Parents going into care - considerations

[KarenG]

Hi all

Like for many the effect of the pandemic has had an extreme impact on my in laws and we are now looking at care options. Is there any advice or considerations we should have in mind?

Mum in law has what her GP describes as ‘end game’ dementia and father in law is very frail and barely able to care for himself let alone her.

We have got carers going in daily and are waiting to hear back from Social Services for the next steps - anything else we should do?

(We have Power of Attorney for FIL but couldn’t get it for MIL as she was deemed to not have capacity, so I don’t know what impact that has on anything!)

Thanks for any thoughts or advice.

Karen

[Mary A]

Visit the care homes in the locality, if you can - covid and lockdown may prevent this now?
A friend and I visited together as we were both in the same position, this was in 2019. We did not make appointments but avoided meal times as we knew they would be busy - we're both nurses.
We both chose the same one for our Mams but for different reasons. Initially we both thought it was too clinical but after some reflection decide it was the best. It is a new build and council run, all ensuite single rooms with large and small communal areas. Best staffing ratio of the ones we visited.
It was a fight to get Mam a place but we got there in the end, she was overwhelmed and tearful when she arrived as she thought it was beautiful.
They ended being 3 doors away from each other my sister's and I would chat to Norah and Chris to my Mam when visiting.
Sadly my Mam suffered a stroke in June and died 10 days later, she remained in the home during this time with excellent care to her (and us).
Norah is still there, problems with visiting during lockdown but I think that has been a national issue.
Wishing you all the best - It's such a difficult time x

[cornishfrogboy]

I am writing this after discussing it with my Dad.

We went through similar from November 2018, when Mum went in to care with Dementia until my Mother eventually passed away in March of 2020. It was totally expected, but she was listed as Covid anyway, despite never being swabbed(to say that I am unhappy is an understatement).

On a positive note, my Dad who is 87 and suffers from Neuropathy, COPD, Prostate and numerous other ailments, weighing 8 stone despite being 6’ 6” , Has become relatively revitalised since Mum went into care. With hindsight, it was clear that he was unable to cope with Mums advancing Dementia and it took a considerable toll on him. He has now wound the clock back around 4 years and whilst I feared that he may himself have required residential care, he now lives perfectly happily with a gardener visiting for 3 hours a fortnight in the growing seasons and a cleaner for 2 hours a fortnight.

The question.
We were fortunate that Mum and Dads GP advised me to get Lasting power of Attorney in place (health and financial) with urgency. In a remarkable coincidence, Dementia was diagnosed around a fortnight after he was aware that the documents were in place. This was crucial in the later care of my Mum as it meant the home could deal directly with my brother and I when making decisions re her well-being.

The day that Mum went in, we helped Dad with the finances. He cashed in every savings account that he had, leaving him with £128k in the bank. Aware that Mum owned half of their home and that in time, the Council might come sniffing when her savings reached £23,500, we did the following..
1. A new account was opened for Dad and he put £64k in it (effectively a financial Divorce). To this account he moved all direct debits that related only to him, as they would continue to be his responsibility. Dads pensions were moved from the joint to this new account.
2. This left the former joint account with £64k. As Mum still had a 50% interest in the House, Half of all house bills were subsequently taken from this account, heating, gardener, cleaner, council tax, the lot, as she had an ongoing financial responsibility to protect her half of the asset. All Car bills came out of the account as my Dad only kept his car in order to visit her at a Care Home 11 miles away. He hardly needed it for his other journey, 1 mile to Asda and in any case, all trips to town, hospital or surgery are courtesy of either Taxi or supportive son (singular).

When Mums assets reached down towards £23,500, we informed Care home and Council as the bill would soon become the Councils responsibility until such time as Dad predeceased Mum and they could go after half of the House as collateral.
We had a visit from the Council when I presented them with a Statement of everything that we had done, the reasoning and also a spreadsheet of all deductions from the former joint account. The Assessor declined Statement and Spreadsheet, commenting that we had been unusually honest in our actions and that he wished it were the same way with some others. We signed some papers in order that Mums attendance allowance and Pension Credits could hence forward go to the Council.

Mum died 2 months later and we then went through the standard procedures, aided massively by the fact that my Brother and I had power of Attorney. As sole inheritors, we split her Money between us as Dad certainly didn’t want it, being intent instead on reducing his own Bank balance towards £23,500. Brother and I now own half of Dads house and that part is thus protected. Dads half clearly is not in the event that he himself requires Care.

