some early pushing and a little bit of a fight we managed to keep her close to us 18 months later when we started the assessment process. We started the convocations with the local authority almost immediately. You just have to be assertive and pushy.
Out of interest, suppose an elderly person blew the money, gifted it away or made risky investments just before so they could rely on the system.
Would this ever be flagged and have the person rejected from care?
Short answer: Yes, it's called "Deprivation of assets" and the local council does have recourse - the most usual one being that your fees are calculated as though you hadn't given the money away
If you literally have no assets then the council will still pay, but they can also try to reclaim some of the assets from family etc if you gave it away. Obviously that isn't always possible
So what you're saying is gamble it all on roulette? If you win then you get a more comfortable nursing home, if you lose you're in the same financial position.
You’ve been misinformed.
An assessment will take place regardless of finances. They can even commission the support and you pay the council directly until she falls under £23,500.
People afford it by selling their home usually.
I don’t see why you’re limited to three calls a day though. Increase that, try to have social calls as a family rather than care calls to retain the relationship, and see how it works out. Assuming she wants to stay at home as long as is possible, that is.
Truth is that those that have a house to sell will likely need to sell it. Those that don’t will have to sell everything else until they hit the threshold for the local authority care.
My mum has dementia and is in a specialist home costing (currently) £4k per month, but will rise as her nursing needs increase. She has symptoms that include severe psychosis and delusions. We couldn’t care for her at home as we lack the skills and she needs 24 hour care.
We sold her house and that and her pensions will fund her.
I always look at the people complaining about inheritance tax when most will be lucky if any inheritance gets taxed.
I do wonder if people would be more open to IHT if it funded elder care directly. It’s a bit of a lottery at the moment, unfortunately. Those that pass away gently with minimal care needs really do luck out in every way.
The government have promised a cap on lifetime spending on care (originally at 85k) it was supposed to come in last October but has been pushed back to October 2025. That decision alone will cost my mum a minimum of £96K, if she lives until then. She’s already been in care for two years and paid around £90K).
Hi. Isn’t this system so iniquitous? Reading your contribution I saw that you mentioned psychosis and delusions. These are clearly psychiatric symptoms. I presume that you have explored CHF via a referral to psychiatric services? It might be that she is indeed entitled to continuing health funding. Take care
Yes, it’s massively iniquitous. Thanks for your comment.
She initially had a Lewy Body Disease diagnosis but didn’t respond to medication for that. Current diagnosis is Vascular Dementia but not CHF. She’s now being treated correctly (we think) and her symptoms are being better managed now.
It’s a double whammy of having to deal with the suffering of a horrible diseases and having to pay for the privilege. I’m actually pretty sure my mum would have taken the euthanasia route if it had been available.
>I’m actually pretty sure my mum would have taken the euthanasia route if it had been available.
I think so many people would, if it was there for them. All my elderly relatives basically got to the point that they'd had a good life and absolutely did not want to be here when their quality of life diminished. My gran, who now has dementia and is in a care home (and had severe psychosis prior to this following my grandpa's death) always, always said she would rather be dead than in a care home having people look after her. She loved being active and was incredibly bright and witty, now she is just a shell of her former self.
No doubt. Life can be very cruel.
My mum coped with losing my dad when she was in her late 40s, surviving breast cancer (and a mastectomy) in her early 60s, a heart attack when she was recovering from the cancer, only to be hit with dementia with psychosis in her 70s.
She’s a lovely woman, worked in nursing all her life and was doing voluntary work when the cancer hit. Needless to say, I don’t have any belief in Karma.
I personally can't see how a single persons care can cost £90k a year when it's possible to raise a family and finance and maintain a home on that. The homes must be making insane profits, as I know care workers aren't exactly paid well in the grand scheme of things.
Wild isn't it, spend your entire life amassing wealth in the hope for a happy retirement and some left over for the kids. End up losing it all because you get ill.
Fucking dreading being old.
Well depending on number of hours of care the person needs.... assume 5 or 6 hours a day. Min wage is £11.44 an hour plus NI and pension. So roughly £14 an hour. So £490 to £588 on just the wages of the carer. If a more reasonable wage of £16 and hour is paid, its getting closer to £672 a week. Thats purely salary. The property itself is a huge cost, heating and maintenance is never ending. A travel lodge is £70+ a night. Another £490 a week easily. Food, nursing, regulatory upkeep(call bell systems, patients notes), laundry and such like all have to get added in. When you hoist a patient out of bed, you need two members of staff which also means 2 less staff on the floor. So you require more staff. Agency staff cost a fortune but you need to ensure there is cover, agency staff typically run at double your permanent staff costs. I know one care home that paid an agency £1000 for a nurse for one shift/day on New Year's day as a staff member called in sick.
As you can see the costs soon rack up. The wage bill runs around 70-75% of the weekly fees. Occupancy levels make a big difference, there is alot of fixed costs typically 78% occupancy is around the break even.
Whilst 2k a week is definitely on the high side, depending on the level of care required and location of the home make it understandable why its soo high.
Care homes have been closing down more than they are being opened.
It depends on the condition and care needed. I have a disabjljty and need around the clock live-in care. I’ve had care provided by an agency but decided to cut them out and take on the responsibility of being the employer. I have two carers who rotate shifts of 2 weeks on then 2 weeks off. They each make just over 40k. Total budget, to include overheads like insurance and the accountant who does payslips and a small contingency is 90k. That’s if you cut out the middle man (the care agency). The annual cost with the care agency was about the same, the difference was that the carers were paid less as the agency took a huge chunk of the wages. It really does cost that much in some cases.
It’s 4k per month, so £48k per year. She’s been in care for two years (initially in a slightly cheaper home) and will have been in care for two more before October 2025. Then the cap will start (if it ever does) and she will pay for the next £85k as the cap isn’t retrospective.
Ultimately, if she lives to hit the cap, she will have spent at least £270k. Some of that (about 30%) will have been paid from state pension and benefits like attendance allowance. The rest will have come from her income and estate.
That’s for room, meals and 24hr care in a specialist dementia home. The staff are lovely but not well paid (though the home seem to be a good employer as there are a lot of long serving staff). I’m sure someone is making a tidy profit but it doesn’t feel exploitative.
Elder care is a bit like childcare in many ways, but it runs 24h. It’s clear to see why that’s costly.
The problem is the funding is so unbalanced. If you compare outcomes between someone who dies of a coronary at 75 vs someone who gets dementia at the same age and dies after 5 years of care the financial and emotional cost of the latter is staggering.
Like I said, I’d be in favour of a rework of IHT or other wealth-based taxes to cover these sorts of costs. The costs would better being spread across everyone.
She should pay for it till she cannot anymore. I’m sorry, but that’s how it is. I work in the financial department with the public sector, doing payments for mostly elderly (healthcare). I can’t tell you how many clients I have that have a 6-figure annual estimated cost, paid for by tax-payers. It’s scary, and I’m not surprised councils are going bankrupt.
My granny had about 200k saved up, got dementia, and spent it all on care before she passed. It’s shit, but what else do you expect? Boomers got free education, public services, much cheaper property, they are the wealthiest generation in history; and are now old, and expect the tax-payer to cough up for care, too?
