FOOL'S EYE VIEW
Your Options For Long-Term Care

By Jane Mack (TMFJane)
November 26, 2002

A couple of weeks ago I wrote about some elderly relatives who have got to the stage where they now need some kind of care. The article generated a surprising number of emails in my inbox from Fools who are facing the same sort of dilemma as I am although I got told off by one person for painting such a bleak picture of the options.

Anyway, since most of us have parents or grandparents who may be in a similar position, we thought it would be appropriate to run a series of articles that covered the options in more depth. So, here's the first of them.

If you want to find out what's available for you or a relative, your first port of call is the Social Services department of your local authority. Not only can they send you a bunch of information but they have a statutory duty to arrange an assessment of your care needs.

The proper way for an assessment to be carried out is for them to pay a visit to your home so don't be fobbed off with answering a questionnaire over the phone and don't let them simply tell you what you need! Your wishes are paramount in this and their role is to provide suggestions after a thorough assessment and not to ride roughshod over you.

I only mention this because some elderly people find the idea of an assessment quite frightening since they think they might be forced to go into a care home. Not the case. You can refuse any care they suggest – something the 94-year old mother of a friend of mine has done even though she really ought to be in residential care. She makes do with a visit from a personal carer three times a day which is the only time she gets a cup of tea since she's too arthritic to lift a kettle herself.

These days the main aim is to enable people to stay in their own home – not least because it's usually far cheaper for everyone concerned. The assessment should include your physical, social and emotional needs so it's not just a case of being supplied with hand rails by the bath or someone to come in to help you wash and dress, but also to arrange access to a day centre so you get some company occasionally.

As you might expect services vary from area to area depending on resources. Many local authorities no longer regard help with shopping and cleaning as essential(!) and tend to provide services to those who need a high level of care such as help with washing and dressing. If you don't like who they send to look after you then you can ask for the money instead under the Direct Payment scheme so you can buy your own care. Not all local authorities offer the Direct Payment scheme and where they do, they'll need to be sure that you're capable of employing someone yourself.

When it comes to who pays for the various services offered by local authorities, unfortunately it usually boils down to you as it's means-tested. Only in Scotland are most of the services free – elsewhere local authorities can charge what they like as long as it's 'reasonable' and they can take their own resources into account when setting their eligibility criteria. They're also perfectly within their rights to choose the cheapest option. However, the government has recently issued some guidance about the sort of charges local authorities should make and it's expected that by April 2003, they should be more streamlined. Nursing care is free however and so is any care you may need to avoid going into hospital or shortly after being discharged.

If you need some sort of personal care and you're over 65, then you may be able to claim Attendance Allowance which can be worth up to £56.25 a week. It's tax-free and is not means-tested but is based on the level of care you need and whether it is day-time or night-time care, or both. If you're under 65 you can usually claim Disability Living Allowance instead.

The forms look a bit of a nightmare to complete but then, what's new? If you're entitled to some financial help because of a disability then that's what it's there for.

Incidentally, regarding the relatives I wrote about the other week, we have agreed between us that the best option is to try and enable them to stay in their own home. We shall listen with interest to what the Social Services say when they come to do their assessment. I'll report back on what it was like.

Useful Links: Help the Aged | Age Concern | Dept for Work & Pensions