It was a totally traumatic time and the big positive was the GP’s wise advice that led to our hasty Power of Attorney work. The other hopeful for your good self was the resurgence in the Health of my very frail Dad, once Mum went into care.

As a footnote, we worked very hard with the care home, chocolates, flowers, kindness, understanding, a reference note when an allegation was made against a member of staff by another, disaffected one etc etc. It was notable that the bill for care, initially set at £800 per week did not increase whilst we were paying, despite her becoming doubly incontinent, aggressive, reliant on a hoist etc etc. On the day that we ceased paying, a fresh assessment raised the fee (payable by the Council) to £1650/week.
Top tip.. Stay sweet with the Care Home!

[Lola]

My sis and me spent time looking at various places for our Mum and chose a small friendly home close to both of us. A good question to ask is staff is how long they have worked there, a high turnover of staff is concerning. The care quality commission websites is useful.

[Tweety1]

Originally Posted by cornishfrogboy

I am writing this after discussing it with my Dad.

We went through similar from November 2018, when Mum went in to care with Dementia until my Mother eventually passed away in March of 2020. It was totally expected, but she was listed as Covid anyway, despite never being swabbed(to say that I am unhappy is an understatement).

On a positive note, my Dad who is 87 and suffers from Neuropathy, COPD, Prostate and numerous other ailments, weighing 8 stone despite being 6’ 6” , Has become relatively revitalised since Mum went into care. With hindsight, it was clear that he was unable to cope with Mums advancing Dementia and it took a considerable toll on him. He has now wound the clock back around 4 years and whilst I feared that he may himself have required residential care, he now lives perfectly happily with a gardener visiting for 3 hours a fortnight in the growing seasons and a cleaner for 2 hours a fortnight.

The question.
We were fortunate that Mum and Dads GP advised me to get Lasting power of Attorney in place (health and financial) with urgency. In a remarkable coincidence, Dementia was diagnosed around a fortnight after he was aware that the documents were in place. This was crucial in the later care of my Mum as it meant the home could deal directly with my brother and I when making decisions re her well-being.

The day that Mum went in, we helped Dad with the finances. He cashed in every savings account that he had, leaving him with £128k in the bank. Aware that Mum owned half of their home and that in time, the Council might come sniffing when her savings reached £23,500, we did the following..
1. A new account was opened for Dad and he put £64k in it (effectively a financial Divorce). To this account he moved all direct debits that related only to him, as they would continue to be his responsibility. Dads pensions were moved from the joint to this new account.
2. This left the former joint account with £64k. As Mum still had a 50% interest in the House, Half of all house bills were subsequently taken from this account, heating, gardener, cleaner, council tax, the lot, as she had an ongoing financial responsibility to protect her half of the asset. All Car bills came out of the account as my Dad only kept his car in order to visit her at a Care Home 11 miles away. He hardly needed it for his other journey, 1 mile to Asda and in any case, all trips to town, hospital or surgery are courtesy of either Taxi or supportive son (singular).

When Mums assets reached down towards £23,500, we informed Care home and Council as the bill would soon become the Councils responsibility until such time as Dad predeceased Mum and they could go after half of the House as collateral.
We had a visit from the Council when I presented them with a Statement of everything that we had done, the reasoning and also a spreadsheet of all deductions from the former joint account. The Assessor declined Statement and Spreadsheet, commenting that we had been unusually honest in our actions and that he wished it were the same way with some others. We signed some papers in order that Mums attendance allowance and Pension Credits could hence forward go to the Council.

Mum died 2 months later and we then went through the standard procedures, aided massively by the fact that my Brother and I had power of Attorney. As sole inheritors, we split her Money between us as Dad certainly didn’t want it, being intent instead on reducing his own Bank balance towards £23,500. Brother and I now own half of Dads house and that part is thus protected. Dads half clearly is not in the event that he himself requires Care.

It was a totally traumatic time and the big positive was the GP’s wise advice that led to our hasty Power of Attorney work. The other hopeful for your good self was the resurgence in the Health of my very frail Dad, once Mum went into care.

As a footnote, we worked very hard with the care home, chocolates, flowers, kindness, understanding, a reference note when an allegation was made against a member of staff by another, disaffected one etc etc. It was notable that the bill for care, initially set at £800 per week did not increase whilst we were paying, despite her becoming doubly incontinent, aggressive, reliant on a hoist etc etc. On the day that we ceased paying, a fresh assessment raised the fee (payable by the Council) to £1650/week.
Top tip.. Stay sweet with the Care Home!