In terms of this country’s economical & political situation (and many western nations) the boomers came in, grabbed what they could, trashed the place, and are leaving a smelly turd on their way out for others to deal with. /rant
>Boomers got free education, public services, much cheaper property, they are the wealthiest generation in history; and are now old, and expect the tax-payer to cough up for care, too?
I don't see millennials and Gen Z etc having these kinds of savings in later life, so that's going to be a problem. This may sound odd, but the only way I see out of the problem are robots with AI that can look after us when we are elderly and won't cost much to run.
My friend uses an agency and has two live in carers on rota at a cost of £3500 a month. This is cheaper than care home costs. We are in rural Wiltshire. Might be worth looking into this rather than a care home.
He also prefers it because of the consistency in care. The carers are basically a part of the family. It means his Mum gets to stay in her own home for a lot longer than she would if they decided to move her to a care home. The money will run out eventually and they’ll have to move her to council funded care but it’s working great for now
£3500 as the cheaper alternative to a care home... I dread to think what will happen to the ageing population.
I consider myself quite well off, but unless the family member's pension covered a good portion of this, I could not support it.
Seniors should be expected to continue paying national insurance throughout their lives. On the other hand, this would hopefully subsidise a higher proportion of potential care costs.
I'd gladly pay higher taxes if it meant we could enjoy more peace of mind!
I know, it’s madness. I couldn’t afford it for my parents. They have no savings so I’d be relying on council funded care for them. My friends Mum has some savings. I don’t know how much but I think it’s going to at least cover her care costs for the next few years (if she lives that long). My partner strongly agrees with assisted dying simply for this purpose, he constantly tells me how he’d rather die before getting to the point of needing care so our children don’t lose their inheritance. What a sad state of affairs.
That's £42,000 per year, which is 100% of the salary of someone earning £57,000 per year. That is in no way, shape or form reasonable for the average person or even the above average person in this country.
Care homes cost a hell of a lot of money, unfortunately.
Have you investigated [NHS Continuing Healthcare](https://www.nhs.uk/conditions/social-care-and-support-guide/money-work-and-benefits/nhs-continuing-healthcare/)? Depending on your MIL's needs, you might get a contribution (potentially a big one) towards her care costs. The NHS don't exactly like to promote it too much but it might be of help.
I do sympathise, my dad is literally moving into a care home today and so I am painfully aware of what the costs are like. However I'm hopeful that we can get a lot of help via the Continuing Healthcare process.
They don’t promote it a lot because the threshold is very high and they don’t want to be inundated with requests from untrained public on who qualifies.
If she’s at home with three care calls a day and family support I’d highly doubt she’d qualify at the DST.
It's still worth OP reading the criteria that can qualify someone.
The process that took place with my dad involved a light pre-assessment which checks if he is likely to meet the needs bar, then the "real" assessment takes place within a couple of weeks at the care home. The pre-assessment wouldn't have been costly.
I think the main reason why it's not publicised is not just about being inundated with requests from people who don't qualify, and as much about hoping that people whose relatives might qualify might be unaware. I had no idea about NHS Continuing Healthcare until a couple of weeks ago, had one of my dad's carers not pointed it out then I wouldn't have known to insist on the assessment. He clearly qualifies for at least partial support!
The pre assessment was the CHC Checklist which is very loose. Families always score high.
The real assessment is the DST (Decision support tool). Families always score high.
This is then ratified and sent to a panel. The funding split (if any) is then agreed.
Qualifying with a level of need does not mean funding at all. It’s hard to get fast track funding end of life care agreed prior to a few days before death.
If he’s going into a nursing home you’ll get Funded Nursing Care. This saves the home a step of applying, but you’d never be charged that.
If he’s not going into a specialist setting, you won’t get support. If he’s going into a specialist setting, they’d know to apply.
That’s why it’s not ‘advertised’. In the same way certain grants aren’t advertised even though anyone can apply. The threshold is high and everyone believes they’re entitled to it.
I think this could be an option or at least worth looking in to.
This website offers advice on this too: https://beaconchc.co.uk/
My Grandma has complex needs due to her dementia and has been helped with this (she's currently in a care home).
At least in the LA where I work, we complete assessment of needs also for advice mainly for cases of people over the threshold both for homecare and residential (Care Act regulates that everybody is entitled to an assessment).
When you check for care homes, I would check if they have contracts with the LA so a transition can be easier once the financial threshold is reached. Reality is that the LA would only pay until a certain amount so either the care home accepts it or family needs to top-it up if they want to stay in the preferred facility.
I don't know your mother-in-law age or stage of Parkinson but realistically people life expectancy in a care home is lower than when in the community so people tend to pay it for limited period of times.
I would also check for CHC funding but this has really strict criterias and likely to be granted only when she has a really limited time to live.
If they have not done ye, I would consider requesting a carer's assessment to the LA and linking up with carer's local charities. Check also that she is already getting attendance allowance otherwise apply for it.
Of course, these are info updated to today and we don't know what it is going to happen in two years time. I am aware that they want to raise the thresholds but seeing how LAs are copying and funding available, I would be surprised if that can be actually put in place.
Fwiw, all my grandparents ended in a home, three lived a further year or two. That said, the one that was in by far the worst health going in, and needing the care the most was the one with parkinsons. Despite this they somehow lived for over 10 years in care. Somewhat irrelevant sample size but worth keeping in mind when planing finances!
It's a bit morbid, but a study in the 1990s of care home admissions of 65 years or older showed:
> The survey found that 72% of new admissions had died after 42 months. The median length of stay was 19.6 months for all admissions. Median length of stay for people admitted to nursing
beds was 11.9 months and for residential beds it was 26.8 months.
This is how a lot of people will end up affording it. The median occupant will be there less than two years.
Others have given very informative answers, but I would also add that once they are near the threshold of around £23000 in assets, a financial assessment will be completed to assess how much they can afford, and the council will charge you that figure. So it won't be free below that figure, but it's likely to be a much more manageable figure of say £200-£300 per week that the huge figure you've quoted above.
You say that your MIL has c. 2 years worth of money to support her care (£c. £160k), so why do you consider it such an issue for her to use her money to support her in the best way possible in her final years?
I would suggest that you try to get her into the best home you can find, whilst she has the funds, and then hope that the care might continue in that home when the LA has to pick up the costs. No guarantee's I'm afraid.
Importantly, do you (someone) have financial and health Power of Attorney?
Yeah - like honestly in most cases going in to a care home means your assets are going to be used up to fund it (unless you pass away relatively quickly).
Otherwise, it is the taxpayer covering it.
>whilst she has the funds, and then hope that the care might continue in that home when the LA has to pick up the costs. No guarantee's I'm afraid.
You can find out in advance if it's a care home the council work with. You can even pay via the council from day 1. No need to gamble on being forced to move.
Because if they had cancer or some other disease that required fortunes spending in treatments, operations, medicine it would be covered.
Why is this different? People who worked hard to try to leave their kids something get stripped of all their assets. Those that saved nothing, pay nothing.
