Most of us would prefer not to think about the possibility of not being able to live independently. But we're living longer than ever, and of the 1.4 million people over 85 in the UK, seven in 10 have a disability or long-standing illness. In a recent survey, 71% of over-75s said they would prefer to stay in their own home if possible. However, 17 out of 20 hadn't discussed their wishes with their loved ones and the same proportion said they hadn't planned for care as they got older. Every day in my practice, I see the consequences of people burying their heads in the sand.
If you don't plan ahead, you may end up needing care in a hurry when a crisis happens. And that means you're less likely to be able to take time to think about what would work for you. But this is an area where it really is good to talk. If your loved ones know what you want, they can work with you to consider all the options - and set up funding if possible.
Funding - what's available?
The funding system for health and social care is complicated, and what's worse, it's changing all the time. If you have savings above about £25,000 in England or Wales, you're likely to need to pay for 'social care'. Free personal care is available for everyone aged 65 and over in Scotland who has been assessed by the local authority as needing it. Even in England and Wales, you may still be eligible for nursing care (in a care home) for any care you need from registered nurses, including those employed by nursing homes. This comes from a fund called NHS-funded nursing care. If you have complex needs, you may qualify for funding through NHS Continuing Healthcare. The rules vary depending on whether you're in your own home or a care home. Your local social services department can help you to navigate through the regulations for your area.
Help at home
If you need nursing care at home, this is provided free on the NHS by district nurses, regardless of your savings. 'Social care' can range from a home help once a week to a daily assistant for dressing, bathing, meals and medicines. Your local Social Services department can arrange a full community care assessment, which can be requested by the person needing it or their carer. In Scotland, help with personal hygiene, dressing, food preparation, continence problems and applying creams or lotions is free, but you may be charged for help with shopping, laundry or housework.
There are lots of scary stories in the press about care homes, but many provide high-quality care and looking around in advance can help you find one that suits all your needs. Some also provide nursing care from nurses on site. Government rules say you should be entitled to a trial stay before you commit to moving into a care home permanently. If your local authority is arranging residential care as part of your social care assessment or a carer's assessment, they can help organise this.
24-hour-a-day care at home
This may sound like a fantasy, conjuring up images of dowager duchesses sitting in solitary splendour while a uniformed maid caters to her every whim. But while it's not cheap, there are high-quality live-in carer services which cost less than many residential care homes. The idea is that a parent company finds, vets, trains and supports the carers, who usually spend two weeks at a time living with you before handing over to another carer on a rota. You get to stay in your own home with a small team of three or four people who know you well and who offer really personal care. They can also provide live-in nursing care, which is more expensive but can be invaluable if you've just come out of hospital. At present demand for services like this is outstripping supply, but if you have a spare room and would prefer to stay in your own home, as many people would, it's a real thought.
Are you a carer? Do you need support?
If you're caring for a loved one and you need support, you can call Carers Direct on 0300 123 1053, for confidential advice and support. They're open from 9am-8pm on weekdays and 11am-4pm at weekends.
With thanks to 'My Weekly' magazine where this article was originally published.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.