Should Old People Pay For Their Own Nursing Care?

[Si Hunt]

There are topics here around what we, as a society, should feel obliged to do to help people. Should we feel obliged to make sure all old people have a roof over their heads? Why? There are plenty of young, homeless people. And often weather someone lives or dies from a disease depends on money - those cases where the cancer-curing drug has been refused to a sufferer on the grounds of cost. It seems that simply being old entitles people to be looked after by the state with no questions asked.

Si.

[Anthony Williams]

There are topics here around what we, as a society, should feel obliged to do to help people. Should we feel obliged to make sure all old people have a roof over their heads? Why? There are plenty of young, homeless people. And often weather someone lives or dies from a disease depends on money - those cases where the cancer-curing drug has been refused to a sufferer on the grounds of cost. It seems that simply being old entitles people to be looked after by the state with no questions asked.

Indeed. One of the charities that I supported while I was living in the UK was the Royal Masonic Benevolent Institute. That one looked after elderly Masons and their elderly relatives, through a number of homes funded entirely by charity efforts by various lodges etc. - no funding by the taxpayer at all.

If the Masons can look after their own, why can't other sectors of society?

[Rob McCow]

Why? Because 1) they've paid taxes all their lives, 2) the state made a promise to them 3) because they can't all look after themselves 4) because to not look after them is obscene 5) because one day we'll all be old too 6) it's our moral obligation 7) not everyone is fortunate enough to be in a position to save money for their old age 8) not everyone is fortunate enough to have a family wealthy enough to look after them 9) because we haven't legalised euthenasia yet.

Also, very few people are (lucky enough to be?) members of the Masons, or even a society like the Masons.

Sorry - quick response because I should be working.

[SiHart]

Well there are always those who, through no fault of their own have lived in poverty, that have slipped beneath the radar of society, that through no fault of their own simply don't have the means to support themselves through old age. I come across them all the time and it's often not that they want handouts, it's that they NEED handouts because they simply haven't got anything. What do we do with them, cast them out to fend for themselves?

It's all very well to sit here and say everyone must pay their way, but that doesn't work in the real world, because we haven't made people provide for themselves for their old age and because, as I said, there will always be a sector of society that can't support themselves.

Maybe you've never come across these people, but they exist and we can't ignore them. I wouldn't want to live in a society that does that. You might say it's unfair that some have to pay and some don't, that some are looked after by their families, some aren't, but that's life and well until there's a sea change in attitudes to old age in all of us, this is as fair as it can be.

[Anthony Williams]

Why? Because 1) they've paid taxes all their lives, 2) the state made a promise to them 3) because they can't all look after themselves 4) because to not look after them is obscene 5) because one day we'll all be old too 6) it's our moral obligation 7) not everyone is fortunate enough to be in a position to save money for their old age 8) not everyone is fortunate enough to have a family wealthy enough to look after them 9) because we haven't legalised euthenasia yet.

Steve - I agree with you, to an extent. The old SHOULD be looked after. It's just a shame that more often than not, the burden of that falls on the shoulders of people who have to sell their house and most of their possessions in order to make sure that they have to be looked after, because they've just saved a little "too much" to get any funding from the State. And I don't believe that that burden should necessarily fall on the State, either - I'm all for charitable institutions looking after the elderly.

Also, very few people are (lucky enough to be?) members of the Masons, or even a society like the Masons.

Well, I was just using my experiences with Masonic charities as an example. There could be a large number of charities which would look after the elderly, rather than the burden falling on the elderly/their families/the state. I honestly think that we should look after our own before giving money to aid Africa - after all, there are plenty of people in the UK that, for whatever reason, are unable to look after themselves.

[Anthony Williams]

Maybe you've never come across these people, but they exist and we can't ignore them. I wouldn't want to live in a society that does that. You might say it's unfair that some have to pay and some don't, that some are looked after by their families, some aren't, but that's life and well until there's a sea change in attitudes to old age in all of us, this is as fair as it can be.