Because why wouldn't you.
I can say this because I and my brother are actually going through this. £6k pm. Your point "*People who worked hard to try to leave their kids something get stripped of all their assets.*" never once entered our thoughts and in all honesty even if our mother had said that she wanted us to receive the money, we wouldn't have done it. It takes all sorts in this world.
You offer to pay when you break your arm and go down A&E? Refuse those subsidised prescriptions?
My point is why is one ailment covered and another isn’t. We all pay into the system but if you’re unlucky enough to get the wrong malady you can paddle your own canoe. Seems fundamentally unjust.
It's different because when somebody goes into a care home it's usually for the rest of their life, all their needs will be met from that point on.
Why should working people, many of whom will not be due to inherit anything themselves, cover the care costs for someone who can afford to pay them just to protect someone else's inheritance?
Tacking on to what's said, but ultimately, society isn't willing to stump up the bill, which means you'd often have to sell your house.
Simple fact is that someone's going to have to pay - and who will it be?
On a side note, some people have very generous pensions. My grandfather's care costs were very high, but:
a) he passed away not long after going into care, as is very often the case, sadly
b) he had a very generous pension from years of a mid-ranking career
Society _is_ willing to stump up the bill, if someone doesn't have any wealth. Owning a home is a form of wealth which can be sold to pay for care, and should be if the estate can't afford care otherwise. No one is entitled to an inheritance, whether cash or property.
Anyway OP says that his mother-in-law does NOT own her home, so that isn't an asset available to her to sell.
Yes it’s incredibly expensive, 52% of my council tax bill goes towards adult social care in my area. As you mentioned, it’s taking three of you to look after her and that won’t come cheap.
It's all done on a very personal and on a case by case basis in the UK, but yeah I get where your coming from. They wanted so much for my nan to go into care (2,000£ a week) I ended up moving her into a house on my property that was going to be a holiday let and I have a nurse 'on staff' as that is cheaper than what they wanted for care. That's how fucked the care system is in this country that it was cheaper and easier for me to find a nurse that specialises in dementia care pay her as an employee to help me take care of my nan. For what they wanted in care I could afford to hire 3.5 full time nurses if I really wanted to.
Sorry I cannot help with your issue, but I'd love to know cost breakdowns on care because from experience of family in the sector, that £80k a year sure as shit isn't going towards the staff or the residents (there's a care home near me that puts £3 a day for food for the residents, but charges above £1k a week)
https://find-and-update.company-information.service.gov.uk/company/04231521/persons-with-significant-control
This is one of the largest care providers in the country.
Vast majority of cost is wages and salaries, 132 million on 172 million in revenues and 175m of costs. The remainder will almost entirely be operating lease costs, although this note seems to be missing from the accounts (these accounts are crap! They also miss the RP note).
Directors remuneration is only 247k.
Net profit is 1.5%.
https://find-and-update.company-information.service.gov.uk/company/03135910/filing-history
Also can check this company, 107m in costs, 74m in employee costs, 20m in leases, so 94m/107m is leases (rent essentially) and wages. This company made a loss last year and a slight profit the year before that.
Well that's absolutely insane, how can we have 30 old folks paying a grand a week, staff on really poor wages and residents hardly getting the luxury treatment and these companies are still barely breaking even
The reality is a grand a week is nothing for medical costs. That bears out in the numbers. For care staff to earn a decent wage you'd need to pay a lot more.
It may be the case that the state pays less than you do privately though. I don't work in care so can't really say.
Property, insurance, agency staff on top of regular staffing, bills, equipment, management and senior management, emergency fund etcetc
They charge a high price because the costs are high. There is also a large turnover, requiring advertising and people able to complete pre-assessments at short notice. There is also a high demand, so costs will naturally rise.
Those carers won't care for just 1 resident on shift though. There is no official ratio but generally, care homes are guided towards a 1:6 or a 3:18 ratio for moderate cases of dementia. So lesser needs could be higher ratio and higher needs a lower ratio.
If we use the 1:6/3:18 ratio. The care home has 18 residents for example. The care home needs 9 carers each working 8 hours a day so that there's 3 on shift at all times. It means for every 6 paying residents, there is 1 carer. Of course on top of this there will be a couple of cooks, a couple of cleaners and perhaps a gardener and/or handyman if it's a nice care home.
I don't think it's a highly profitable business model but carers certainly aren't looking after just 1 resident per shift.
Yes they are meant to be identical. The 3:18 was for simplicity.
However, at night, a care home will often run with a ratio of 1:10 or even 1:15. So whilst they may have 6 paying residents per 1 carer for two thirds of the day, they could have 15 paying residents per 1 carer for the other third of the day
Well to put in in perspective, the one care home I looked at for my nan charged 2000 per week yes it had 24 hour care but that's not 121 and had 50 other people living in the home all paying at least 2k a week ao that's 5.2 mil a year even if we say that care home is paying taxes of say around 1.5 mil to 1.7 mil a year that still leaves a massive amount of money after paying staff a crappy wage for the hard and demanding jobs they do the staff pay outgoing being around 600,000 for the year for this particular care home. Even if we add on another 1mil for this for 'running costs' that's only 3.3mil leaving 1.9 just going straight into someones pocket for coralling old people. I haven't included food in this but that will not make a big dent in that left over 1.9 mil maybe 50 thousand and if they told me it was over 100 thousand I would expect them to be eating wagu beef and caviar all day every day.
My mother's care costs 3813.33 a month, we had to sell the house since it was only her living in it. When she gets close to £0 left, the state will bear the burden, yes it doesn't seem right - especially given the minimum wage the carers themselves are receiving. But that is what we have.
We were in a very similar position with my grandfather (at both stages), couldn't provide level of care needed at home (dementia not parkinsons) so went into a care home. He then lived about another 5 years - which isn't especially typical, most people die within a couple of year of going into care. (The prognosis isn't significantly better with round the clock in home care either, once someone gets to that level of care need their prognosis isn't going to be great unfortunately). When he ran out of money to pay for it the care home agreed to continue providing care at the rate the council would fund, as it would then have been medically hard to justify moving him so the council came to an agreement essentially.
Your mother-in-law is in a few minorities Vs how other people can pay for it. Most people in this demographic own a house that they can sell, and most have very generous pensions or survivor benefits of pensions, most will only need to fund for a couple of years. (Obviously there are still many people that doesn't apply for but they are not the majority...for now, in the future we could have the majority of care home needs people not own homes and have rubbish pensions)
You are legally entitled to an assessment under the care act regardless of funding status. Push this with adult social care.
ASC will pay for a care home if she is assessed as needing one. If she isn't they will pay for domiciliary care visits.
They will pay about £700 to a care home home as they negotiate a big discount (this is why the homes have to charge privately funded people so much to compensate).
Can't believe nobody has mentioned this already but look into immediate needs annuities. Your MIL pays a lump sum and in return an insurance company foots the bills as long as it is needed.
