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Long-term care: the questions you need to ask

Choosing the right long-term care option can be a confusing experience. This guide sets out your options, the financial implications and the key questions to ask.


by Michelle McGagh on Sep 12, 2012 at 15:33

Long-term care: the questions you need to ask

Moving an elderly family member into care throws up some difficult decisions about the type of help they need and the costs involved. However, planning ahead can help take some of the stress out of a fraught situation.

One of the mistakes families make is not thinking about long-term care needs until that need is staring them in the face, according to Mario Ambrosi of care home provider Anchor Trust.

‘It can be difficult to choose the right option [for a family member] so it is a good idea to invest in advice,' he said. 'We see people making decisions at the point of care and we have been urging the government to invest more in advice and getting people to think about [long-term care needs] in advance.’

For those who are considering care for a loved one, the choices can be daunting, and the costs even more so. However, the types of care on offer can be broken down into three main groups.

Sheltered housing

Sheltered housing is also known as ‘retirement housing’, and is typically for people who are still independent but want the security or community aspects that a retirement village can provide.

Residents are provided with their own front door so they retain their independence, but have the option of being visited by an on-site manager. They can choose the frequency of the visits, from never to every day, depending on the level of support they need.

Residents can buy properties in the village on a leasehold basis or rent them.

The cost of renting or buying depends on where the village is. Properties in the South East will be more expensive than those in the North, the same as any property in these areas. However, Ambrosi said the average rental price of an Anchor sheltered housing property is £130 per week.

The rent is split into two parts: the cost of renting the property and the service charge on top, which covers the cost of an on-site manager, repairs and maintenance of the property.

Depending on levels of income and savings, those planning to rent in a retirement village may be entitled to benefits from their local authority to help cover the cost of the rent. However, all local authorities are different and there is not, as yet, a standard amount of help that can be received across the country.

For those who wish to buy a property in a retirement village, the properties are sold on a leasehold basis. There are typically other fees that apply on top of the purchase price of the property, such as fees for the management of the grounds, repairs and maintenance.

Retirement villages have a community element to them that many older people find appealing: this could include fitness facilities, common areas, gardens and bowling greens. If the villages are outside of a major town often facilities for travelling into town to go shopping and visit the hairdresser are provided.

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6 comments so far. Why not have your say?

Linda Green

Sep 12, 2012 at 17:51

This article leaves a lot out. A sheltered housing scheme is not a care home, and a residential care home is not a nursing home. Any elderly person should look into setting up enduring power of attorney with someone they trust - this kicks in if the person becomes unable to make decisions for themselves due to dementia or illness. You also need to look at the costs of support if you stay at your current home and the benefits available [eg Attendance Allowance] - although the amounts paid out are very small compared with the cost of care.

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John Houghton

Sep 12, 2012 at 19:03

This is a very one sided article which as previous reader points out leads a lot of options and services out.

It strikes me that the article has been written as an advertisement for Ambrossi and Anchor.

It is true that people need to start planning for care now and making financial plans to be able to afford it.

Privately provided care in the home is the best option available for most people and was not discussed in the article.

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White Stick follower

Sep 12, 2012 at 19:29

For residential Nursing care in the Surrey, Hants , Berks area you can expect to pay over £800 per week. My relative is in a first class mid-range home @ £825 pwk. Others in a similar category which I visited were nearer £900, one in North Hampshire was appalling, charging over £800, full of locked and chained fencing, barriers,doors all inside the building with two groups of 'residents' one men, the other women both staring blankly at TV screens. (I've seen more freedom when visiting prisons). Staff supervisor was very pleasant, but staff were stood around chatting showing no iinterest in residents. Even the staff/visitor toilets were dirty and featured broken sanitary ware. Despite its 3 star CQC rating I would not domicile my dog in it. Fortunately for a mere £25 pwk more my relative is in a very pleasant home, also 3 star rated, with caring, interested staff and not only all boxes ticked, but ticked meaningfully. My relative pays own care costs because of Gov't rules. If you want top class 'hotel' style living then think of £1600 pwk and extra charges for giving out medicines, applying plasters or dressings & etc etc. Spend the lot in your earlier years and the State will provide, be prudent, hard working and pay your taxes and the Gov't expect you to pay,leaving a mere £14k or so before helping out. The £14K just about covers the funeral and solicitors fees in proving the Will.

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The Wills Man

Sep 12, 2012 at 20:01

Informative but not exhaustive - not a criticism but folk reading this need to know there are other options as well.

An article on CRAG would be useful too I guess.

The options for paying for Care - particularly residential care are very few for most folk and amount to two in general terms - Insurance or pay out of capital.

If you are neither wealthy nor poor then expect to lose all of your savings and value of your home under current rules.

Up to NRB can be protected in a Trust if you do it early enough and the cost is minimal compared to the value of your home.

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Rose G

Sep 13, 2012 at 09:36

If anyone is relying on the CQC to protect vulnerable people, then I would advise you do not hold your breath.

The CQC is not known to act promptly, in the patient's interest. We have had some care homes where their licences were removed, but were able to come back the following week, with a new name and a new licence.

If you are lucky and have family that can care for you, then this is the best option for older people. Care homes from back in the days when I nursed, are where those who have no one to care for them at home are left to cope in institutions whose main care is to budget their books. They pay their workers such low wages, it makes a tough job, a lot tougher, while the companies that own care homes & their owners have a high life, at taxpayers expense, frequently, if the elderly person cannot afford to pay for their care.

The whole system of caring for vulnerable people seems to attract bullies, & those who want to harm people. Frequently, background checks are not carried out on staff as this attracts a charge to the company, and can take as long as 6 months or more. The police should be on the streets policing crime, not sat in back offices, churning out CRB checks as another way of bringing in income.

I am sure there must be some care homes that actually offer a decent service, but they will be in the minority. Getting old is scary if you have to rely on strangers to care for you.

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steven fieldfare

Sep 13, 2012 at 18:48

Agree with Linda Green - much is left out or understated.

4 additional points:

impression left in section on assisted living is that benefits will cover additional costs - highly unlikely, carer allowance is around 60 per week and taxed.

in all articles on care, an average care home charge of 26K is bandied about with a forward projection that assumes low inflation; a majority of care homes have already passed the forward projection, after additional non core charges are taken into account, perhaps because costs rise faster than RPI.

higher cost of nursing care is not made clear; and the difficulty of meeting the NHS assessment criteria for "continuing care" needs.

after self funders run out of money in their care home of choice, Councils invariably move them to a low cost home.

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