Money

Long-term-care services at a glance

11th December 2013

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Finding the long-term care that’s right for you

As we get older, health issues and reduced mobility can often make daily life more challenging. No matter how independent you want to be, the time may come when you need to think about the long-term-care services available to you.

Finding the long-term care that’s right for you

The first step is to ask your local council (or Health and Social Care Trust in Northern Ireland) to carry out an assessment of your care needs to help decide on the best care for you.

Clearly the main considerations will centre around your own well-being and independence, for example do you need nursing care or help with day-to-day tasks? It will also look at the needs of the people who live with you. But you’ll also need to consider other things, for example where family and friends live, what hobbies and interests you have, and whether you have (or would like) pets.

How a local authority care-needs assessment works

Home care or domiciliary care

Given a choice, most of us would like to stay at home as we get older. To help us do so, there’s a range of support services available, such as regular visits from a home care worker to help with personal care, shopping and preparing meals. Other services include ‘meals on wheels’, monitored personal alarms and household equipment to help with everyday tasks.

There may also be local day centres where you can socialise and enjoy various activities, with transport available to get you there.

Contact Age UK to find out what’s available in your area

Pros

You get to stay in your own home and keep all your belongings.

You’ll stay close to what’s familiar to you in your neighbourhood.

The value of your home isn’t taken into account when calculating how much you should pay for home care services.

You don’t need to adapt your home or receive care until you actually need it, so it’s a more cost-effective solution.

You retain full control over the care and support you receive, and can change things if you’re not happy.

Cons

If you have difficulty getting out and about, and don’t have friends or family visiting you, it can be lonely.

Despite alarm systems and regular visits from carers, you can still be at risk.

Home modifications and equipment can be unsightly and can affect the value of your property.

You may not like support workers coming into your home.

Care services to help you stay in your own home

Sheltered housing and extra care

These are purpose-built homes that that you can buy or rent from local authorities, housing associations or private companies. They’re designed to let you remain as independent as possible, while providing extra support if you need it. You get your own front door but there is usually on-site support, such as a warden, communal facilities and alarm systems. Sometimes the accommodation is available in retirement villages, which tend to be larger complexes offering more leisure and care services.

Alternatively, if you need different levels of care or plan to move into the care home at a later date, ‘extra care’ or ‘assisted living’ schemes are worth thinking about. You’ll live independently in your own home, often in the grounds of a care home, but will have nearby access to many services that help make your daily living easier.

Pros

You get to live independently in a smaller, and easier to manage, purpose-built home.

Your spouse or partner can move in too.

Friends and family can visit – depending on where it is, moving to a care home may actually mean moving closer to family, clubs and faith organisations.

It’s secure with round-the-clock alarms and/or wardens.

Many homes allow pets.

You can often take your own furniture and other belongings.

If you’re downsizing, you may be able to access some of your capital to make your finances easier.

Cons

You might miss the buzz of living among young families.

You may have to move away from things and people you know.

Moving to a smaller home might mean getting rid of some possessions.

You might have to sell the family home in order to buy or rent the new place.

Care homes

If your needs can’t be met at home or in supported housing, a care home may be the answer. There are two types:

care homes without nursing care that provide help and assistance with personal care, and

care homes with nursing care that have registered nurses and experienced care assistants in constant attendance.

Both are places where you can live (often with a spouse) and have your care needs met by trained staff. Some also have accommodation and support for older people with dementia.

Pros

If you have extensive or complex care needs, trained staff are always on hand.

You’ll always have company – friends and family can visit too.

There will often be organised activities.

You won’t have to worry about utility bills, meals and household chores.

It’s safe and secure.

You’re free to come and go, provided it doesn’t put you at risk.

Cons

It can be expensive.

All your belongings will need to fit in one room.

You may feel that you’ve lost some or all your independence.

Pets might not be allowed – although you can obviously check before moving in.

You may not enjoy the company of the other residents in the home.

Care home or home care?

Choosing the right care home

Intermediate care

This type of care is provided by the NHS. It’s often received in your own home but can also be received in a care home. These short periods of intensive medical care may include at-home medical support from a GP, 24-hour rapid response team or hospital-at-home scheme, therapy and nursing care.

You may qualify for intermediate care if:

you would otherwise need extended and inappropriate in-patient care

the recommendation has come as a result of a needs assessment

there’s a planned outcome that maximises your independence and well-being (typically that you can return home)

it’s limited to maximum of six weeks, and

it involves cross-professional working (for example doctors, specialist nurses and physiotherapists working together as a team).

Pros

You’ll get the specialist intensive care you need, around the clock.

You may be able to receive care at home.

The care provided is free (and so is your accommodation if you go to hospital).

Cons

If you’re treated in hospital, you could be away from home for up to six weeks.

Respite care

Does your partner or carer need a short break from caring for you? Or perhaps you need to stay somewhere for a short while to recover from illness? Going into respite care could be the answer, and some care homes allocate specific rooms for this purpose. Each local authority will have its own policy for charging for respite care.

Pros

You’re able to give the person who cares for you a break.

You may benefit from receiving the care if you are recovering from an illness.

You may enjoy the change of scenery and the company.

Cons

You may have to pay a lot for the accommodation.

You’ll be away from your home and familiar surroundings.

How much is it going to cost?

TOP TIP

24-hour care at home could around £150,000 a year. In these cases, residential care is usually more cost effective.

The average cost of a residential care home place in the UK is about £28,000 a year, and £37,500 if nursing care is required (according to healthcare experts Laing & Buisson’s most recent report, 2011/12). If you live in the South East, it could be closer to £50,000.

Despite the housing price slump, the value of sheltered housing has held up well – not good news if you’re selling to buy. And even if you’re going down the care-at-home route, you’ll find that at approximately £17.30 an hour, two hours of daily care could amount to more than £12,500 a year. Live-in care can start at £40,000 a year.

If you need 24-hour care at home, costs could easily rise to more than £150,000 a year. In these circumstances, residential care is usually more cost effective.

Care services at a glance

Type of care	State-funded?	Self-funded?	More information
Home care	Yes	Yes	Local authorities are likely to charge for services.
Sheltered housing	Yes	Yes	You may be entitled to Housing Benefit.
Intermediate care	Yes	No	It’s usually restricted to six weeks.
Respite care	Yes	No	In some circumstances, you’ll need to pay.
Residential home	Yes	Yes	You may be self-funded, or part-funded by your local authority (or Health and Social Care Trust in Northern Ireland).
Nursing home	Yes	Yes	You may be self-funded, or part-funded by your local authority (or Health and Social Care Trust in Northern Ireland). You may be fully funded by or receive a contribution towards the nursing costs from the NHS (or HSC in Northern Ireland).
Hospital	Yes	No	Accommodation, nursing care and personal care costs are provided free.