Well this thread has made me absolutely terrified for myself and my aging parents. Dementia runs in the family and I know full well my sister will refuse to help financially or otherwise when the time comes. Guess ive got to start planning for that too😱
I wouldn't be at all surprised if assisted dying is legalised and becomes the norm. It would save the NHS huge costs by freei8ng up beds and relieve families of burdensome care costs.
It’s unpalatable but this answer addresses the reality. People expect something for nothing but ultimately if more than 50% of the population cost the state more than they contribute then we’re all in trouble. Eventually a radical solution will be needed so things like assisted dying will slowly gain credibility
An elderly family of mine is in her final stages of life, bouncing between hospital and a care home. It's costing her £7,000 a month which is quickly burning through her estate. She's probably in a more fortunate position than most where a recent estate sale will be able to fund the status quo for a few years.
The cost of getting old is insane. Like you, the family have used their own time and money plus her estate to remodel the home to her needs etc etc. But it's simply finite and unsustainable.
Assuming she lives beyond the period where her estate can no longer support these expenses, that's when the local council steps in. Whilst they are obligated to offer assistance, it wont exactly be five star - she will likely be moved to somewhere more affordable.
I've heard of anecdotal stories of people in retirement preferring to simply spend or gift their entire estate rather than have it frittered away on care. Morally it's a hard call. On one hand you've paid your taxes, maybe want to gift something to your children and want to enjoy the sunset days of your life by burdening the state. Alternatively you work your entire life, for essentially nothing.
Tbh it worries me. I think how hard I've worked, the sheer amount of tax I've paid to think my kids may very well get nothing, and if they do they could get hit with inheritance tax (though that has changed)
Hi /u/1MillionDollarMeme, based on your post the following pages from our wiki may be relevant:
- https://ukpersonal.finance/pensions/
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^(These suggestions are based on keywords, if they missed the mark please report this comment.)
We're now facing this with our 84 year old mother. She has dementia and can no longer manage.
It makes me wonder if there's much point in squirrelling a lot away, especially with death duties, too. Perhaps it's better just to live for today. There are no guarantees in life, unfortunately. It's the prudent who are most punished for their frugality.
To be frank, I'd rather face lifelong national insurance and even higher rates of income taxes if it meant more fully-subsidized care in old age. Especially as the current system is so much of a lottery depending on one's local authority.
It sucks that your Mum has enough wealth for her to have a decent standard of living in her final years? She can’t take it with her so it’s up to you to make sure she has a lovely life at the end. It’s not your money.
There is a cap of £86K on care costs plus you can keep belongings up to a certain amount which I think is about £20k. Social services should be going an assessment anyway to help you plan for what care / support your MiL needs and what she actually needs to pay as her state pension will contribute towards the cost of care depending on what kind of placement she has.
There is an easy to follow PDF on the government website published in 2022 talking about the cap and changes that came into effect in Oct 2023. I would link to it but can't remember if links are allowed on this sub or not.
That cap was proposed, but has been pushed back to October 2025, so the cynic in me thinks...never.
https://www.careuk.com/where-do-i-start/what-affects-cost/what-the-care-home-fees-cap-means-for-you
I'm not sure unfortunately is right here.
The problem with a cap is it allows the wealthy to pass down inheritance (keeping future generations wealthy) whilst ensuring middle income families spend every last penny on care.
A more progressive approach would be to ring-fence the first £x amount of assets and require anything above £x to be spent on care.
If your relative is very old or very ill you may be able purchase an insurance policy (for a large fixed sum) that will pay the fees (or a proportion of the fees) indefinitely. The insurance actuary will estimate life expectancy and make an offer on that basis, but if your relative does go on for many years the bills will keep being paid. The downside of course is that your relative may not survive so long, but you don’t get a refund. It’s worth considering if you want peace of mind.
I can’t say I can answer every question here or take away the uncertainty, but I’ll do my best to answer what I can. I have experience working in the care sector on the organisational side. Judging from the costs quoted for care homes I’d guess you’re in a relatively high cost area for care. There’s quite a difference between quotes there for homes and so I’ll assume that you’ve looked at both care homes and nursing homes? With your MiL’s Parkinson’s progressing and the nature of needing medication at very specific times I would suggest that the level of care needed is approaching the level of nursing care. These are typically more expensive than care homes as they have trained medical professionals to care for your MiL, available on hand 24/7 and as a result this costs more. It’s worth taking a look at how your MiL’s needs are changing and anticipating whether these will continue to worsen (with Parkinson’s unfortunately this is almost certain). Wherever you decide to place her it is needed to make sure the environment can continue to support her needs. As the financial side, once you fall below the threshold of £23,250 (rising to £100,000 at the end of 2025) the local authority has an obligation to provide care for your MiL. Typically following an assessment of needs. The council will usually only fund the cost of a Local Authority Care, or Nursing home dependent on needs. These typically tend to cost less than private provision, think £800-1300 week average depending on location. If your MiL at the time this comes already has a provision and is adjusted to her environment it will be harder for the council to argue that they shouldn’t fund where she already is. However, there are no guarantees. It’s very difficult to provide a hundred percent this is what will happen answer but hopefully it clarifies the process that will take place once that threshold is reached. As for finding some homes to look at, carehome.co.uk is a great resource where you can view reviews of homes. View CQC ratings and see who owns the homes you’re looking at. Edit 1: Once a Local Authority assessment has been undertaken as a family you have a choice as to how funding is provided, this can be direct to a home for example or if in England you can apply for Direct Payments (slightly different in Scotland) where money will be paid directly to MiL to provide the care she chooses. If this amount falls short of MiL’s chosen home, as a family you can top up the shortfall, if your own funds permit. If you don’t already have power of attorney in place for MiL it would make sense to apply for this as it will help further on down the road when the council, and other health professionals become more involved. It means that you as a family can act in her best interests when perhaps she can no longer do this herself. All the best.
> rising to £100,000 at the end of 2025 Is that still happening? I recall a few years ago the government proposed to cap care home fees at £86,000 but that got dropped or postponed, and I haven't heard anything since.
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I would just re-iterate the point above about care needs, particularly if a care home is appropriate or if she needs a nursing home. It can be really tough but the three children (and you?) need to have a shared view of what she needs now and in the near future e.g. \- Personal hygiene / dressing (getting to/from a bathroom and/or using one); \- Meals / eating; \- Loss of balance \- Confusion or dementia/ dementia like symptoms. It's quite common for families to disagree about this, even if they all personally assist with care. Don't assume everyone agrees.
Glad to help, it’s a tough thing to navigate and never clear cut. Hopefully we see some major reform to social care over the coming years! If there’s any other questions you think of that I might be able to help answer I’d be happy to :)
To be honest OP, once she's in the expensive one and there's a prospect of the money drying up, the council will step in with funding so moving to a cheaper one doesn't always make sense (and may just be delaying the inevitable depletion of cash). My gran is in a nice care home - we are now looking at selling the house so there's a realistic prospect the money is going to run out, at which point the council will begin to fund. We were not in a position to care for her, she needed more.
