FOOL'S EYE VIEW
The Costs of Long Term Care at Home

By Jane Mack (TMFJane)
November 29, 2002

Earlier this week in the first of our series of articles on long term care options for elderly people, we started with the preliminary steps – namely getting an assessment from your local Social Services to ascertain your needs. Are you ill enough to need nursing home care or sufficiently infirm to require residential care? Would sheltered accommodation be the best route?

As we said, the cheapest option for all concerned is usually for the elderly person to remain in their own home. It's almost always what the elderly person wants too and with the help of a few adaptations such as grab rails in the necessary places and perhaps a personal carer coming in to assist with physical needs, it's not surprising that the vast majority of elderly people (about 80%) are still living at home.

However, what do we mean by the 'cheapest option'? Not surprisingly, your local authority won't pay for any of the costs if you can afford to pay for them yourself and your assessment will include a financial check to find out how much you can afford to contribute to the services you require in the home.

The general rule of thumb is that if you have in excess of £19,000 in capital and/or savings you will be charged the full cost for all of the services received. This will not include the value of your home and furniture if you are living in it but any other assets or income will be taken into account although it's important to note that it is only your assets and income that are assessed – anything your spouse personally owns won't come into the equation.

Once you're down to your last £19,000, it then works on a sliding scale of contributions until you're finally left with assets and savings of £11,750 at which point Social Services will pay for the lot. Whatever your financial situation, the idea is that everybody will be left with a minimum amount of income to cover general living allowances – this is the equivalent of basic income support/Minimum Income Guarantee plus 25%.

So – what happens if you are in the fortunate situation of having more than £19,000 in assets and an income that is more that the Minimum Income Guarantee plus 25%? How much are these charges for services?

Well, as our earlier article mentioned, the government has recently issued some guidance about the sort of charges local authorities should make and these will come into force by April 2003. They will still have discretion about which services they want to charge for so it's impossible to tell you exactly what the costs of paying for care in the home will be.

What I can do is tell you what my own local authority is proposing to do since at least it will give you a rough idea. First of all, they plan to charge for everything. Second, this is how much they want to charge:

Personal home care              £16.50 per hour
Community support               £10.50 per hour
Day Care                        £3 - £6 per day 
       (depending on whether a meal is provided)
Transport                    £0.80p per journey
Meals                                £3 per day
Laundry                            To be agreed

So, let's assume we have an elderly woman living alone in her own home with a fairly decent pension income as well as assets and savings of more than £19,000. Let's assume she needs help for an hour each morning and each night with washing, dressing, using the loo etc and that she gets a visit from Meals on Wheels once a day and is transported to the local Day Centre for some company once a week. Her costs over 7 days will be:

Personal Care                       £16.50 x 14
Day Care                                     £3
Meals                                    £3 x 7
Transport                                 £1.60

My maths isn't really up to much but as far as I can make out her total bill will be £256.60 a week or £13,343.20 a year. And that's on top of what she needs to pay her ordinary household bills.

You can make up your own mind about whether it's truly the cheapest option. Remember that in a residential care home the fees will include all your living costs but that once you've moved out of your home, the value of it then gets added to your total assets.

And, finally, to mention the assessment again, according to my own local Social Services, there's a waiting list depending on how urgently you need to be assessed. If, for example, you can't get in and out of the bath but you can just about manage a strip wash at the sink, then you'll be the lowest priority and won't get an assessment visit for 'several months'. As with many local authorities, Social Services are over-stretched, under-staffed and under-resourced – and, invariably, under-appreciated.

But 'several months'?

More: The Fool's Pension Centre & Savings Centre | Age Concern