Beginner's guide to finding elderly care

Callers to the Autumna elderly care advice line have one thing in common - they are struggling to navigate their way round the social care system.

So, Autumna, who look at everything from the consumer perspective, decided to run a short YouTube Live webinar on September 5th 2020 entitled 'The Beginner's Guide to Finding Elderly Care' which aimed to address this issue and give impartial and expert advice on what elderly care options exist and how to start looking for them. What follows is a precis of the webinar content.

The aim of the Autumna webinar was to cover:

• Who has to pay for their own elderly care.
• The 3 main types of care available.
• And then 4 key things that should be considered when deciding which of the 3 main care options are right for you, or your loved one.

The most common phrase we hear from callers to the Autumna elder care advice line is:

"I don't know what to do, I've never had to look for care before."

It’s not surprising. Most people don’t want to think about growing old, and they certainly don’t want to worry about social care until they really have to – often when they’re in crisis – when mum or dad has had a fall – or they’re becoming confused and they’re really not coping on their own anymore.  And then of course, they need to find a solution - fast.  

As with anything though, the choices you make are so much better, if you DO know what to do, and you HAVE the information you need to hand.

And that’s what the Autumna webinar will help you with.

It will take you through:

• The first steps of identifying your elderly care options
• What support those options give you
• Where to look for legal and financial advice for your elderly care
• Practical support and advice on the logistics of moving into a care home

Who has to pay for their own elder care?

Essentially in England, if you live alone and are looking for a care home, if you have assets - including your house of more than £23,250 – then you will be paying for your own care.  You are what’s known as a self-funder – or private payer.

There are some exceptions and there are some non-means-tested benefits you may be entitled to – this is a complex subject so if you need more detailed answers try here.

So, what are the three main care choices available to you and what are the differences between them.

Elder care options generally split into three main categories:

• Home care
• Live-in care, or
• Care homes

You might also want to consider assisted living in an Integrated Retirement Community. In essence though, they generally include a combination of home care and care homes.

Option 1. Home care

Home care agencies provide support in your own home.  A carer will visit you and then leave.  How often is entirely up to you, your needs and your budget.

Home care includes everything from companionship and somebody helping you with your shopping, to personal care – help with washing and dressing and they can also provide nursing care.  You can employ a home care agency for a short period - as respite or a temporary break - or for long term home care.

The big benefit of home care is that you stay in your own home and it’s flexible - you can have as much or as little care as you need.

So, how does home care differ from Option 2 - Live-in care?

With Live-in care, somebody is living with you in your house. 

Live-in care can work especially well, and can be very cost effective, if you’re a couple and you both need some sort of care and support.

Live-in care agencies can provide a range of care similar to home care; companionship, personal care, nursing care and respite care. One crucial difference of course, is that there is a carer in the house overnight. If anything goes wrong, there’s always someone on hand.  This can be hugely reassuring for families

You will of course need a spare bedroom for the carer.

Bear in mind both home care and live-in care carry a cost of the care plus you are still running your own home with all of those associated costs.

Option 3. Care homes – or residential care.

Negative media reports associated with care homes and the Coronavirus are understandably making families very nervous about the prospect of residential care.

The thing is as Steve Hemsley, editor of a Care Home Management magazine once said:

“We give great care isn’t a news story – the media is only interested when it goes wrong.”

Whilst we all are aware of the terrible effects of the virus on care homes at the start of the pandemic, there is a case now for saying that actually care homes could be some of the safest places to be if you are elderly – and safety after all is fundamental in any decision about elderly care.

You can search for S.A.F.E care homes on Autumna and this will give you information about the measures care homes are taking to keep their residents and staff safe.

With a care home - you live full time in the home. Unlike home care or live-in care, all of your costs are included in the price - food, utilities, laundry, medicine and of course, care.

There is somebody on hand 24/7 to support you and the home will have the equipment and space to support whatever your needs are, something to consider if you are trying to stay at home.

However, the big advantage of a care home is the social engagement. There are other people and activities to interact with.

We often speak to families – sons and daughters – who feel terribly guilty if they can’t look after their parents in their own home, yet we see so many cases where mum or dad really flourish when they move into a care home.

Moving into a care home is however a big step and it is worth spending a few minutes on the two different types of care home.

What's the difference between a residential care home, and a nursing home? 

Whilst residential care homes and nursing homes might both provide support for dementia care, he main difference between them is that a nursing home will have nurses on site 24.7. A residential home will not.

It is worth mentioning here that making a move into a care home can be logistically quite challenging, particularly if you don’t live nearby. If you need specialist help in this area try here or fill out one of our simple questionnaire and we'll send you a shortlist of care providers that should be able to meet your needs.