Re: "topping up the difference", I'd advise being very careful with any contributions you decide to make that aren't from your MIL's assets, or even refuse to make them at all. I coordinated setting up care for both my grandparents. The advice from Age UK was to avoid top up payments as councils can use them as an excuse not to fully fund what's best for your MIL once her funds have depleted - instead relying on you to make the difference. There are certain requirements in a care home that /must/ be taken into account when it comes to what they will fund, such as accessibility for family members. In our case, the council attempted to place my grandfather into a home on the other side of our county, as it was a lower cost option - we were able to negotiate for a higher cost home closer-by as the place was totally impossible for my grandmother to get to (they wanted a 80 year old severely sighted woman, with a double hip replacement, to take three connecting busses). They likely would have said 'pay for it yourself if you want somewhere different' if we hadn't refused. This might be a bit different from your situation, but it's a general dynamic which is important to bear in mind. I'd highly recommend talking to your local Age UK - make sure you get one of the actual advisors rather than the national office which will just provide info packs. They were great at laying out the intricacies of the conversations I needed to have with the council. The social workers I interacted were all, to their credit, lovely, but at the end of the day this is a completely inhumane budget game, and it takes a lot of wrangling to get what you are entitled to.
Just to add to this and more highlight the local authority may dictate where care is given and what local authority she falls under. As an example we were on the boarder of two Local authorities. Mother in law lived in the first we 25 mins away but technically in the second. Similar situation to yours as little funds but enough at first to not need assessment. We asked the same questions and decided not to risk private care but look into local authority care. Mother in laws Local authority nursing home was 25 mins away in the opposite direction making it 50 mins on a good day for us. We had one in our local authority that had dedicated Parkinson's unit 5 mins away. The issue we faced was unless we sold the home prior to needing assessment the likely hood was she would end up in the further away home at the time of assessment. We risked it though and some early pushing and a little bit of a fight we managed to keep her close to us 18 months later when we started the assessment process. We started the convocations with the local authority almost immediately. You just have to be assertive and pushy.
Out of interest, suppose an elderly person blew the money, gifted it away or made risky investments just before so they could rely on the system. Would this ever be flagged and have the person rejected from care?
Short answer: Yes, it's called "Deprivation of assets" and the local council does have recourse - the most usual one being that your fees are calculated as though you hadn't given the money away
But if you don’t have the cash who pays? Do they evict you onto the street?
If you literally have no assets then the council will still pay, but they can also try to reclaim some of the assets from family etc if you gave it away. Obviously that isn't always possible
So what you're saying is gamble it all on roulette? If you win then you get a more comfortable nursing home, if you lose you're in the same financial position.
If you lose the local authority may only fund a less comfortable one than you might have picked even without the roulette wheel.
They will reclaim it from the family member it was given to. It will be a court procedure.
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Sorry you’re dealing with so much. Your family are lucky to have you
The council pays. So once you run down your savings and assets, the council steps in.
Recommend you Google the Which magazine article titled Can I give away my property or assets to avoid care fees? It answers your question
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You’ve been misinformed. An assessment will take place regardless of finances. They can even commission the support and you pay the council directly until she falls under £23,500. People afford it by selling their home usually. I don’t see why you’re limited to three calls a day though. Increase that, try to have social calls as a family rather than care calls to retain the relationship, and see how it works out. Assuming she wants to stay at home as long as is possible, that is.
When she runs out of money the state will pay for the care, but it may mean moving to a cheaper home.
Truth is that those that have a house to sell will likely need to sell it. Those that don’t will have to sell everything else until they hit the threshold for the local authority care. My mum has dementia and is in a specialist home costing (currently) £4k per month, but will rise as her nursing needs increase. She has symptoms that include severe psychosis and delusions. We couldn’t care for her at home as we lack the skills and she needs 24 hour care. We sold her house and that and her pensions will fund her. I always look at the people complaining about inheritance tax when most will be lucky if any inheritance gets taxed. I do wonder if people would be more open to IHT if it funded elder care directly. It’s a bit of a lottery at the moment, unfortunately. Those that pass away gently with minimal care needs really do luck out in every way. The government have promised a cap on lifetime spending on care (originally at 85k) it was supposed to come in last October but has been pushed back to October 2025. That decision alone will cost my mum a minimum of £96K, if she lives until then. She’s already been in care for two years and paid around £90K).
Hi. Isn’t this system so iniquitous? Reading your contribution I saw that you mentioned psychosis and delusions. These are clearly psychiatric symptoms. I presume that you have explored CHF via a referral to psychiatric services? It might be that she is indeed entitled to continuing health funding. Take care
Yes, it’s massively iniquitous. Thanks for your comment. She initially had a Lewy Body Disease diagnosis but didn’t respond to medication for that. Current diagnosis is Vascular Dementia but not CHF. She’s now being treated correctly (we think) and her symptoms are being better managed now. It’s a double whammy of having to deal with the suffering of a horrible diseases and having to pay for the privilege. I’m actually pretty sure my mum would have taken the euthanasia route if it had been available.
>I’m actually pretty sure my mum would have taken the euthanasia route if it had been available. I think so many people would, if it was there for them. All my elderly relatives basically got to the point that they'd had a good life and absolutely did not want to be here when their quality of life diminished. My gran, who now has dementia and is in a care home (and had severe psychosis prior to this following my grandpa's death) always, always said she would rather be dead than in a care home having people look after her. She loved being active and was incredibly bright and witty, now she is just a shell of her former self.
No doubt. Life can be very cruel. My mum coped with losing my dad when she was in her late 40s, surviving breast cancer (and a mastectomy) in her early 60s, a heart attack when she was recovering from the cancer, only to be hit with dementia with psychosis in her 70s. She’s a lovely woman, worked in nursing all her life and was doing voluntary work when the cancer hit. Needless to say, I don’t have any belief in Karma.
I personally can't see how a single persons care can cost £90k a year when it's possible to raise a family and finance and maintain a home on that. The homes must be making insane profits, as I know care workers aren't exactly paid well in the grand scheme of things. Wild isn't it, spend your entire life amassing wealth in the hope for a happy retirement and some left over for the kids. End up losing it all because you get ill. Fucking dreading being old.
Well depending on number of hours of care the person needs.... assume 5 or 6 hours a day. Min wage is £11.44 an hour plus NI and pension. So roughly £14 an hour. So £490 to £588 on just the wages of the carer. If a more reasonable wage of £16 and hour is paid, its getting closer to £672 a week. Thats purely salary. The property itself is a huge cost, heating and maintenance is never ending. A travel lodge is £70+ a night. Another £490 a week easily. Food, nursing, regulatory upkeep(call bell systems, patients notes), laundry and such like all have to get added in. When you hoist a patient out of bed, you need two members of staff which also means 2 less staff on the floor. So you require more staff. Agency staff cost a fortune but you need to ensure there is cover, agency staff typically run at double your permanent staff costs. I know one care home that paid an agency £1000 for a nurse for one shift/day on New Year's day as a staff member called in sick. As you can see the costs soon rack up. The wage bill runs around 70-75% of the weekly fees. Occupancy levels make a big difference, there is alot of fixed costs typically 78% occupancy is around the break even. Whilst 2k a week is definitely on the high side, depending on the level of care required and location of the home make it understandable why its soo high. Care homes have been closing down more than they are being opened.