Si, I agree - but it's far from an ideal situation. Why should some have to pay and others not? There will always be people who've fallen on hard times, while some have simply just not been frugal and spent their way into poverty through trying to fund lifestyles that they simply cannot afford. It's virtually impossible to differentiate between the two, and it's certainly not fair that those who have been careful and frugal have to fund their own way, while people in the latter of those two categories don't. But is there a better system? I suspect not, sadly. Doesn't mean that what we currently have is exactly fair, either.

[SiHart]

True. But currently what other way is there? How can you make it fair? You can't, not without a hell of a lot of chnages to attitudes... it won't happen quickly or quietly and I don't think I'll ever live in a society that's totally fair. It's a compromise, and the bast we can do at the moment.

[Anthony Williams]

True. But currently what other way is there? How can you make it fair? You can't, not without a hell of a lot of chnages to attitudes... it won't happen quickly or quietly and I don't think I'll ever live in a society that's totally fair. It's a compromise, and the bast we can do at the moment.

I agree with you there, Si. Attitudes do need to change, in general. For three years, my mother worked as a debt management consultant. And she found many lower-class families who were heavily in debt - a lot of them were unemployed and claiming maximum state benefits. They all had flat-screen TVs, and their children all had designer trainers. And they were all up to their eyeballs in credit card debt.

And yet, if things remain the way that they are, when they're in their 80s, and in need of care, they'll get it free of charge on the state, regardless of how many County Court Judgements or declarations of bankruptcy they have to their name. We talk of social responsibility, but where is the social responsibility of such people?

[Jon Masters]

There can never be a 'one system fits all' because there are too many variables involved.

Not everyone who cannot afford to pay for care has fallen on hard times or frittered their money away in hedonistic lifestyles.
Both my grandmothers lived much longer than their husbands , lived in rented accomodation, worked in poorly paid jobs after their families left long up to their retirement. One had to go into warden controlled accomodation for about the last 6 years of her life and lived off her meagre state pension and benefits. In no way would you be able to describe her lifestyle as luxurious, and what little savings she had she wisely spent to make her last few years a bit more comfortable.

Similarly, as has been argued in other topics, why should my taxes and NI contributions be used to pay for this ? Neither of my parents lived long enough to need care, and yet they worked all their lives and paid in plenty to the system. For a variety of reasons I'm unlikely to reach a ripe old age (thanks, genetics !) so can I have all my money back if I don't make it ?

And sometimes you wonder why people think they should have their cake and eat it. Some children of elderly people seem to feel the state should look after their relatives when they can't or won't , but don't think they should give up the house or savings they might inherit from that relative when they've gone. When my Dad became ill I made it very clear that I didn't need to inherit anything from him, and that he should use his resources however he saw fit. If someone who lives alone in a house they own has to go into care and is never going to be able to live at home again, why should that asset not be freed up to pay for their accommodation ?

Every system is potentially unfair. Unless you restructure the whole of society, it will continue to be so.

[Zbigniev Hamson]

If someone has saved all their lives and has "too much" in savings, are reaching the ends of their lives and need to move into a home that costs money, what is the thinking behing the idea that they SHOULDN'T pay for it? What else are they going to use those savings for at this point? I agree that it isn't "fair" as such if some have to pay and some others don't, but I can't see what's so fundamentally wrong about expecting someone who has lots of money stashed away to pay for their own care if it's possible.

[Si Hunt]

As we've discussed, it's not unfair per se. If everyone could do it. The unfairness is when someone with savings has to pay for the same care as someone without anything.

Most debates on here roll back to the same thing - should people with savings pay more for the same thing as people without any?

Si.

[Anthony Williams]

Most debates on here roll back to the same thing - should people with savings pay more for the same thing as people without any?

Exactly.

Basically, why should someone who has been frugal and contributed a lot to the state through taxes have to pay for themselves, while someone has only ever claimed off the state and never paid anything in doesn't? THAT is grossly unfair.

Yes, there are people who've fallen on hard times, too. I totally acknowledge that. But my point is that in a truly fair society, either everyone would get their care paid for when they're elderly, or no-one would.

[Si Hunt]

I guess the counter argument to that is, in a fair society everyone would start off with the same opportunities, but not everyone does.

Si.

[Jon Masters]

I guess the counter argument to that is, in a fair society everyone would start off with the same opportunities, but not everyone does.