If you are not sure whether you want to take the big step of moving into a care home you can consider respite care.

This is a short stay of usually between 2 – 6 weeks, often to give a carer a much-needed break, but it is also a very good way to ‘try before you buy’.

So those are your three main care options.

What are the four key points that will help you decide which of these care options, is right for you? Home care? Live-in care? Or care homes?

Let's start by saying everybody is different – there is no right or wrong answer to this.  But this should help you decide:

• Safety – will the person be safe in their choice? For example, if the person in question has dementia and is prone, for example, to take a walk and get lost, it might be safer for them to be in a care home.

Some care homes have been designed with curved corridors that always bring you back to where you started.  Specifically designed for somebody with dementia.

In another example, a recent call to our advice line was from a daughter who lived several hundred miles from her mum who had been diagnosed with dementia 3 or 4 years earlier.  Mum was deteriorating quite quickly - possibly because of  the lockdown.  She had carers coming in a few times a day, but her daughter was really worried about what was happening at night.  The Autumna advice line team suggested either live-in care or a care home – not only to keep mum safe, but also to let her daughter sleep at night!

• Isolation – We touched on it briefly, but the Coronavirus has highlighted fairly starkly that isolation can be very debilitating for people living alone and can exacerbate conditions - particularly dementia.  A move to a more stimulating environment can definitely bring benefits and is something to take into consideration.

• Cost – Consider the cost of your choice of care. Can you afford it and if so for how long?

Having recently supported a family who had run out of money and been asked to leave the care home their mum had lived in for 2 years, it can’t be emphasised enough how important this is.  If you are asked to leave a care home because your funds have depleted, then you have chosen the wrong care home. Take financial advice - and this applies to live-in care too.  Annuities might be the best option if you’re going into a care home, but equity release might enable you to stay in your own home and have 24hr support.

• Finally - The future – have you future-proofed your elder care choice?

Again, the last thing you will want to do is find a care solution that works now, only to find you have to go through the whole process again 6 to 12 months down the road.  There is clear evidence for example with vascular dementia that care needs will become increasingly acute over time. Make sure any choices you make now can accommodate deteriorating illnesses.

And briefly, touching on the retirement village option – all Autumna would say is: Don’t leave it too late.

Consider the retirement village option early and enjoy the community benefits they offer. Our advice line team had a very sad case recently where, by the time the purchase negotiations had run their course and the solicitors had done their thing, the lady in question had deteriorated to such an extent that she never actually picked up the keys to her apartment, and instead had to find a place in a nursing home. 

To sum up these four key considerations when assessing your elderly care options its: safety first, then look at social stimulation, thirdly, how much you can afford and finally have an eye on the future.

What are the legal and financial issues associated with elderly care?

It’s really important with both the legal and financial aspects of elderly care, to get your ducks in line as early as possible.

You need to have conversations with family - preferably before there is a crisis - to ensure everybody is in agreement.

If we deal with legal issues first.  An LPA (or lasting power of attorney) is really important. If you lose mental capacity, someone will need to have the legal ability to act on your behalf. This can be for your financial affairs and also your health and welling.  Without an LPA in place, important decisions can take much longer and can become extremely costly because you have to go through the Court of Protection. For more information, try here.

Paying for care.  Taking advice early in the care search process can really benefit you.  If you are considering a care home, then understanding your financial situation will ensure you choose a care home within budget, or it will allow you to have a conversation with the home and you can discuss how long your funds will last.

If you are considering live-in care, then you may want to look at equity release as a means of paying for the care and staying in your own home

So, to sum up, while COVID has had a catastrophic effect on many industries, Autumna thinks it might have benefited families who are looking for care now.  Providers are posting more information online which is making it much easier for you to research your care options. 

Top tip – check out the Facebook page of any provider you are considering using – this will give you weeks and months of visual evidence of exactly what they have been doing!

In the past you might have 2 or maybe 3 providers to consider but now you can access detailed online information that makes it easy to research 7-8-9-10 providers!  And you can do that in the middle of the night, you're not limited any more to when providers are open to visitors.

If you need help and want to discuss your individual family situation don’t forget you can still speak to us on a good old-fashioned phone number 01892 33 53 30 or via live chat on the Autumna website. 

So that’s it. a quick precis of what was covered in the Autumna 'Beginner's Guide to Finding Elderly Care' webinar. Autumna really hopes it has given you some useful pointers.

And just know, you are not alone.  We are care experts and we can advise and support you.