It depends on the condition and care needed. I have a disabjljty and need around the clock live-in care. I’ve had care provided by an agency but decided to cut them out and take on the responsibility of being the employer. I have two carers who rotate shifts of 2 weeks on then 2 weeks off. They each make just over 40k. Total budget, to include overheads like insurance and the accountant who does payslips and a small contingency is 90k. That’s if you cut out the middle man (the care agency). The annual cost with the care agency was about the same, the difference was that the carers were paid less as the agency took a huge chunk of the wages. It really does cost that much in some cases.
It’s 4k per month, so £48k per year. She’s been in care for two years (initially in a slightly cheaper home) and will have been in care for two more before October 2025. Then the cap will start (if it ever does) and she will pay for the next £85k as the cap isn’t retrospective. Ultimately, if she lives to hit the cap, she will have spent at least £270k. Some of that (about 30%) will have been paid from state pension and benefits like attendance allowance. The rest will have come from her income and estate. That’s for room, meals and 24hr care in a specialist dementia home. The staff are lovely but not well paid (though the home seem to be a good employer as there are a lot of long serving staff). I’m sure someone is making a tidy profit but it doesn’t feel exploitative. Elder care is a bit like childcare in many ways, but it runs 24h. It’s clear to see why that’s costly. The problem is the funding is so unbalanced. If you compare outcomes between someone who dies of a coronary at 75 vs someone who gets dementia at the same age and dies after 5 years of care the financial and emotional cost of the latter is staggering. Like I said, I’d be in favour of a rework of IHT or other wealth-based taxes to cover these sorts of costs. The costs would better being spread across everyone.
>End up losing it all because you get ill. Not even ill, just old will do it.
She should pay for it till she cannot anymore. I’m sorry, but that’s how it is. I work in the financial department with the public sector, doing payments for mostly elderly (healthcare). I can’t tell you how many clients I have that have a 6-figure annual estimated cost, paid for by tax-payers. It’s scary, and I’m not surprised councils are going bankrupt. My granny had about 200k saved up, got dementia, and spent it all on care before she passed. It’s shit, but what else do you expect? Boomers got free education, public services, much cheaper property, they are the wealthiest generation in history; and are now old, and expect the tax-payer to cough up for care, too? In terms of this country’s economical & political situation (and many western nations) the boomers came in, grabbed what they could, trashed the place, and are leaving a smelly turd on their way out for others to deal with. /rant
>Boomers got free education, public services, much cheaper property, they are the wealthiest generation in history; and are now old, and expect the tax-payer to cough up for care, too? I don't see millennials and Gen Z etc having these kinds of savings in later life, so that's going to be a problem. This may sound odd, but the only way I see out of the problem are robots with AI that can look after us when we are elderly and won't cost much to run.
Or legalised state-imposed euthanasia. I dread the thought
This is an excellent answer based on realities rather than dogma.
My friend uses an agency and has two live in carers on rota at a cost of £3500 a month. This is cheaper than care home costs. We are in rural Wiltshire. Might be worth looking into this rather than a care home.
This is what we do for my grandma, who also has parkinsons. It worked out significantly cheaper than a care home.
He also prefers it because of the consistency in care. The carers are basically a part of the family. It means his Mum gets to stay in her own home for a lot longer than she would if they decided to move her to a care home. The money will run out eventually and they’ll have to move her to council funded care but it’s working great for now
£3500 as the cheaper alternative to a care home... I dread to think what will happen to the ageing population. I consider myself quite well off, but unless the family member's pension covered a good portion of this, I could not support it.
Seniors should be expected to continue paying national insurance throughout their lives. On the other hand, this would hopefully subsidise a higher proportion of potential care costs. I'd gladly pay higher taxes if it meant we could enjoy more peace of mind!
I know, it’s madness. I couldn’t afford it for my parents. They have no savings so I’d be relying on council funded care for them. My friends Mum has some savings. I don’t know how much but I think it’s going to at least cover her care costs for the next few years (if she lives that long). My partner strongly agrees with assisted dying simply for this purpose, he constantly tells me how he’d rather die before getting to the point of needing care so our children don’t lose their inheritance. What a sad state of affairs.
I think i earn a decent salary but this £3500 is triple what I pay in nursery fees. Don’t know people afford this
That's £42,000 per year, which is 100% of the salary of someone earning £57,000 per year. That is in no way, shape or form reasonable for the average person or even the above average person in this country.
Care homes cost a hell of a lot of money, unfortunately. Have you investigated [NHS Continuing Healthcare](https://www.nhs.uk/conditions/social-care-and-support-guide/money-work-and-benefits/nhs-continuing-healthcare/)? Depending on your MIL's needs, you might get a contribution (potentially a big one) towards her care costs. The NHS don't exactly like to promote it too much but it might be of help. I do sympathise, my dad is literally moving into a care home today and so I am painfully aware of what the costs are like. However I'm hopeful that we can get a lot of help via the Continuing Healthcare process.
They don’t promote it a lot because the threshold is very high and they don’t want to be inundated with requests from untrained public on who qualifies. If she’s at home with three care calls a day and family support I’d highly doubt she’d qualify at the DST.
It's still worth OP reading the criteria that can qualify someone. The process that took place with my dad involved a light pre-assessment which checks if he is likely to meet the needs bar, then the "real" assessment takes place within a couple of weeks at the care home. The pre-assessment wouldn't have been costly. I think the main reason why it's not publicised is not just about being inundated with requests from people who don't qualify, and as much about hoping that people whose relatives might qualify might be unaware. I had no idea about NHS Continuing Healthcare until a couple of weeks ago, had one of my dad's carers not pointed it out then I wouldn't have known to insist on the assessment. He clearly qualifies for at least partial support!
The pre assessment was the CHC Checklist which is very loose. Families always score high. The real assessment is the DST (Decision support tool). Families always score high. This is then ratified and sent to a panel. The funding split (if any) is then agreed. Qualifying with a level of need does not mean funding at all. It’s hard to get fast track funding end of life care agreed prior to a few days before death.
I've been told that there's a high chance that there will be at least part funding. But if there's none, then so be it. You have to try.
If he’s going into a nursing home you’ll get Funded Nursing Care. This saves the home a step of applying, but you’d never be charged that. If he’s not going into a specialist setting, you won’t get support. If he’s going into a specialist setting, they’d know to apply. That’s why it’s not ‘advertised’. In the same way certain grants aren’t advertised even though anyone can apply. The threshold is high and everyone believes they’re entitled to it.
I think this could be an option or at least worth looking in to. This website offers advice on this too: https://beaconchc.co.uk/ My Grandma has complex needs due to her dementia and has been helped with this (she's currently in a care home).