See more...

CFB had your mum continued to be in the carehome would the council have paid the bills but would they have taken half the house? If yes I assume your dad would be able to live there then you would be presented with a bill once he was no longer with you?
Totally shocking I agree they can take your pensions but to take your savings and house is horrendous. Happened to my FIL but his pensions mostly covered the cost!
Really aggravates me as someone who has worked hard all their lives and has a bit of money put by has to use it whereas someone could not have worked a day in their lives and gets it all paid where is the fairness? Hence take the pensions but nothing else!
It’s great that your Dad is managing at home and is so independent .

[cornishfrogboy]

Originally Posted by Tweety1

CFB had your mum continued to be in the carehome would the council have paid the bills but would they have taken half the house? If yes I assume your dad would be able to live there then you would be presented with a bill once he was no longer with you?
Totally shocking I agree they can take your pensions but to take your savings and house is horrendous. Happened to my FIL but his pensions mostly covered the cost!
Really aggravates me as someone who has worked hard all their lives and has a bit of money put by has to use it whereas someone could not have worked a day in their lives and gets it all paid where is the fairness? Hence take the pensions but nothing else!
It’s great that your Dad is managing at home and is so independent .

See more...

They would have valued the house and placed a charge against it.

If Dad had died first, then I would have then sold the house, put Mums half in a bank account and resumed paying either the Council (so they could pass it on) or direct to the care home.

If Mum died first, then no claim on the House by the Council as long as Dad remained in it.

Clearly Mum was medically ill (Vascular Dementia is recognised as an illness, just like any other), then why is her care not covered by the NHS?
I appreciate that the NHS cannot afford to pay for all such care, so surely National Insurance should rise to meet the bill?

[KarenG]

Hi all thanks for your good wishes and advice and particular thanks to CFB and his dad for sharing their experience.

I have a small glimmer of hope that MIL going into care first (and she is the priority) may mean FIL can continue in their home a bit longer with appropriate support. But right now he has given up on life (literally) and I think it’s possible that when MIL gets a place - hopefully soon - he may just go to sleep. He keeps repeatedly telling my DH this anyway

I will take all of this onboard thank you.

DH is an only child and the burden is quite heavy.

We are worried about their ongoing safety

[Tweety1]

Originally Posted by cornishfrogboy

They would have valued the house and placed a charge against it.

If Dad had died first, then I would have then sold the house, put Mums half in a bank account and resumed paying either the Council (so they could pass it on) or direct to the care home.

If Mum died first, then no claim on the House by the Council as long as Dad remained in it.

Clearly Mum was medically ill (Vascular Dementia is recognised as an illness, just like any other), then why is her care not covered by the NHS?
I appreciate that the NHS cannot afford to pay for all such care, so surely National Insurance should rise to meet the bill?

See more...

Oh I thought they would have put a charge on anyway. I thought they would have ploughed through everything until only the £23k was left inc her half of the house! I just thought Dad would be allowed to live it and then when he died it would be taken from the estate.
It’s all a mindfield...

[cornishfrogboy]

Originally Posted by Tweety1

Oh I thought they would have put a charge on anyway. I thought they would have ploughed through everything until only the £23k was left inc her half of the house! I just thought Dad would be allowed to live it and then when he died it would be taken from the estate.
It’s all a mindfield...

See more...

That is not how it was explained to me by the Council assessor. He could not even look at it whilst my Dad was resident.
This was borne out by the fact that in the final figures presented, having taken over the finance in November 2019 and Mum passing in March 2020, there was no further monetary requirement from them. They paid up with the Care Home and Mums money remained in the family. The Funeral and other expenses were deducted and the remainder split.

I would suggest a chat with Citizens advice.. or your Council depmnt responsible would allay your fears and remove me from having given legal advice on which you acted...

[Guest]

The rules on charging vary by country and potentially then varied by rate by local authority so one size may not fit all. Which country do your in laws live in Karen?

Have a look at age concern. They have good info sheets on financial assessment and charging.

The assessment of care is critical and the extent to which your mum needs nursing support rather than care. One falls within NHS and the other to Local Authorities. There is a big difference in next steps.

It's a hard stage of life and a hard decision to help make for people you love. But it's also a horrible disease, for the individual and the family. Dementia UK has some specific advice worth reading too.

Best wishes to you all. I am not there yet but it's a journey I will travel in the next few years 😢 so I am starting to dig around and learn now.

Thanks to CFB and his dad for his frank and open post.