Who pays the price of dementia care? - Autumna

Posted by Debbie Harris

Who pays the price of dementia care?

Don't believe everything you read in the press!

One of the first things we all discover in crossing the threshold of the care maze, is that if our assets exceed £23,250, we'll be funding our own care. But surely that won't apply if we have a medical condition - or dementia? According to the Daily Mail...

"Costs for dementia care home residents who pay their own way to spiral to £78k a year - £21k MORE than councils will pay for sufferers with no savings... the disparity will hit middle-class families because free care is given only to those with less than £23,250 in savings of housing wealth."

The Daily Mail - front page news - Thursday, July 18 2019

Before you panic - let's unpack that a bit 

True? Only to an extent. 

Yes - if you have assets exceeding £23,250 you are, in theory responsible for meeting the costs of your care. Less than £23,250 and your local authority is responsible.

 But it's not quite as straightforward as that - as with everything, there are exceptions.
 

Do you have an ongoing medical condition?

If you are discharged from hospital, or moved from home into a residential care home and you have a medical condition that needs ongoing treatment, you may be eligible for NHS Continuing Healthcare, or Funded Nursing Care. In either case, it will be a multi-disciplinary team from the NHS and Local Authority that make that decision on the basis of current and future treatment needs, and your local Clinical Commissioning Group will determine how much will be paid. 

The agreed sum will be paid directly to the care home on a monthly basis - the care home will not be able to influence the amount of the payment. The Local Authority will review your case regularly: after the first three months and then annually. If and when your nursing requirements diminish, funding will be reduced or withdrawn.

Let's assume that you are in good medical health and have no nursing requirement but are unable to look after yourself and so need the support provided by a residential care home environment. In this case, you will be expected to fund your residential care needs yourself, assuming your assets exceed £23,250. If you are a home owner, the chances are that your assets do exceed that sum - but if you have a spouse, partner, child or relative (over 60 or disabled) living at home with you, then bear in mind that the value of the house will not be taken into consideration.

It is very common for a person with dementia to move into a residential care home specialising in dementia (not all homes do), once they are unable to cope at home - and are perhaps becoming a danger to themselves. At that point, it is highly likely that they won't have nursing needs and so, if their assets exceed £23,250, they will be expected to fund their residential care - in a dementia care setting. However... 

Is dementia a medical condition requiring ongoing nursing care? Discuss.

For the purposes of budget management, not necessarily. It depends on the individual concerned and the relative severity of their symptoms and how they present on a daily basis. And therein lies the challenge we all have to be aware of: dementia is a generic term covering many different strains - Vascular, Frontal Lobal or Lewy Body to name but three.

Dementia is a condition that thousands of people live with and manage well...

… some for many years. It takes various forms and can be slow in its progression. Sadly though, it will ultimately and irrevocably compromise a person's ability to function mentally or emotionally. It is progressive and terminal. And other symptoms, associated with it, may develop. However, although it can ultimately require dedicated 24-hour care, it is important to recognise, and to factor into our early calculations, that it often does not qualify for nursing care or therefore, funding from the NHS or local authority.

So with reference to the recent attention-grabber in the Daily Mail:

a. whether or not people with assets exceeding £23,250 should pay for their own care is one topic.

b. If, how and when people living with dementia should be supported financially is a separate topic.

Both are contenders for ongoing discussion but what the article with its shock tactics highlights to us here at Autumna, is how important easy access to well sign-posted, reliable information is for any of us who will be funding our own care. A little knowledge is vital - the more we know, the better. And it's our job to help you.
 

'You suffer from a heart condition, but you live with dementia.'

One is an illness which may entitle you to funded medical care. The other is a condition which requires specialist dementia care - not necessarily nursing or medical care.

"We need to understand that dementia is not, in itself, an illness and perhaps that's why is does not qualify the person living with it, for financial support. Yes, it requires specialist dementia care, but it does not necessarily require nursing care or ongoing medical treatment. As such it probably won't qualify for NHS Continuing Healthcare or Funded Nursing Care."

Debbie Harris, Founder of Autumna

A responsibility to inform and a desire to help.

Regardless of any loyalty (or otherwise) we may each have to a particular newspaper, we are all indebted to news publishers for the vital role they play in drawing our attention to what is going on. However, they also have a responsibility to inform in a balanced way. Sensationalism when it involves the big topics that impact us all is not the way to go, particularly when it affects the elderly and vulnerable.

Unfortunately, the Daily Mail article, in its desire for a 'Shock, Horror' headline, has not painted a complete picture - which is less about the difference in costs met by self-funders and local authority funded dementia residents, and more about how different medical conditions are viewed: what qualifies for funding and when.


Remember - Autumna is much more than just a care directory

If you find yourself confused by 'what the papers say', don't hesitate to call Autumna on 01892 335 330 for practical, sympathetic and honest support. That's what we're here for.

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