Shaleeza Hasham, head of hospitality & communications at care home group CHD Living, says…
Understand if this is the time for a relative to move into a care home
“Most people don’t have to think of care until they are faced with the overwhelming realisation that their needs or the needs of their loved ones have changed. For some families, this realisation may come following an accident such as a fall, which leads to a stay in the hospital. During this time, it may become clear the person will not be able to return to their own home. However, this may not always be the case. If an elderly person is living independently in their own home, changes to their wellbeing and living abilities may be more gradual and less easy to notice. In this situation, it can be more difficult to determine when a move into a care home might be necessary.
“There are a few signs to look out for though, such as changes to your relative’s eating patterns, confusion or missed doses of medication. These behaviours need to be monitored closely because of risks to a person’s health and safety, and if any of these are occurring consistently, this is a sign that more support is needed. Fortunately, there are some fantastic assistive technologies available, which can alert family members to changes in a loved one’s behaviour while also supporting them to live independently in their own home for longer.”
Establish whether only one of your parents needs full-time care
“As we get older, our needs naturally change and, when it comes to ageing couples, there is a chance one parent could require a higher level of care than the other. Occasionally this can mean having to live in separate residential care homes, or that one person remains at home while the other moves into care. Of course, this is a very sad situation and one that most would rather avoid. Fortunately, many homes now offer shared rooms for couples, so that they can transition into a residential care setting together and continue enjoying their lives as a couple.
“As well as residential care, many providers also offer a diverse range of bespoke care, which could be more suited to an ageing couple. These include care in your own home from short supportive visits to full-time, live-in care, support and companionship. Some providers also offer extra-care living, which is a great option for couples who wish to remain in the same household. Here, they can continue living independently in a safe apartment while still accessing care and support from nursing and care centres.”
Get to grips with looking for a suitable care home
“Take some time to research care homes and pin down ones that you like. While you’re doing this, remember to consider who it is you’re choosing the home for. If your loved one, for example, has an active social circle which they are likely to continue being part of, they may want to stay in (or close to) the area in which they currently live. Alternatively, if you’re going to be their primary visitor, then they may wish to be closer to you.
“Initially, avoid overwhelming yourself with an extensive list and narrow down your choices to three to five homes. Make sure to take advantage of the Care Quality Commission (CQC) website, too; here, you can input your desired postcode area and view the registered services in that area. You can also take some time to read the latest inspection reports and update yourself on any recent developments.
“Once you’ve checked the CQC website, take a look at the homes’ websites for reviews and testimonials, in addition to specialist websites like carehome.co.uk and NHS Choices for more impartial views. You might also find recent news stories helpful; good homes often have stories featured in the local press about recent events, and it’s worth following the homes on social media too so you can see what residents are getting up to.
Understand the different types of care homes
“While all care homes offer accommodation and personal care, there are specialist types of care home that offer additional services for residents with greater needs. Residential care homes can offer emergency, respite, short term, long-term care and even palliative care to older people and young adults who require support in a residential setting, rather than in their own or family home.
“Nursing homes are more suitable if your loved one requires continual support for specific conditions or types of disability, as these offer the same type of care as residential ones but with the addition of 24-hour medical care from a qualified nurse. Other care options include assisted living housing, retirement villages, adult day care centres and domiciliary care for people who would benefit from support in their own homes.”
Know what to expect when you visit a potential care home
“When it comes to visiting homes, it’s important to pay attention to how the home feels. Smells are particularly important; if it’s unpleasant, it may be a sign of poor housekeeping or poor personal hygiene. It’s also important to observe how the residents live at the home; do they appear settled and content? Do they look well cared for, with clean clothes and clean nails, etc? If a person seems distressed or upset, observe how the staff respond, and whether they take a respectful approach.
“Take the time to find out what activities the home organises and what opportunities for socialising there are, so you can feel assured that your loved one will have an enjoyable and fulfilling experience. If you have the time, try to visit the home on other occasions – and at least once with your loved one. We would always recommend arriving at a care home at least once without booking an appointment beforehand. That way, you’ll see the home as it is usually, and you may get a more accurate picture of what it’s like.”
Look at what kind of financial support exists
“Paying for residential care is expensive, but you may be eligible for financial support from your local council or, in some circumstances, from the NHS. This will, however, depend on the value of your assets, as anyone living in the UK with assets totalling more than £23,250 will have to fund their own care. In Scotland, this threshold increases to £28,000, and in Wales the threshold is £50,000. If the value of your assets falls below the threshold, the local authority should start paying for some or all of your care. Usually, the level of contribution will be based on a means assessment.
Most individuals who reside in either a residential or a nursing home will also be eligible for RNCC or FNC, which is a government top-up to cover the nursing contribution towards care. Costs of care will vary depending on the provider, location and the type of care required. As an example, at CHD Living our extra care starts from £700 a week and residential, dementia and nursing care starts from £1,200 a week.”
Emma Hammond, financial planner at Charles Stanley, says…
Agree what financial provisions need to be put in place
“It is vital your parents make their wishes known to family and friends in the event they are unable to make decisions for themselves. Besides having a valid and up-to-date will in the event of their death, it is important to have some sort of ‘living will’ or written instructions available in case their mental health suddenly deteriorates.
“We would also strongly recommend Lasting Powers of Attorney be put in place, of which there are two types; health and welfare, which enables their appointed attorney to make health and personal care decisions on their behalf. The second is property and financial, which enables financial decisions, such as accessing bank accounts and sale of property, if required. All decisions made by the attorney should be made with the co-operation of your parents if possible, or in their best interests if not.”