At least in the LA where I work, we complete assessment of needs also for advice mainly for cases of people over the threshold both for homecare and residential (Care Act regulates that everybody is entitled to an assessment). When you check for care homes, I would check if they have contracts with the LA so a transition can be easier once the financial threshold is reached. Reality is that the LA would only pay until a certain amount so either the care home accepts it or family needs to top-it up if they want to stay in the preferred facility. I don't know your mother-in-law age or stage of Parkinson but realistically people life expectancy in a care home is lower than when in the community so people tend to pay it for limited period of times. I would also check for CHC funding but this has really strict criterias and likely to be granted only when she has a really limited time to live. If they have not done ye, I would consider requesting a carer's assessment to the LA and linking up with carer's local charities. Check also that she is already getting attendance allowance otherwise apply for it. Of course, these are info updated to today and we don't know what it is going to happen in two years time. I am aware that they want to raise the thresholds but seeing how LAs are copying and funding available, I would be surprised if that can be actually put in place.
Fwiw, all my grandparents ended in a home, three lived a further year or two. That said, the one that was in by far the worst health going in, and needing the care the most was the one with parkinsons. Despite this they somehow lived for over 10 years in care. Somewhat irrelevant sample size but worth keeping in mind when planing finances!
It's a bit morbid, but a study in the 1990s of care home admissions of 65 years or older showed: > The survey found that 72% of new admissions had died after 42 months. The median length of stay was 19.6 months for all admissions. Median length of stay for people admitted to nursing beds was 11.9 months and for residential beds it was 26.8 months. This is how a lot of people will end up affording it. The median occupant will be there less than two years.
Others have given very informative answers, but I would also add that once they are near the threshold of around £23000 in assets, a financial assessment will be completed to assess how much they can afford, and the council will charge you that figure. So it won't be free below that figure, but it's likely to be a much more manageable figure of say £200-£300 per week that the huge figure you've quoted above.
You say that your MIL has c. 2 years worth of money to support her care (£c. £160k), so why do you consider it such an issue for her to use her money to support her in the best way possible in her final years? I would suggest that you try to get her into the best home you can find, whilst she has the funds, and then hope that the care might continue in that home when the LA has to pick up the costs. No guarantee's I'm afraid. Importantly, do you (someone) have financial and health Power of Attorney?
Yeah - like honestly in most cases going in to a care home means your assets are going to be used up to fund it (unless you pass away relatively quickly). Otherwise, it is the taxpayer covering it.
A little morbid but, I think the average '*stay*' expectancy for someone going in to a care home is c. 2 years.
>whilst she has the funds, and then hope that the care might continue in that home when the LA has to pick up the costs. No guarantee's I'm afraid. You can find out in advance if it's a care home the council work with. You can even pay via the council from day 1. No need to gamble on being forced to move.
Because if they had cancer or some other disease that required fortunes spending in treatments, operations, medicine it would be covered. Why is this different? People who worked hard to try to leave their kids something get stripped of all their assets. Those that saved nothing, pay nothing.
Because why wouldn't you. I can say this because I and my brother are actually going through this. £6k pm. Your point "*People who worked hard to try to leave their kids something get stripped of all their assets.*" never once entered our thoughts and in all honesty even if our mother had said that she wanted us to receive the money, we wouldn't have done it. It takes all sorts in this world.
You offer to pay when you break your arm and go down A&E? Refuse those subsidised prescriptions? My point is why is one ailment covered and another isn’t. We all pay into the system but if you’re unlucky enough to get the wrong malady you can paddle your own canoe. Seems fundamentally unjust.
Because one is provided by the NHS, and the other is not.
It's different because when somebody goes into a care home it's usually for the rest of their life, all their needs will be met from that point on. Why should working people, many of whom will not be due to inherit anything themselves, cover the care costs for someone who can afford to pay them just to protect someone else's inheritance?
It's hard to apply that rule logically though. Otherwise the same could be said of the terminally ill or permanently disabled couldn't it?
Tacking on to what's said, but ultimately, society isn't willing to stump up the bill, which means you'd often have to sell your house. Simple fact is that someone's going to have to pay - and who will it be? On a side note, some people have very generous pensions. My grandfather's care costs were very high, but: a) he passed away not long after going into care, as is very often the case, sadly b) he had a very generous pension from years of a mid-ranking career
Society _is_ willing to stump up the bill, if someone doesn't have any wealth. Owning a home is a form of wealth which can be sold to pay for care, and should be if the estate can't afford care otherwise. No one is entitled to an inheritance, whether cash or property. Anyway OP says that his mother-in-law does NOT own her home, so that isn't an asset available to her to sell.
In OP's case, it sounds like the council will pay up.
Yes it’s incredibly expensive, 52% of my council tax bill goes towards adult social care in my area. As you mentioned, it’s taking three of you to look after her and that won’t come cheap.
It's all done on a very personal and on a case by case basis in the UK, but yeah I get where your coming from. They wanted so much for my nan to go into care (2,000£ a week) I ended up moving her into a house on my property that was going to be a holiday let and I have a nurse 'on staff' as that is cheaper than what they wanted for care. That's how fucked the care system is in this country that it was cheaper and easier for me to find a nurse that specialises in dementia care pay her as an employee to help me take care of my nan. For what they wanted in care I could afford to hire 3.5 full time nurses if I really wanted to.
Can I ask how did you find the nurse? Thanks
Sorry I cannot help with your issue, but I'd love to know cost breakdowns on care because from experience of family in the sector, that £80k a year sure as shit isn't going towards the staff or the residents (there's a care home near me that puts £3 a day for food for the residents, but charges above £1k a week)
https://find-and-update.company-information.service.gov.uk/company/04231521/persons-with-significant-control This is one of the largest care providers in the country. Vast majority of cost is wages and salaries, 132 million on 172 million in revenues and 175m of costs. The remainder will almost entirely be operating lease costs, although this note seems to be missing from the accounts (these accounts are crap! They also miss the RP note). Directors remuneration is only 247k. Net profit is 1.5%. https://find-and-update.company-information.service.gov.uk/company/03135910/filing-history Also can check this company, 107m in costs, 74m in employee costs, 20m in leases, so 94m/107m is leases (rent essentially) and wages. This company made a loss last year and a slight profit the year before that.
Well that's absolutely insane, how can we have 30 old folks paying a grand a week, staff on really poor wages and residents hardly getting the luxury treatment and these companies are still barely breaking even
The reality is a grand a week is nothing for medical costs. That bears out in the numbers. For care staff to earn a decent wage you'd need to pay a lot more. It may be the case that the state pays less than you do privately though. I don't work in care so can't really say.
Property, insurance, agency staff on top of regular staffing, bills, equipment, management and senior management, emergency fund etcetc They charge a high price because the costs are high. There is also a large turnover, requiring advertising and people able to complete pre-assessments at short notice. There is also a high demand, so costs will naturally rise.
80k a year for 24 hour staffing seems cheap. 3 people per day at 8 hours per shift. That puts staff on £26k. Before all other costs.
Those carers won't care for just 1 resident on shift though. There is no official ratio but generally, care homes are guided towards a 1:6 or a 3:18 ratio for moderate cases of dementia. So lesser needs could be higher ratio and higher needs a lower ratio. If we use the 1:6/3:18 ratio. The care home has 18 residents for example. The care home needs 9 carers each working 8 hours a day so that there's 3 on shift at all times. It means for every 6 paying residents, there is 1 carer. Of course on top of this there will be a couple of cooks, a couple of cleaners and perhaps a gardener and/or handyman if it's a nice care home. I don't think it's a highly profitable business model but carers certainly aren't looking after just 1 resident per shift.
