The looming care crisis for the elderly

Thanks to funding cuts from councils, many families face mounting bills for looking after their elderly relatives.

It was widely acknowledged after George Osborne announced his spending review that pensioners had come out relatively well. The basic state pension was left intact, free from the cuts. Indeed, there have been suggestions that it could rise to £140 a week to all pensioners in the years ahead.

But the government cuts are far too wide-ranging to leave such a large group as pensioners unaffected, and now we know one area where they are going to be badly hit: their care when they are elderly and infirm.

In a BBC survey released last week, more than half of the English councils questioned said that they were concerned about how they would fund the service to care for elderly or vulnerable adults at home.

This came on the back of news that care home prices have risen by an average of 20% over the last four years.

A whole generation of pensioners could be left struggling to provide for their care as a result of both the government’s cuts and the rising cost of care. And it may well be their children – in their 40s or 50s – that have to take on the burden.

Care at home – preferable, but is it affordable?

There’s a lot to be said for helping pensioners to live in their own home for as long as possible.

Most importantly, pensioners themselves tend to prefer the independence of living at home.

If they begin to struggle mentally or physically, then they often feel safer in an environment that they know and recognise. Their friends are likely to be nearby. They retain a sense of responsibility, as they can keep doing easy household tasks (washing, cooking etc), even if they can’t manage to get out of the house.

On top of that, care at home is much more affordable than paying for an elderly person to go to a care home.

The average cost of a care home is £36,000 a year, with the most comfortable costing close to £50,000 a year. That’s substantially more than sending a child to even the most exclusive public schools.

Care-at-home services generally charge far less for daily visits to a home. Carewatch generally charges between £10 and £13 an hour for a carer to visit an adult in the morning or evening (although it can go higher than this, depending on the circumstances). Assuming two visits a day, this equates to a payment of between £7,300 and £9,490 a year.

Age UK estimates that there will be one million pensioners requiring care at home by 2012, yet the recent cuts make it highly uncertain whether all councils will be able to accommodate their needs. Pensioners may need to rely on their savings or their families in order to get their care service of choice, whether they are in their own home or in a care home.

So if it’s not care at home, what then?

Care homes are clearly a booming business. Their fees can be astronomical, and all pensioners (as well as their families) at least need to consider how they would finance a stay in one of these homes if it becomes necessary.

When looking at care homes, though, there are obviously more factors to bear in mind than price. What are your relative’s needs? Do you need lots of hands-on nursing care, or are you dealing with conditions like Alzheimer’s or dementia? Do you want the care home to be near your relative’s family, so you can visit them regularly?

You can survey the options out there with comparison sites like Compare Care Homes and Bestcarehome.co.uk.

What can the government do to help?

It’s unwise to rely on the government to cover all of your care costs. With increasing numbers of people requiring care facilities, the government is hard-pressed to take on fully the costs of only a small minority, and that will not be changing in the near future.

That said, there are lots of ways that the government does help people going into care.

Before your relative goes into any care home, there must be a needs and a financial assessment made by your local council.

If you live in England and own less than £23,000 in capital, the council will contribute to your care. This £23,000 can come from your savings, shares or property. If you boast in excess of £23,000 then you will have to meet the costs of your own care.

Essentially, if you own your house, then you will be put in this category, although this might not be the case if your partner still lives in this house. In that case, your savings and investments would have to get over the £23,000 benchmark for you to miss out on support from your council.

Bear in mind that while it is a £23,000 barrier in England and Northern Ireland, the equivalent level in Scotland is £22,500 and in Wales it is £22,000.

There are several forms of benefit that your relative could be eligible for if they receive care in a care home.

Attendance allowance is a tax-free benefit aimed at those 65 or over who need someone else to look after them. You can get one of two rates (£47.80 or £71.40) depending on the severity of your condition.

Registered nursing care contributions (RNCC) are provided by the NHS to people that need nursing care in care homes. This is also available to people with dementia. The current level is £108.70.

NHS Continuing Care is a programme where all of your care needs are covered by the NHS, but you will not be surprised to hear that it’s a minority (under 47,000 in March 2009) that are eligible.

The decision is made on the basis of the nature of your condition, as well as its complexity (in treatment), its intensity and its unpredictability. You have to apply for this scheme, and you can appeal if you’re not successful. For more information on NHS Continuing Care, see this leaflet from the Alzheimer's Society.

Facing the future

As someone whose grandparents have recently used both care-at-home and care homes, I know how difficult a process it can be. Working out how to care for elderly relatives is likely to become an increasingly pressing issue for more and more people in the coming years.

It’s crucial that at the very least families begin to consider how they will pay for the care of older relatives in the future. You simply can’t afford to rely on the government to pay for this.

Tell us what you think

Do you think that the government should be doing more to help people look after themselves in their dotage, or is it up to each of us as individuals to take this responsibility? Let us know via the comment box below!

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