Si.

Indeed, and everyone would be paid exactly the same wage per hour of work done regardless of the job, and would have to pay exactly the same for everything they bought, no matter where they lived in the country.

Probably the only "fair" way would be everyone would have to pay for their own care, and if they couldn't afford it the bill would be passed on to their relatives. Those relatives could then decide whether they would rather give up inheriting their relative's savings to pay for the care. Expect the return of the giant Victorian family where you try to have as many kids as possible to keep you in your old age (tough luck if you can't have kids).

Maybe you could take out 'old age' insurance instead of life insurance to pay for your care - though no doubt there would be a maximum you could claim.

Of course, anyone without living relatives of any kind would have to go to the trouble of getting themselves sponsored by private companies (Stanna pensioners ?), beg for charity money or hitch hike to Switzerland. Or just turn the heating off one Christmas. Not a very dignified old age though.

And don't forget your Death Taxes, Citizen !

[SiHart]

I guess the counter argument to that is, in a fair society everyone would start off with the same opportunities, but not everyone does.

Si.

Well quite and this is why the present system is a compromise, that will make those unlucky enough to have savings pay. It's not fair, but no system ever will be.

[Zbigniev Hamson]

Basically, why should someone who has been frugal and contributed a lot to the state through taxes have to pay for themselves, while someone has only ever claimed off the state and never paid anything in doesn't? THAT is grossly unfair.

Well, the whole point of the welfare state or any sort of socialism in general, is that society as a whole contributes to some sort of general pot which can be accessed by the most needy when they need it. Regardless of how well the whole system is handled, by the very definition it will alway be the people with the most who pay more into the system than they get back, while the people with the least get the most benefit from it. How fair or unfair you see that depends largely on where you stand on the political spectrum.

I do think it's quite wrong to suggest that anyone who doesn't have any (or enough) savings to pay for their own residential care MUST be someone who has only ever claimed off the state and never contributed though.

[SiHart]

Turning the question round to Ant and Si, just how would you make the system "fair"?

[Anthony Williams]

Turning the question round to Ant and Si, just how would you make the system "fair"?

I'm not really sure there's an easy way of doing it, to be honest. As I've tried to indicate (probably unsuccessfully), I don't think the current system is fair, I know what a fair system would be, but I don't think there's any way to implement it.

[Zbigniev Hamson]

You can make the system "fair" by not giving out any freebies and allowing people only the care they can afford themselves, resulting in the poorest section of society basically being left to fend for themselves.

Or

You can make the system "fair" by providing an equal service to everyone, regardless of their wealth, resulting in the richest section of society subsidising the poorest.

Either one of these options will still be seen as unfair by a large group of people, and anything inbetween probably won't be seen as fair by anyone at all. I don't think you can have a universally "fair" system because there's no universal agreement on what "fair" means. It's probably better to try and think in terms of decency rather than fairness. I would say that it's decent that those who can afford to pay are expected to pay, and it's also decent that those who can't afford to pay (for whatever reason) aren't left to rot as if they are worthless. It's not fair but it seems the right thing for a society to do.

Of course, it would be even nicer if free care could be made available to everyone, even those who CAN afford it, but then that will obviously mean an increase in contributions or taxes, which the richer will pay more of, so it's still unfair.

Basically it boils down to capitalist ideals versus socialist ideals, how the two are equally fair/unfair in different ways, and how they don't and never will marry together very well. So have fun trying to sort that out

[Si Hunt]

Hang on, just to note that I've not advocated any unfair way of doing things. My post just speculated some questions. I really don't know if the current system is fair or how to make it so.

Si.

[Paul Clement]

I guess, with the greatest respect (because my parents fall into this bracket) people today expect a higher standard of living which doesn't include devoting their retirement to full-time care of a parent. In the old days they'd just cope, but it's sort of not an option these days in the same way an outdoors loo is not an option, even though you'd survive if you had to use it.

Si.

