Care homes or care at home


Care homes have worked extremely hard to bring the situation under control during the Covid-19 pandemic and the death rates at the time of writing are now no higher than would normally be expected at this time of year. However, the spike of deaths in care homes during the peak of the pandemic has given many a reason to question whether care at home may be a more suitable option for their needs.

A recent survey has suggested that 97% of the population would prefer to stay at home, but few explore the options before the need becomes urgent.

Discussions around making a will may seem normal nowadays but planning your funeral and talking about old age care is not a common topic. There are pros and cons to both care homes and care at home, but there is every need to discuss the options with your family.  Only 27% of the UK population has planned how they would fund care, instead decisions are made at crisis point where it can be challenging to understand the options.  The earlier you have the conversation with your family or people around you, the better. It is important you have powers of attorney in place to enable your family to make decisions on your behalf; you don’t need to invoke them until you are ready.

A mix and match approach to home care can include regular visits from a home care worker to help with personal care, shopping and preparing meals and other services can include ‘meals on wheels’, monitored personal alarms and household equipment, and adaptations to help with everyday tasks.  Transport to local day centres can be an important aspect to help you to socialise and take part in activities.

The following pros and cons are taken from moneyhelper.org.uk.

Care at home pros and cons

Pros

  • The cost of care at home might be cheaper. However, as the amount of support you need increases, it might become cheaper to move into a care home
  • You get to stay near friends and family. Staying in the same neighbourhood is really important to some people.
  • You have more control over the care and support you get. You’ll be able to tailor how much help you get as your needs change.
  • You can continue to live with your pets. If you need help looking after them, try contacting the Cinnamon Trust – they might be able to help.
  • You might get more money for care. The value of your home isn’t taken into account when calculating how much you have to pay towards your care. It might if you move into a care home, although this will depend on who’s still living there.

Cons

  • Carers aren’t around 24/7. This might mean you feel less safe in your home. A live-in carer, an alarm system, fall detectors or a bed sensor might help you feel better.
  • Your carers might change. The agency you use will probably try to send the same person every time. But they might not be able to due to sickness and time off.
  • Carers might turn up late. This could be because they have an emergency at their previous call. If you have a strict schedule, this might be difficult for you.
  • It could get more expensive if you need more help. For example, you might need a cleaner, a gardener or need hairdresser to visit.
  • The responsibility for your home still falls with you, ie the garden, upkeep and maintenance of appliances.

Moving to a care home – pros and cons

There are two types of care homes:

  • Care homes without nursing care that provide help with personal care.
  • Care homes with nursing care that have registered nurses providing 24-hour nursing care and experienced care assistants providing personal care.

Both are places where you can live, often with a spouse, where trained staff meet your care needs.

Some also have accommodation and support specifically designed for older people with dementia.

Pros

  • Trained staff are always on hand. This means you might feel more safe and secure.
  • No need to worry about utility bills, meals and household chores. It’s all sorted for you, which might mean it’s warmer, safer and cleaner.
  • You’ll always have company. There will always be someone to talk to, as well as organised activities.
  • They can manage any medication you need to take.

Cons

  • It might be more expensive. This is especially the case if you don’t qualify for local council funding.
  • Quality of care can vary. All homes need to reach a minimum standard to be registered, but quality does vary. You can check the quality on the Care Quality Commission website
  • All your belongings will need to fit in one room. This might mean that you can’t be surrounded by all the personal items you’d like.
  • You might feel you’ve lost some of your independence. A good home should help minimise this by helping you live as independently as you can. You might lose some privacy though.
  • Pets might not be allowed. If they do claim to be ‘pet friendly’, check what that means. It could be that pets are allowed to visit but not stay.
  • You might not enjoy the company of the other residents.
  • Family and friends can feel guilty. For example if they’re not able to help more or visit as much.

According to moneyhelper.org.uk, Home care costs work out as follows

Estimates will vary depending on your needs but:

  • £15,000 a year, for 14 hours of care a week. Based on the UK Homecare Association’s estimate of what councils should pay, as a minimum it’s £20.69 an hour. If you’re self-funding, you might pay more.
  • If you need full-time care during the day, costs could be more than double the above.
  • If you need carers to move in around the clock and you have complex needs, it could cost about £83,200 a year. In those circumstances, residential care is usually more cost-effective. If you don’t have complex needs, fees should be less – about £41,000-£65,000 a year.
  • You’ll still have the cost of maintaining your house, but you have the advantage of being in familiar surroundings.
  • If you and your partner both need care, home care might be more cost-effective. Some home care providers only charge a supplement to cover the second person, rather than doubling the cost of care for one person.

There are various benefits available and it is easy to find free support (details below) but here are some points to think about.

  • If your capital and savings are below £14,250, you will have your care paid for. If you have between £14,250 and £23,250, you will have to fund all of your social care.
  • There are benefits available such as Attendance Allowance where anyone deemed as needing support at home is eligible for an attendance allowance, which amounts to between £57.30 and £85.60 per week.  This is not a means tested benefit and your main carer may be able to apply for a Carer’s Allowance too. Also, anyone with a dementia diagnosis is exempt from council tax.

Resources

Age UK – for older people, their families, friends and carers

Call 0800 678 1602

Helpline open: every day of the year, 8am to 7pm

www.ageuk.org.uk

Independent Age – for older people, including advice about care, money and health

Call 0808 503 7945

Helpline open: Monday to Friday, 8.30am to 6.30pm

Email: advice@independentage.org

The Silver Line – for older people

Call 0800 4 70 80 90

Helpline open: every day of the year, 24 hours a day

Money and benefits

Money Helper – a Government website for advice about money and benefits

Call 0800 138 7777

Helpline open: Monday to Friday, 8am to 6pm

Citizens Advice – for advice about money and benefits

Call 0800 144 8848

Helpline open: Monday to Friday, 9am to 5pm

Citizens Advice will not charge you to call its national phone service or helpline, however your service provider may do.

If you have any questions about care or would like to discuss later life planning in general, please contact us.

Roswyn Bradshaw is a caseworker in the private client team at Barker Gotelee Solicitors in Suffolk.

For more information on our range of legal services including elderly client care, please call the team on 01473 611211 or email bg@barkergotelee.co.uk