Alternatives to ‘Care’
It is baffling why all the focus on older living should be on the cost of ‘care’, be it social care or residential care.
More often than not, it is the quality rather than the cost of care which is the problem.
Handsome is not as handsome pays when it comes to care. Plus, most grannies would rather throw themselves off a bus than submit to either. So, given that there are going to be an extra million over 80s within 20 years, why aren’t we thinking outside the box?
Living with the family – Back to the Future?
It is a fact that in societies where older people live with their family, in multi-generational households, the incidence of dementia is far lower. You don’t have to be Einstein to realise there could be a link between older people being part of a social group and their mental well- being.
Not everyone gets on with their older relatives or could bear the idea of their mother or father taking up residence. And not all grandparents want to be that closely involved in their children’s lives. But there are benefits and it is going to become more common, as the housing shortage and care crisis continue.
Options can be limited by space and cost, but also by imagination. Although many homes these days do not appear to offer the possibility of a granny annexe or it might seem too costly, there are a wide variety of possibilities for extending homes – especially if the older relatives can help fund such alterations.
Some families opt to invest in a large property, big enough for all, well before the grandparents become infirm. The benefits can be obvious. Others opt for self-contained arrangements, which can provide that extra elbow room essential to some relationships.
Not only can living costs be reduced by such arrangements, it is also a potential method of securing inheritance – depending on the ownership terms of such an agreement and the timing of the purchase/alterations.
Out of the Box – Ghastly phrase but appropriate
As an alternative to sharing a house with older relatives, there is a growing market in granny pods – some of which come flat packed. These can be placed in the garden, adjacent to a family member’s home and can appear literally overnight.
Australia has led the way in developing these pods and for a ready-made pod or cabin the cost can be £50-£70,000, if you buy one outright. Some are really luxurious. If you buy a self-build kit, you can be looking at a fraction of that price but you will need to be handy. Obviously, they will inevitably attract the interest of planning authorities. In Australia, you can rent one and return it when no longer needed.
Several companies in the UK are developing this market here. These can be found easily on the internet and these pods/cabins look set to become a regular feature and can always be adapted for student use.
Co-owning a property - Not alone at home
If you haven’t got a family, or would rather not live with them anyway, there is always the option of living with friends or even strangers in a shared living arrangement, designed to split costs and cut down on social isolation.
A group of older women in London has developed an entire housing project, where each woman has her own property but they share areas and live communally. See here for more information. They took their inspiration from overseas, but such arrangements look set to be a real alternative for older people in future. There are other shared living arrangements springing up around the country. A little research can find if there are any in your area.
These should not be seen as an alternative to a care home, if someone has substantial care needs. But they offer community and cut social isolation. Friends, sisters and even wider social circles are investing in properties suitable for communal living. It is not just a Marigold Hotel fantasy.
Live-in Care - Compromise but comfortable
If an older person is beyond moving or would simply rather stay in their own place, they can still avoid going into residential care. There are increasing live-in options. These are becoming more popular but are not cheap. Having said that, neither is a residential home.
Under such an arrangements, a carer lives with you. This can be a direct contract or through one of the many agencies,
When the carer takes a break, agencies will send a stand-in or relatives can take over, if the person cannot be left at all.
While this could be costly, it can actually be less expensive than a residential home and more appealing to families - the house does not have to be sold and the relative gets to stay where they are happy.
Agencies usually sort out tax, national insurance and pension. This means they are more expensive than introducers.
There are downsides, of course.
Family members can be unhappy at the idea of a ‘stranger’ living in their parents’ home and becoming a key figure in their parents’ lives.
But, when the alternative may be residential care, it may not seem so bad.
You may not be happy with a particular carer – but there are others. And, if you go through an agency, you can always change.
It sounds expensive but ,when you think that residential homes can charge similar amounts,
considerably more if you’re talking about a couple, then live-in care can be a real alternative.
Plus, some local authorities currently do not take account of the value of your property when assisting with home care funding – so they will help pay as long as you do not have much cash in the bank. Some will even contribute towards the cost of live-in care, if you qualify under their rules.
At the moment, each Local Authority has its own rules about how sick or needy you have to be to qualify - and you need to find out what is applicable in your parent’s area. Even if you cannot get any funding, this could be the best worst option.
There are numerous live-in care agencies, many operate on a local basis others are nationwide. You ,obviously, will take a close interest in a live-in carer’s background and experience . But reputable agencies will carry out rigorous tests and training .
If you are a fund holder [where you are granted money by the authorities to pay for care], you may be able to use this money to pay for live-in care and even top-up, if necessary. But the rules vary from one local authority to another.
In terms of funding, equity release can be a way forward, to pay for care, so the cost will only be felt when the house is sold.
There are increasing numbers of assisted living or extra care housing projects - although you do have to prefer the company of older people, since many are cut off from the local community - often deliberately.
They offer the prospect of remaining 'at home' but they also entail living in an exclusively older community or 'ghetto'. It may be that this is the best on offer in the current situation. Both offer independent living of a sort for older people - with support.
In many Sheltered or Assisted Housing sites, there will be a warden and communal rooms - offering social opportunities. But the warden may not be a 24-hour fixture. Such places vary greatly in terms of facilities and care offered. And someone who struggles to live independently in an adapted home, may also struggle in a light-touch sheltered property.
However, you can have care visits in a sheltered home and, supporters argue, it is the best of both worlds - home living and care home-style protection. But some sheltered options are not available once you become very infirm and you may need already to be resident before you become in need of assistance.
Extra Care housing is the way of the future, if you listen to its supporters. And they are many. It is similar in some ways to sheltered housing. But it is usually much more luxurious and offers a lifestyle to which many older people could only aspire.
Gyms, swimming pools etc are all part of the deal and some developments seem like exclusive social clubs for the well-heeled older generation with properties costing into the millions. But, when you need it, there is care and help. What's not to like? Well....
It is wise to check the small print.
Extras costs and service charges can be high.
Also, some developers take a slice of the proceeds when you come to sell - rather as the Government is planning to do with social care. The idea is not to overload residents with full cost of the care until they sell.
These places look great but you need to make sure the costs are not going to spiral out of control.
Some have care homes on site, for when the need arises. But they can be just like any care home.
They are increasingly popular in the antipodes and likely to become a major feature of life for the older market here.