Si, is it really that reason why people wouldn't care for their parents in their old age? It seems a very self-centred reason to me. I could fully understand someone saying they couldn't afford to provide the care because they would have to give up work and would therefore be unable to support themselves let alone their parent. It seems even more realistic that people would be unable to care for their parents if they had complex needs that it would require a professional carer to deal with, such as dementia. However I'd hate to think we had grown into a society where the elderly were viewed as burdens by their children just because the children would be unable to afford that foreign holiday, new car or other luxury. After all, these are the same parents that worked hard and cared for that child for 18+ years without feeling they negatively impacted on their standard of living.

I still think a financial package available to people to care for their elderly parents, something that stops them from having to lose the money they need to support themselves, would mean more people would provide the care themselves until a point was reached where they were incapable of doing it due to rising levels of caring support required.

As to what would be fair, I think I would have to agree with the comment above that said we could have a fair system or a decent system. Personally, I would go with the decent system. It's not about wasting/spending money through life. For a lot of people they will work their lives at close to national minimum wage, living their everyday lives in a very much hand to mouth way. The idea of saving something for retirement doesn't enter the equation when every penny you get just about manages to pay the bills. They work in jobs that don't pay a lot, don't have the opportunity or sometimes ability to do a higher paying job. Should they be penalised for that in their old age? If they hadn't done those jobs, things would have been a lot harder on those in better paid work who would have suddenly found themselves with nobody cleaning up the supermarket or serving on the tills, sweeping their streets or slogging away in factories making their much needed items.

[Si Hunt]

Si, is it really that reason why people wouldn't care for their parents in their old age? It seems a very self-centred reason to me

I don't know. I'm being honest here and thinking of my Mum and Dad and my Nan. Yes, it's horrible to have to ask if they would look after her, and obviously if all the money ran out they WOULD because they wouldn't just cast her out (!). But, you know, it's not just a merry game of "granny in the spare room" is it. We're talking about taking an elderly lady to the toilet, washing her, goodness knows what else if they can't cope on their own. It's not dignified, and it's not pleasant. I don't think that makes them self-centred to want to avoid this. I suppose it's as much about the dignity of the old person as anything; imagine your son/daughter having to wash you.

I guess what I was driving at was that today's generation of parents would probably hope/expect not to have to do that unless it was absolutely necessary. I suppose you'd pay more for it not to happen. I don't know of many situations where a grandparent has moved back in with the son/daughter these days. In fact, I can't think of one. Where-as in previous times it was commonplace.

Si.

[Paul Clement]

I don't know. I'm being honest here and thinking of my Mum and Dad and my Nan. Yes, it's horrible to have to ask if they would look after her, and obviously if all the money ran out they WOULD because they wouldn't just cast her out (!). But, you know, it's not just a merry game of "granny in the spare room" is it. We're talking about taking an elderly lady to the toilet, washing her, goodness knows what else if they can't cope on their own. It's not dignified, and it's not pleasant. I don't think that makes them self-centred to want to avoid this. I suppose it's as much about the dignity of the old person as anything; imagine your son/daughter having to wash you.

I guess what I was driving at was that today's generation of parents would probably hope/expect not to have to do that unless it was absolutely necessary. I suppose you'd pay more for it not to happen. I don't know of many situations where a grandparent has moved back in with the son/daughter these days. In fact, I can't think of one. Where-as in previous times it was commonplace.

Si.

But from what you've just said, Si, it would seem it would be the care side of things that would prove the difficult thing to have to overcome for a variety of reasons, which I would fully understand. That's a far cry from not wanting to because it would cramp your lifestyle, which seemed to be what you were implying people would feel more nowadays. Yes, I'd agree that caring for your parents with very intimate personal care responsibilities isn't something that would be easy for either parties to come to terms with. I could fully understand that being a reason to have the care come from a professional source.

I think you would be surprised about how many people are undertaking care of their parents though. Certainly, when working as an adviser for Income Support customers, I came across a vast amount of people who were claiming the benefit as they also received Carer's Allowance for a father or mother who was in receipt of Disability Living Allowance (under 65) or Attendance Allowance (over 65). Obviously not all of these people lived at home with their children, with a large number being cared for in their own homes as a way of enabling them to retain that certain level of independence. Having said that, few of these would have involved someone who is the age of your Nan, with most being parents in their 60's or 70's.