Set up power of attorney in plenty of time
“If your parent has lost capacity and there are no powers of attorney in place then you will need to apply to the Court of Protection to enable you to make decisions on their behalf and to be able to assess their bank accounts etc. This can be a very long and potentially costly process and the delay can result in your parent/s not getting the help they need in time. The Court may also appoint their own attorney if they feel this is necessary, and this can cause family conflicts if you are not in agreement with decisions being made and further delays may result.”
Know that support does exist
“Remember, people over a certain age and on a low income are entitled to claim for the following on an annual basis: heating allowance, public transport concessions, housing benefit, TV license concessions, council tax support. There are numerous sites and links online, such as Age Concern UK, which provide help and support. Even if your parents are well, they may still qualify for help, so make sure they are getting all they are entitled to.”
“Depending on your parents’ medical conditions, they are likely to qualify for attendance allowance, a weekly benefit which helps with associated additional costs for people living with a disability or health problems. There are two rates depending on severity of illness. Attendance allowance is not means tested. If your parent needs to go into a care or retirement home, then they will still receive this. However, if they are receiving local authority funding for their care, then this forms part of the ‘means test’ and the benefit may be removed. If your parent is not yet in care and they are being looked after by you or another person, then it is possible for other benefits.”
Jodie Wielgus, a solicitor and partner in the private client team at Ramsdens, says…
Rely on the Court of Protection
“If your parent(s) loses their mental capacity without setting up power of attorney, you can apply to the Court of Protection to appoint a deputy to make decisions on behalf of someone else. A deputy can be appointed in relation to either, or both, a person’s property and affairs and personal welfare. This can be a family member or close friend, or a professional such as a solicitor, who is specially appointed by the Court of Protection to act.”
“Created under the Mental Capacity Act 2005, the Court of Protection has jurisdiction over the property, financial and welfare affairs of those who lack the capacity to make such decisions for themselves. As well as having the power to appoint a deputy to manage the affairs of someone who is deemed not to have the requisite mental capacity to make such decisions, it can also make one-off decisions on a specific issue, for example where someone might live.”
Get a statutory will drawn up
“In these circumstances, an application can be made to the Court of Protection for a statutory will. This has the same effect as a will executed by the person who has capacity to do so and can be made if there is no will in place or if it is felt that an existing will no longer reflects the person’s circumstances and so should be revoked.”
Apply for support from the state
“If you are looking after a relative as a result of illness or disability, then you may be entitled to one or more state benefits to help with the costs which you incur during your role. This can range from carer’s allowance, to carer’s credit and a carer premium, all of which either provide you with state benefit or act as an allowance on top of the benefits you already receive.
“If you or your elderly relative have ongoing significant health needs, then your care may be paid for through the NHS Continuing Healthcare. In order to receive this, an assessment will be required to determine whether or not your ongoing needs are significant enough to warrant the funding the scheme provides.”
Keep a thorough record
“When taking care of an elderly relative either as a family member, attorney or deputy, it is always important to remember that you have a duty to act in their best interests at all times. It is advised that a record is kept so that the financial and/or health decisions which have been made can be checked by other family members should they wish to do so, or the Court of Protection which requires an annual report to be submitted if you have been appointed as a deputy.”
Ready to have the conversation? Here’s some advice from the team at The Live-In Care Hub about broaching the subject with elderly relatives…
Start talking about it now
“We’ve found some shocking statistics that show the majority of those looking for information on care options on the internet, still wouldn’t talk to anybody about their options. No matter how far-off needing care seems, the sooner the topic is out in the open the better. Being prepared is so important, and understanding what your parents want is really helpful, especially if something unexpected happens like a life-changing medical event.”
Use real life examples
“A really good way to get a conversation started without springing it on your parents out of the blue, is to talk about loved ones or friends and colleagues who have been through experiences recently relating to care. You could talk about what you would want when you are older so that the conversation remains open and inclusive.”
Pick your moment
“It is important that this conversation happens in a relaxed and quiet environment where you can chat about everything properly. You may need several chats to clarify everything discussed, in which case try to ensure those chats happen at a time where there won’t be disturbances and where there aren’t time constraints. You may also wish to keep these discussions in private.”
Think carefully about who’s involved
“When there are other siblings involved, or perhaps one of your parents is too unwell to make a decision about their care, you have to make sure everyone who should be involved is involved in a discussion about care plans. This makes it easier to be prepared for the discussion and also ensures everyone concerned is able to ask any questions they would like an answer to. With something as important as this, it is essential that everyone is in agreement.”
Suggest options rather than dictating your own opinions
“It is important to suggest the different care options to your parents rather than dictate your own opinions and preferences. Talk about home helps, care homes, live-in care and home care in an unbiased way, but with the focus being on the best option for your parents’ quality of life. Being too opinionated could make your parents think that their feelings don’t matter but good care is all about what matters to the person being cared for. Approaching the subject with respect is so important and is more likely to result in a positive outcome.”
Understand the importance
“It is really important that you talk to your parents about care options, and it isn’t something you should put off. It might be a difficult conversation to have, but it will result in this important topic being out in the open. The more you know about what your parents want, the more likely their long-term care plans will be the best for them and the rest of the family.”
For more information and support on care options for elderly relatives visit the Government website here or Age UK.
DISCLAIMER: Nothing published by SheerLuxe is intended to constitute medical, legal or financial advice. Always consult an independent professional advisor before making any decisions which might affect your personal, financial or legal circumstances.