January 17, 2010

UK: The price of care for elderly relatives

. LONDON, England / The Independent on Sunday / Money / January 17, 2010 Has a visit home revealed that grandparents can't cope any more? It's time to think about long-term care. By Neasa MacErlean If you are wondering how to arrange long-term care for an elderly relative, then you are not alone. January is a time of peak activity in this sector. The Elderly Accommodation Counsel, for instance, always sees a surge in inquiries at the start of each year. And calls for help to the charity also went up 15 per cent at the beginning of this month, compared to the same period a year ago. The main reason why issues come to a head in January is that many families discover at their Christmas reunions that an older relative is struggling to cope. On top of that, this year's bad weather has also shown up the failings of poorly insulated housing as well as exposing vulnerable people to very challenging conditions. Finding grandmother out in the snow in a summer dress is a common wake-up call for families. It usually confirms that she is becoming confused and does need some kind of help. Advice is easier to get than it used to be. In some ways, the national system for providing care to older people is working far more efficiently than it did a few years ago. Organisations such as the Elderly Accommodation Counsel (EAC) and Symponia, a network of financial advisers, are not reporting a shortage of care homes or delays in responses from local Social Services departments. The main problems appear to lie elsewhere, in the quality of the residential homes, for example, and in the unnecessary hardship suffered by disabled pensioners who do not claim all the benefits which may be due to them, particularly attendance allowance. Photo credit: eac.org.uk What many people will find hard to take, however, is that they will need to pay for some or all of their care. The proportion of elderly people getting financial assistance on care home fees has fallen 11 per cent to 59 per cent from 2002, according to the Liberal Democrats. And the numbers receiving funded care in their own homes have fallen over 16 per cent since 2000, according to Age Concern. Local authorities are going to be under significant pressure to cut back even more over the next few years as the Government seeks to reduce the public debt. Average weekly fees in a UK residential home are £479, according to the researcher Laing & Buisson, and £669 for a nursing home. But, in England, only people who are assessed as having under £14,000 in capital assets will escape making contributions from their capital; and income from pensions, benefits and other sources will be assessed and, after certain deductions, will nearly always be put towards the cost of home fees. If the local council is having to contribute, in England it can take all of the individual's income (subject to various rules which families should check are being followed), leaving the person with a weekly "personal expenses allowance" of £21.15 (a figure which rises to £21.90 in April). If relatives want to do the best they can for elderly relatives, they should be very careful in choosing a home. A high fee level does not guarantee good service, and nor does a strong rating under the UK's care home inspection regime. Some homes can look nice on open days but are unpleasant places to live. Even expensive homes which have good inspection reports can be disappointing, according to Age Concern. "It can often be extremely difficult for people to judge the true quality of care services for older people," says Andrew Harrop, head of public policy at the charity. "Better monitoring and inspection of care services is urgently needed." Changes are happening, year by year, in this sector. This is both a good sign (as action is being taken to remedy problems) and a bad one (as those problems still persist despite a continuing national outcry about conditions in homes). One of the more positive moves is that of helping people to maintain their independence, either by encouraging them to stay in their own homes as long as possible or by building more retirement villages and "extra care" flats for them. There are now about 35,000 extra care flats in England, providing people with their own space but easy access to care and facilities such as hairdressing and shops. Ironically, local authorities often found it easier to put people into homes in the past, but attitudes are changing, says Colin Angel, head of policy at the United Kingdom Home Care Association. "Home care needs an awful lot more organisation than putting someone into a home but the Government has realised that it is far more cost-effective," he says. We can expect more changes to follow this year's general election. All three main parties have announced policy changes. "We will see a resurgence of the pre-funding of long-term care," predicts Jeremy Davies (left), co-founder of Symponia. If that is true, then people in their fifties or younger could expect to be asked to pay some sort of contribution, if they can, ahead of the time when they need care. But these are controversial issues and could only be implemented following a national debate. [rc] How to obtain long-term care Continue reading Copyright 2009 Independent News and Media Limited