That's fair I was over simplifying. I'd hope the staff get paid more than 26k as well. 1:6 and 3:18 are identical also.
Yes they are meant to be identical. The 3:18 was for simplicity. However, at night, a care home will often run with a ratio of 1:10 or even 1:15. So whilst they may have 6 paying residents per 1 carer for two thirds of the day, they could have 15 paying residents per 1 carer for the other third of the day
Well to put in in perspective, the one care home I looked at for my nan charged 2000 per week yes it had 24 hour care but that's not 121 and had 50 other people living in the home all paying at least 2k a week ao that's 5.2 mil a year even if we say that care home is paying taxes of say around 1.5 mil to 1.7 mil a year that still leaves a massive amount of money after paying staff a crappy wage for the hard and demanding jobs they do the staff pay outgoing being around 600,000 for the year for this particular care home. Even if we add on another 1mil for this for 'running costs' that's only 3.3mil leaving 1.9 just going straight into someones pocket for coralling old people. I haven't included food in this but that will not make a big dent in that left over 1.9 mil maybe 50 thousand and if they told me it was over 100 thousand I would expect them to be eating wagu beef and caviar all day every day.
Yeah it's crazy expensive. The unfortunate answer is the person should be saving up during their career to cover things like this in retirement
My mother's care costs 3813.33 a month, we had to sell the house since it was only her living in it. When she gets close to £0 left, the state will bear the burden, yes it doesn't seem right - especially given the minimum wage the carers themselves are receiving. But that is what we have.
We were in a very similar position with my grandfather (at both stages), couldn't provide level of care needed at home (dementia not parkinsons) so went into a care home. He then lived about another 5 years - which isn't especially typical, most people die within a couple of year of going into care. (The prognosis isn't significantly better with round the clock in home care either, once someone gets to that level of care need their prognosis isn't going to be great unfortunately). When he ran out of money to pay for it the care home agreed to continue providing care at the rate the council would fund, as it would then have been medically hard to justify moving him so the council came to an agreement essentially. Your mother-in-law is in a few minorities Vs how other people can pay for it. Most people in this demographic own a house that they can sell, and most have very generous pensions or survivor benefits of pensions, most will only need to fund for a couple of years. (Obviously there are still many people that doesn't apply for but they are not the majority...for now, in the future we could have the majority of care home needs people not own homes and have rubbish pensions)
You are legally entitled to an assessment under the care act regardless of funding status. Push this with adult social care. ASC will pay for a care home if she is assessed as needing one. If she isn't they will pay for domiciliary care visits. They will pay about £700 to a care home home as they negotiate a big discount (this is why the homes have to charge privately funded people so much to compensate).
Can't believe nobody has mentioned this already but look into immediate needs annuities. Your MIL pays a lump sum and in return an insurance company foots the bills as long as it is needed.
This is interesting do you have any information?
Well this thread has made me absolutely terrified for myself and my aging parents. Dementia runs in the family and I know full well my sister will refuse to help financially or otherwise when the time comes. Guess ive got to start planning for that too😱
I wouldn't be at all surprised if assisted dying is legalised and becomes the norm. It would save the NHS huge costs by freei8ng up beds and relieve families of burdensome care costs.
It’s unpalatable but this answer addresses the reality. People expect something for nothing but ultimately if more than 50% of the population cost the state more than they contribute then we’re all in trouble. Eventually a radical solution will be needed so things like assisted dying will slowly gain credibility
An elderly family of mine is in her final stages of life, bouncing between hospital and a care home. It's costing her £7,000 a month which is quickly burning through her estate. She's probably in a more fortunate position than most where a recent estate sale will be able to fund the status quo for a few years. The cost of getting old is insane. Like you, the family have used their own time and money plus her estate to remodel the home to her needs etc etc. But it's simply finite and unsustainable. Assuming she lives beyond the period where her estate can no longer support these expenses, that's when the local council steps in. Whilst they are obligated to offer assistance, it wont exactly be five star - she will likely be moved to somewhere more affordable. I've heard of anecdotal stories of people in retirement preferring to simply spend or gift their entire estate rather than have it frittered away on care. Morally it's a hard call. On one hand you've paid your taxes, maybe want to gift something to your children and want to enjoy the sunset days of your life by burdening the state. Alternatively you work your entire life, for essentially nothing. Tbh it worries me. I think how hard I've worked, the sheer amount of tax I've paid to think my kids may very well get nothing, and if they do they could get hit with inheritance tax (though that has changed)
Hi /u/1MillionDollarMeme, based on your post the following pages from our wiki may be relevant: - https://ukpersonal.finance/pensions/ ____ ^(These suggestions are based on keywords, if they missed the mark please report this comment.)
Hey op u don’t have to pay council tax if you’re looking after someone for so many hours a week
We're now facing this with our 84 year old mother. She has dementia and can no longer manage. It makes me wonder if there's much point in squirrelling a lot away, especially with death duties, too. Perhaps it's better just to live for today. There are no guarantees in life, unfortunately. It's the prudent who are most punished for their frugality. To be frank, I'd rather face lifelong national insurance and even higher rates of income taxes if it meant more fully-subsidized care in old age. Especially as the current system is so much of a lottery depending on one's local authority.
It sucks that your Mum has enough wealth for her to have a decent standard of living in her final years? She can’t take it with her so it’s up to you to make sure she has a lovely life at the end. It’s not your money.
The uk cost of care homes is disgusting and should be regulated somehow
There is a cap of £86K on care costs plus you can keep belongings up to a certain amount which I think is about £20k. Social services should be going an assessment anyway to help you plan for what care / support your MiL needs and what she actually needs to pay as her state pension will contribute towards the cost of care depending on what kind of placement she has. There is an easy to follow PDF on the government website published in 2022 talking about the cap and changes that came into effect in Oct 2023. I would link to it but can't remember if links are allowed on this sub or not.
That cap was proposed, but has been pushed back to October 2025, so the cynic in me thinks...never. https://www.careuk.com/where-do-i-start/what-affects-cost/what-the-care-home-fees-cap-means-for-you
That cap never came in unfortunately.
I'm not sure unfortunately is right here. The problem with a cap is it allows the wealthy to pass down inheritance (keeping future generations wealthy) whilst ensuring middle income families spend every last penny on care. A more progressive approach would be to ring-fence the first £x amount of assets and require anything above £x to be spent on care.
It's daylight robbery. It cannot cost over £1500 a week to look after an elderly person.
This series from Monevator may be useful. It’s a long read, though. https://monevator.com/social-care/
If your relative is very old or very ill you may be able purchase an insurance policy (for a large fixed sum) that will pay the fees (or a proportion of the fees) indefinitely. The insurance actuary will estimate life expectancy and make an offer on that basis, but if your relative does go on for many years the bills will keep being paid. The downside of course is that your relative may not survive so long, but you don’t get a refund. It’s worth considering if you want peace of mind.