With many families spread throughout the country, and sometimes beyond, Christmas can be the one big opportunity for a get-together. But, while it can be a time of great merriment, it can also be the time when you notice that an elderly relative might benefit from some additional care and support. Working out what's best for them isn't always easy, especially with emotional concerns often adding to the considerations around health, wellbeing and finances. This 10-point plan will help you consider the options available.
Consider the types of care available
Care homes aren't the only option if an elderly relative is finding it difficult to cope. Care can be provided in the home for anything from a short daily visit through to having someone live in to provide round-the-clock care.
You may also want to consider supported living arrangements, such as sheltered housing, where residents have the benefit of an on-site warden; retirement villages, which often have more communal facilities; or extra care housing, where domestic support and personal care can be provided, if needed.
There are also two types of care homes - residential care homes, which provide help with activities such as washing, dressing and meals; and nursing homes, where medical care can be provided, too.
Speak to the local authority
Although local authorities are feeling the financial pinch, they are a good starting point when looking for care. "Speak to someone in the adult social care team," says Chris Horlick, managing director of care at Partnership. "Some authorities are very good and will be able to handhold, others will only signpost, but they should all be able to provide useful information."
Arrange an assessment
Local authorities also have a statutory obligation to provide a care needs assessment. This will look at your relative's health and assess their care requirements. "Most local authorities will only provide care if the person's needs are either substantial or critical," says Philip Spiers, consultant to First Stop Advice. "Additionally, their finances will be assessed to determine whether the local authority will pay for the care."
Consider a power of attorney
If a relative is considering care, it's sensible to arrange a power of attorney, as this can help you manage their affairs and make decisions on their behalf, if necessary.
These must be arranged while the person still has mental capacity and there are two types available: an ordinary power of attorney, which allows you to manage their finances while they still have mental capacity; and a lasting power of attorney, which can cover their property and financial affairs and/or their personal welfare.
Lizzie Feltoe, policy adviser at Age UK, explains: "The personal welfare element covers areas such as where they live and what treatment they receive and only comes into play if they no longer have mental capacity."
Guidance can be found at the Ministry of Justice website (www.justice.gov.uk or 020 3334 3555) and there's a fee of £130 for each of the two elements of a lasting power of attorney.
Select a care home
Care homes vary greatly but, with the average length of stay two years and one in 10 residents living over eight years in care, it's important to spend time picking the right one. Tim Seal, regional director at Bupa Care Homes, recommends visiting a few before deciding. "Look for the obvious things such as whether it's well looked after and how the staff interact with the residents, but also check out the facilities and think about whether it's right for your relative," he explains.
It may also be possible to try out a home before making your decision. Where possible, Calderbank suggests arranging a short stay in the home for your relative. "This will give you both a sense of whether it's right," he says. "Remember it's a place to live not just a place to stay, so make sure it suits them."
Paying for care
Your relative will be expected to pay for their own care unless the value of their assets, including property if they're moving into a care home, is less than £23,250 (£22,750 in Scotland and £22,000 in Wales). "The local authority will provide some support if the assets are below this level, covering everything once it falls below £14,250," explains Seal.
Check benefit entitlement
Care costs can be significant - the average residential care home costs £27,200 plus a year, while you can pay £37,500 or more a year for a nursing home, according to Partnership - so it makes sense to claim all the benefits on offer. "If someone needs care they should claim for Attendance Allowance from the Department for Work and Pensions. This isn't means tested or taxable and you don't need to be receiving care to receive it," explains Bill Calderbank, managing director of CareAware. Someone assessed as needing care at day or night would receive £51.85 a week, while the rate increases to £77.45 if care is required around the clock.
You may also be entitled to help from the NHS through its Continuing Care funding. This is based on a health assessment and if health needs are great, care costs could be picked up by the NHS. Calderbank adds: "There are all sorts of benefits available, so speak to a specialist or your local Citizens Advice Bureau to make sure you claim everything you're entitled to."
Average weekly care home fees around the UK 2011/12
| Area | Care homes (£) | Care homes with nursing (£) |
| London | 679 | 850 |
| East Anglia | 554 | 736 |
| Southern Home Counties | 583 | 806 |
| Northern Home Counties | 607 | 867 |
| South West | 522 | 735 |
| West Midlands | 470 | 700 |
| East Midlands | 488 | 650 |
| North West | 474 | 647 |
| Yorkshire and Humber | 483 | 650 |
| North | 487 | 589 |
| Wales | 472 | 646 |
| Scotland | 566 | 672 |
| Northern Ireland | 466 | 553 |
Source: Partnership
Weigh up the financial planning options
Anything from savings and investments through to equity release and immediate needs annuities can be used to meet the cost of care. "What's right will depend on an individual's circumstances, but it's worth exploring all the options to see what works best," says Horlick.
For instance, if someone wants the peace of mind of a guaranteed income for life, an immediate needs annuity may be appropriate. Two companies are active in the market - Partnership and Friends Life - and both offer a range of options. As an example, payment from the annuity can be deferred for up to five years, reducing costs substantially, but giving certainty around future costs.
Get specialist financial advice
If you want to discuss the options available to you relating to funding long-term care, speak to an FSA-regulated financial adviser. To provide advice on this area, they will also need to hold specialist qualifications such as the Chartered Insurance Institute's CF8 or the Institute of Financial Services CeLTCI. This ensures they have an understanding of all the issues.
Calderbank also recommends looking for certain accreditations. "Look for Later Life Adviser Accreditation, which is audited and endorsed by the Financial Skills Partnership, and I'd also advocate finding a member of the Society of Later Life Advisers (SOLLA)," he explains.
