Should Old People Pay For Their Own Nursing Care?

[Si Hunt]

The Government will today reveal its long awaited plan to stop pensioners using up their life savings to pay for residential care.

I find this a tricky issue, and one which I am personally affected by. My Nan is 90 and has recently had to go into care. She's now finding that, even by renting out her home, it's not enough to pay the nursing home fees. So eventually she will have to sell her house and everything she owns to pay for her care.

Now, ordinarily and according to my usual views on these things, that should be fair. This is what you work for - not to retire, get your rent paid for you, then die with thousands in the bank. If you want something, be it childcare or nursing care, you should pay for it.

The trouble is, that folk with no savings get their care paid for them. Because you can't chuck old people out in the street if they are broke. So my Nan will be selling her house, but living with someone who didn't work and save to buy one who is getting their fees paid for by the state.

But what's the answer? Perhaps it IS better for the state to pay everyones nursing fees, if they are to pay anyones, rather than only paying for some peoples and making other people use up their savings for the same care?

What do you think?

Si.

[Rob McCow]

It's a really difficult one. Our capitalist society, for all it's benefits, is really not set up to deal with the elderly and those incapable of work.

The care companies make their money, whether it's given to them in benefits or direct from their clients. That's fair enough, they've got their employees to feed etc.

In theory, the elderly should be able to pass any savings on to the next generation, but sometimes the reverse happens and the younger generation ends up paying for the welfare of the elderly. Without wanting to use anybody's parents / grandparents as a specific example, if you have someone living with poor or variable health to the age of 100, then that ends up requiring a lot of care, attention and money.

In the end, the care has to come from somewhere. The pension system should work, but unfortunately the value of money and the cost of care keeps changing.

[SiHart]

The Alzheimers Society have hit out at the Government's plans: http://alzheimers.org.uk/site/script...hp?newsID=1253

[Si Hunt]

It doesn't give much information - it just says it's rubbish without saying why.

Si.

[SiHart]

Lets look at the key facts offered up today:

Funding - Capping costs is considered the "right basis" for change, but there is no commitment to introduce it. Instead, ministers want to look at cheaper options to the £35,000 level suggested last year.
Deferred loan scheme - This will be made available to those who need to pay for residential care. It means the costs they occur can be taken from their estate after death. Interest will be charged.
National standards on access - A universal threshold will be set detailing who can get access to care. At the moment each council can set its own criteria. But the risk is that those councils that are more generous now will end up tightening their criteria under the change.
Moving home - Those receiving care will get the right to transfer their packages to other parts of the country if they move. Currently they have to undergo new assessments, which results in some losing out.

More info on it all here: http://www.bbc.co.uk/news/health-18800601

[Nyder]

"Service Users"?? No Lansley - PEOPLE.

[Paul Clement]

There is no real difference in this situation than there is regarding people claiming benefits vis-a-vis Housing Benefit & Mortgage really. The only reason this is such a public domain topic is because it revolves round the elderly. The government wants people to save and invest their money in property etc... but not solely for the person's benefit. They also look at it for their own financial reasons. A person with property has their own source of income whether through renting or selling, which the government expects them to utilise when times get tough. In the case of the elderly, it's supporting yourself through the care process and in the case of younger people who become unemployed it's the fact that the mortgage interest payments only that get paid while the non-saver in rented accommodation receives all his rent.
Is it fair that two people in very similar circumstances is treated differently, of course not. However, if care was paid through the state for everyone, the national spend on benefits would increase at a time when the government is desperately trying to decrease it. So, the decreases would have to happen elsewhere. A working age of 75 before state pension age comes in could end up a very real prospect, a push for sales of houses when going onto benefit for a long time could become a necessity. Trying to fund one group of people will almost always impact on another group.

Perhaps the question should be, what can be done to ensure more care is undertaken within the family rather than relying on care homes. What financial support could be put in place to enable the sons & daughters of the elderly to be able to look after their parents in their own homes rather than having to send them to live in the care home. Something that would offset or at least partially off set a loss of earnings if someone had to give up work or downgrade their hours to care for their parent. There is already something available called Attendance Allowance, but I'm not sure that really goes far enough as it stands.

[Nyder]

I suppose in the "olden days" you had two, sometimes three generations of families living in the same home, with the younger members looking after the older ones. I guess that scenario has all but disappeared now...

[Rob McCow]

Would this be the good old days where nobody owned their own home and there was one outdoor toilet between 14 people?

It's not so unusual these days for the younger generation to build extensions or find room for the older generation to move in. Towards the end of her life, my grandmother lived very close to my mum and my aunt, so there was no need for them to move in full time. Towards the end she had to go into a home, because the care demands became too difficult. But that was only for the last year or so of her 90-year life.

I don't know what costs were associated with my gran's old age, but I do know that various members of our family spent a lot of time looking after her.

[Si Hunt]

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.

[Rob McCow]

I think you're right. Sadly, full time care is very hard work. It's terrible to describe older people as a burden, but if you can't feed or wash yourself then you need to have that level of care and it costs time and money.

These days, people need to have savings for their old age.

Coming back to your initial argument, that it's not fair if one person saves up money or sells their house to look after themselves in their old age, while another person gets it all from the state - I am pretty certain that the state-provided care wouldn't be of the same quality. The basic costs are always going to be expensive, so there's the same baseline level of cost. But if you have money of your own, you at least have some options.

[Si Hunt]

Not so. As I said, my Nan has recently been in a home, and people in there with her are getting it state funded, while she uses up her savings.

Si.

[SiHart]

It'd a very emotive subject and I don't quite know how I feel about it all. It makes me all too aware of my own mortality.

