The facts are we are living longer as a population. 10 million people alive today will reach 100 (17% of the population), 875,000 are already aged 65.Figures from the Office of National Statistics and The Department of Work and Pensions show that the number of people reaching 85 years of age has doubled since 1984 from 660,000 to 1.4 million and is estimated to reach 3.2 million in 2033 which represents around 5% of the population.
Unfortunately for many the quality of health in later life may diminish. Progressive diseases such as dementia lead to a life of dependency for even the most basic daily tasks. According to the Alzheimer’s Society in the U.K there are 850,000 people who are diagnosed with the disease in 2015 with an estimated 1 million by 2025. Out of every six people aged over 80, 1 will have dementia, 2 out 3 will be women and it’s estimated that 80% of those who are in care homes will have some form of dementia or severe memory problems.
Many families provide as much help as possible with elderly relatives but for most there comes a time when that responsibility becomes too much. The physical, emotional and psychological demands inevitably take its toll and for the welfare of all concerned, professional care is the best option.
Each Council or Local Authority has an obligation to provide care with the exception where care is provided by the NHS. This is known as “Continuing Health Care” (CHC) and is paid for by the NHS Trust responsible for that care. However, the “eligibility criteria” is strict and many are assessed as being ineligible.
After a needs assessment where care is not funded by the NHS, the local authority should provide or arrange community care services. Each Authority sets its own eligibility criteria but it must comply with national guidance issued by the Government to promote fairness and consistency.
NHS continuing healthcare is free to the user, unlike social and community care services provided by the local authorities. These services are to be paid for by the individual depending on their income and capital assets including the care user’s home. The true costs will only be known when a family member is in need of care and much depends on the asset values based on the upper and lower limits.
The current upper limit in for England is £23,250 and the lower limit is £14,250. So, for those who own a property the likely hood is that the value of the home will be above the upper level and so they should pay for their care in full themselves, or should they? Let me explain.
Where a person has ongoing care needs, perhaps after a stay in Hospital, those needs must be assessed to establish the level of care and support needed. If that assessment has not been carried out properly in accordance with the Department of Health National Framework for Continuing Health Care and NHS Funded Care 2012, procedural errors could result in an incorrect care needs assessment. On no account should a care assessment be influenced by a persons financial status which is only considered once the care and support needs have been agreed. All too often financial details are requested from unsuspecting families of the person in need of care which often results in the person in need of care paying for for what should have been funded by the NHS.
The subject of care and the process of care needs assessment is complex. For most the language used and the paperwork involved is all too daunting. At an emotional stressful time, families are asked to make decisions whilst under extreme pressure which proves too much for many. The assumption that the care user or even the family have to pay for the care costs even when the person in need of care does not have the means. The authorities fail to mention that no one is obliged to pay for another person’s care, although families may want to contribute. Never the less, where a person has been assessed for care and does not have the funds available, the obligation is on the Local Authority to pay for that care. If the family then choose to pay extra for better facilities or a home more conveniently situated, then that is their choice, but not an obligation.
The recent introduction of the Care Act 2014 makes available access to a Universal Loan Scheme as long as the care user qualifies. The criteria laid out in the Care Act requires adequate security for the loan, usually by way of a first legal charge on property. But this option whilst convenient may not be the best choice. First of all, has the assessment been carried out properly? Is it certain the continuing health care is not available and has the proper assessment even been carried out? Should there be a limit on the amount of loan charged against property, after all, it is a mortgage.
So, there are lots of questions to be answered and considerations to contemplate in deciding who should provide care and the discussion of money,who pays?, is another subject .