Phil Parry explores the services provided for the elderly in Wales.
I have recently had to put my elderly mother into a home. This was a traumatic experience, but less difficult than the previous few months.
With the present controversy over implementing the recommendations of the Williams commission, and slimming down the 22 local authorities in Wales, it has given me an insight into what is at stake at a personal level.
This month’s news of the closure of a care home in Abergele, after inspectors found evidence of neglect, made the issue even more pertinent.
I effectively “bought” a year for my mother by arranging care to support her in her own house. By the end, I had organised five carer-visits, plus meals on wheels, to call at her small semi-detached house every day. But once the early morning carer arrived to get my mother up and washed, and found her sitting on the bed freezing cold that was it. It was game over. My mother evidently had got out of bed in the night and could not get back in again. Within hours she was out of the house she had lived in for more than 50 years, never to return.
First she went into respite care then into a residential home. A quick but important decision had to be made by me about which residential care home was suitable, because my mother would obviously spend the rest of her life there.
I used all my journalistic powers investigating the home I had in mind, and even loitered unseen in the lounge listening to how the nurses coped with a particularly obstreperous old woman. They were patient and kind, and the home, thankfully, is superb. The care my mother received over the last year was also exceptionally good. But arranging it was another matter.
The difficulty is there is little or no co-ordination between services. I had to make several telephone calls – sometimes to different people in the same building – to arrange nursing care, doctors visits, physiotherapists, social services etc. I had to do it, for example, to sort out the cutting of my mother’s toe nails, which she obviously could not do herself, but could not, apparently, be carried out by the carers. I would have had to endure a wait of months for this vital service to be carried out through the NHS, so, like many others, I arranged it privately.
I stress that all the care my mother received was excellent. But co-ordination, apart from through me, was lacking. Luckily I work mainly from home and I am flexible, so I could attend to things but heaven only knows how I would have done it working in an office from nine to five.
Once it became obvious my mother, who is 89, could not cope in her own house, I entered the maze of financial arrangements. Let there be no mistake the end of life is undignified, and a worry for loved ones. You are allowed “savings” of a few thousand pounds before the local authority steps in to pay the basic price of a residential bed.
I had to arrange to sell my mother’s house to pay for her care, for which you are “given” three months. The local authority will pay the basic package of care upfront, which has to be paid back, while you sell the house. The house is valued at about £200,000, and once it sells, it is deemed my mother then has accessible finances to pay for the home.
After this period, if the house is still on the market, the authority will in effect “lend” the money, at a minimal rate of interest, and continue to pay for the residential home upfront. Once the house is sold, residential care must then be paid privately until the resources have reached the “savings” figure (unless you have been canny and dodged the taxman by getting your parent to “gift” you the house at least seven years before he or she dies).
For my mother’s fairly dingy room, the home charges £610 a week. This is not the top rate and the home is very good. The more basic rooms, without an ensuite toilet, which the local authority may fund, are more than £550 a week.
I have calculated my mother will be able to live in the home for about eight and a half years before the money runs out – she will then have to move to a cheaper room or even to another home at what, at that point, will be a very great age.
All of these immensely complicated financial decisions have to be made when your brain is in a position where it is least able to cope with them. When the time came for me to decide on a home for my mother – an extremely important choice which had to be made very quickly – I came face to face with the problems of having 22 local authorities in Wales.
The social services department in Monmouthshire – which is superb – had details for homes in their county but not for those in the next-door one, Newport. I live in Cardiff so obviously Newport would be nearer for me, but I had to establish any information about homes there myself.
This needs to be sorted out, and sooner rather than later. The financial situation, however, has no easy policy solution. My mother is not a poor woman. She owns a house worth several thousand pounds and has savings on top, so she has significant financial assets.
On the one hand, somebody working hard and without much money might rightly say ‘why should I pay through my taxes for the care of a rich person?’ On the other hand, at an emotional level, it does not seem right for somebody to be forced to sell the home she has lived in for the last half century, to pay for care in the last few years of life.
Arranging support for my mother has been enormously difficult and an emotional roller- coaster.
But at least now I know she is safe.
One thought on “An old story”
What we have here is a classic example of silo working with the complete disjoint of service provision from Ambulance, Health , Social Care and private home providers. Often the front line staff provides a dedicated range of care and health provision within a bureaucratic structure that often never listens to the professionals. Why this has been allowed to happen when the funding originates from one source (Welsh Government) is beyond belief. It is such a tragedy that the morale of front line staff is so low from working within a system that clearly is neither efficient of cost effective.
With the known facts of increasing numbers of elderly residents this cannot carry on.
Top down target setting to meet political aspirations are nothing more than a fanciful way of chasing a dream and keeps those in need in a pigeon whole that prevents them being moved on.
How often do we hear of people being blocked in hospital beds because their care package has nor been sorted. I have just come across one in Wrexham where an elderly person was ready for discharge but it took two weeks before the care provider could discuss the requirements as the necessary Council officer was on holiday and no one else was authorised to sign the necessary paperwork.
Unless we are going to progress to a system of no treatment as defined by the now discredited (I hope) Liverpool Pathway then there will only be increasing pressures.
Our politicians need to be very wary now that within a few years there will be more retired people than workers in Wales — the democratic right to determine a political future and policies will rest with the silver surfers..
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