[Nyder]

I agree with Si Hunt. My Uncle is in a care home and has to pay for it, which has an additional financial impact on my Auntie who still has to pay rent on her house (she's now living there alone which is another tale!), and so is dependent on my Uncle's work pension, all of which is going to fund his care home stay.

[Si Hunt]

It'd a very emotive subject and I don't quite know how I feel about it all. It makes me all too aware of my own mortality.

It does make you realise how important it is to take good care of yourself.

That said, my Grandad is 90 odd and things are suddenly starting to go wrong with him. The only reason can be that he's just... old. You can't go on forever. Sooner or later, you're going to wear out.

It's funny, we all hope that cancer or the speeding bus WON'T get us, but if it doesn't... what will happen to us? I guess we'd all like to die suddenly of a heart attack aged 100, but realistically you tend to just get weaker and frailer until you can't look after yourself anymore. It's all rather frightening if you have your independence.

Si.

[Jon Masters]

It all boils down to the familiar debate of state vs personal - what do we think as taxpayers we should be funding and what do we not want to pay for ? As a country do we want a National responsibility for how we look after the elderly, or do we leave them to their own devices ?

The sad truth is that our success in treating previously fatal conditions is bound to lead to an increasing number of people who will need large amounts of support before they die of, effectively, old age. Paying for that support relies on an increasing population in work. Unfortunately the joined up thinking required to solve some of these problems is beyond the ability (and the will) of most governments.

[Si Hunt]

If everything else was sorted out, all the problems would cancel each other out. If enough people were working, they would all have pension schemes, and everyone would be able to look after themselves in old age.

Sadly the system is screwed every which way so the problems escalate down.

Si.

[SiHart]

This is one of the reasons why i think we need to work longer. I know that's not popular, but with everyone living longer you can't expect the state to pay for your retirement when that retirement could be 30+ years.

[Si Hunt]

I agree. I made sure I had a pension scheme from an early point. My first company didn't offer one, so I took out a personal one instead. The trouble with pensions is that, of course, investments can fluctuate. There've been months when I've got my statement and hundreds and dissapeared off it in weeks! It's quite disheartening.

I've no desire to give up work, I'll keep going forever! That said, eventually I'd love to work part time, in a shop or something close to home. That would be a lovely way to finish up my days. I never want to quit work entirely.

Si.

[Jon Masters]

This is one of the reasons why i think we need to work longer. I know that's not popular, but with everyone living longer you can't expect the state to pay for your retirement when that retirement could be 30+ years.

Except that has a big impact on the number of jobs available and therefore unemployment. It's like when the TV to report about the fit 80 year old who is still working full time, and in the next report feature young people who are stuck on benefits because they can't find work.

The pension idea (or indeed National Insurance even more so) should work in theory, if the money you paid in was earmarked for your own use in the future. Instead the government spend the money you pay in now on other people who need it now. And even if it was 'your money', it's easy to see how the economics of the future would leave you in a 'Sunmakers' style situation where you could never meet your debts.

ETA: I must be the anti-Si - I've been wanting to never work again for at least the last 10 years !!

[Anthony Williams]

Except that has a big impact on the number of jobs available and therefore unemployment. It's like when the TV to report about the fit 80 year old who is still working full time, and in the next report feature young people who are stuck on benefits because they can't find work.

In theory, if everyone worked longer, more people would have disposable income, and thus spend more, driving up consumption and encouraging the retail sector to take on more people. In theory.

Anyway, to the original point, I wholeheartedly agree with Si. My Grandmother also recently went into a home (I wonder if it was the same one, knowing that they voth live in Clacton!), and is in exactly the same situation. She scrimped and saved her entire life, never ever spending much on herself, and never taking a penny from the State. So, what happens now? She has to pay for her own care, because she has "too much" in savings, while those around her who've not been frugal and spent every penny that they've ever earned are bankrolled by the State.

Is it my imagination, or is that simply not right?

[Si Hunt]

My Nan's in with the nuns. She's quite lucky, it's clean and they look after her well.

It's a bit like God's waiting room though. She had a friend who promptly had a heart attack and died in the middle of bingo. You're gonna get that though.

Si.

[Anthony Williams]

My Nan's in with the nuns. She's quite lucky, it's clean and they look after her well.

Ah definitely a different home, though. That said, Clacton's the Costa Geriatrica these days, so there must be about 1000 nursing homes in the surrounding area.

It's a bit like God's waiting room though. She had a friend who promptly had a heart attack and died in the middle of bingo. You're gonna get that though.

That's the sad reality of nursing homes - you suddenly realise that all these poor old dears are basically there, waiting to die. My grandmother desperately wants to go home, but she's not yet well enough to go home - she needs to get her strength up through getting her weight up, and she refuses to do that. It's a pretty sad situation, really

[Si Hunt]

My Nan was like that. She couldn't wait to get home and she detested being in care. When eventually the time came, she sat there and suddenly her house seemed so big and dangerous and she seemed so small. She didn't like it. She wanted to go straight back to the home, so she did. You may find this happens to your Nan.

Si.

[Rob McCow]

Is it my imagination, or is that simply not right?

Possibly, but then again what's the alternative? You have to do something with elderly people and the state can't afford to pay for all of them. Private industry isn't going to be interested as there's no way you can make money out of caring for an old person. That's not an investment. Charities may do something, but they only have limited power.

With the elderly, it's important that they do have some kind of activity while they're being cared for. Whether it's drawing, dancing, going out for walks in the park or even having their nails painted. That can make the difference between waiting for death and having a life.