New here

my husband and I are informal carers for both my elderly parents. More of a supportive and organisational care ATM.
Both have memory problems and Dad has just been diagnosed with vascular dementia and also has physical disabilities secondary to arthritis , a previous hip fracture and a small stroke last year. He has osteoporosis and fully anticoagulated for stroke prevention.
Mum (who does all the cooking, and most of the washings and shopping) has widespread arthritis (ankles/shoulders/hips/spine) with quite bad curvature in her spine which was aggravated after she had a hip replacement which left her with leg length discrepancy. Also neuropathy in her hands and feet.
Never realised how hard it would be to get them the care and living modifications they need. Leaves you wondering why exactly the NHS seems to be focused on reducing heart attacks and strokes ie getting people to live longer when health and social care is for the elderly is so uncoordinated and fragmented and just doesn’t help people maintain their independence. Where’s the “rehabilitation”? Even after Dad’s fractured hip when he was in hospital for 4 weeks on an elderly rehab’ ward the focus wasn’t on rehab aspects like getting washed/shaved in the bathroom (as opposed to in bed with a bowl of water), eating meals at the table (Dining room and TV room there but just not used) and dressing independently. Very, very limited OT input and nursing staff didn’t seem to have a clue how to encourage independence.
The carers we have going in are about 19/20. Little experience and probably don’t even have an NVQ in care. I’m a retired nurse and hoped that (as things like instilling eye drops and putting compression stockings on seem to be classed as social care these days) they would pick up on and report skin issues, red eyes etc. Almost be my extra pair of eyes. The £15.60 an hour he pays is a rip off. I know registered nurses working in the NHS who don’t earn anything like that amount.
Would love to try and find a carer privately.

How is their care being funded at the moment?
A diagnosis of dementia means that dad is EXEMPT from Council Tax.
Do you have Power of Attorney?
Do they own their home, or rent?
Do they have over £46,000 between them?
Have they had a Social Services Needs Assessment?
Have you had a Carers Assessment?
Do you have any other brothers or sisters?
Are you living with them, or have a home of your own?

All the questions are very relevant, not as random as they appear!!

Hi & welcome Susan

Just a quick reply …

I’ll be back later.

The carer doesn’t get the whole fee. It’s the agency’s who take the large commissions etc.

There is a lot more to getting your own private carer.

Hi bb,
I don’t mind questions and understand they aren’t random. Just thankful that you’re showing an interest!
My Dad is self funding
He’s just started getting AA 2 months ago
He lives with my Mum so I assume that means they’ll qualify for a 25% reduction in Council Tax then?
My husband and I have EPA. It was set up many years ago with my parents as attorneys for one another. My parents have now surrendered their powers and the EPA has been registered with the OPG.
They own their own home
Do you mean over £46k annual income or in savings?
My Dad has a named social worker (since October last year) for all the good she seems to be. Dad was just under an annual review before then, but I requested a review of his needs in October when he started having falls and had a fairly acute episode of confusion during the night and fell. The SW did it over the phone (she’s never met him) but I’ve just discovered that his care plan wasn’t updated.

I’m just about to ask for a SS assessment for my Mum and also need to broach the subject of another memory assessment (she had one about 4 years ago which was borderline). Unlike my Dad, she’s quite prickly and not very easy going.Reluctant to have people coming into “her” house. Sometimes adamant that she can do all the things that are required, when it’s clear that things get forgotten, and she forgets past conversations and events. In a lot of ways , my Mum creates problems that harder to deal with/resolve than Dad does! The ongoing situation since he fractured his hip 3 years past November has been very hard for all of us. It’s affected our relationships and also my health (I suffer from anxiety and an autoimmune condition) I’m eternally grateful that I have such a supportive and laid back husband.
I’m an only child
I haven’t had a carers assessment, but my NHS pension is £600 a month so assume I wouldn’t be entitled to anything
We live in our own home

Oh yes, I understand that completely. I didn’t word it very well.
Regarding finding a carer privately, what I was trying to convey was that I don’t have much confidence in the carers because they’re so young and you know they’re only on minimum wage or thereabouts. Thanks for the link.
My Dad has a lot of needs, even if some of them only involve checking/assessment.

I must have a look at the documentation from the care agency. I’ve had some time out from visiting as often since Christmas (and obviously it’s COVID time too), so I’ve not been as “on the ball” ,although I’m at the end of my tether trying to get his social care increased (since last October).

Have a read …

You sound well organised.
Definitely get mum to have another test, then if positive it will mean she can have AA too, and Council Tax exemption, which I think means the won’t pay anything at all.
No one wants to admit to needing help, but it’s what she needs, not wants, that matters now.
The £46k is savings, over that Social Services expect people to arrange their own care.

So we could ask for a carers assessment for my Mum?

To be fair, having completed the AA form for Dad, I think Mum would probably qualify for the lower rate as she has significant difficulties with anything that she has to use her hands for, has chronic pain (everywhere!), and can’t bend down or reach up very far for things. Walks with a stick and has a noticeable limp (unequal leg length since hip replacement and curvature of the spine) despite one of her shoes being built up. I need to get back in touch with podiatry/orthotics too.

Yes, we were caught out about 6 months ago when the care agency had the capacity to increase Dad’s care , but Mum didn’t want people in the house more often. Then we had a chat and husband and I said it was about what Dad needed so she agreed, but then the carer agency didn’t have the capacity to increase care, and then we became aware that the Social worker has to OK the increase even though Dad self pays.
We’re not sure if it’s better if we carry on getting the care via the council or whether it’s easier to just go it alone. If we did that presume that Dad would still have his Social Worker? The system we have goes back to when he was discharged from hospital following his hip fracture. Initially he had the Intermediate care team (NHS) going in for 6 weeks and then carers via the council.

If you are sure dad has to pay for the care he receives, then you can do whatever you want.
That means that he has over roughly £46,000 in savings.

After I had a head on smash that nearly killed me, I had a private physiotherapist to help me recover from knee replacements, all paid for by the car insurance in my case. She also worked in the NHS with my consultant, and said how much she enjoyed seeing me, and being able to give me all the sessions I needed, rather than the standard NHS amount.

If you parents’ savings are just over the threshold, think about how to reduce their savings lawfully. You can spend whatever you like on proper treatment for them, they can have new carpets if some a getting thin, etc. Maybe a walk in shower.

As a retired nurse yourself, maybe employing a fully qualified nurse for a few hours a week would be better than the no qualification carers?

Needs assessment for Mum and carers assessment for you.

I can’t imagine how hard it must be for younger people after traumatic injuries ,trying to get the therapy input they need. The NHS spends so much on “medical” interventions and way too little on the rest.
I looked at some physio for Dad at our local private hospital after his hip fracture and they were prepared to provide it for £40 per 30 mins, but I didn’t have much success finding anyone at a private practice. There are a few practices in the area, but non that say they do anything with older people. I might contact the private hospital again but not sure if they’re open ATM. He would definitely benefit from some balance training and that was the comment that that the Falls consultant made in the GP letter.

I think one of the HUGE advantages of finding someone privately would be the continuation of care, which over and over again has been shown to be beneficial to people with enduring health problems, and also in people suffering with dementia. ATM he only has 2 visits a week and one week in 2 it’s 2 different carers. Also the fact that I could explain things to someone face to face and put together our own care plan.
The carers can’t get there till 09.30 so he has his breakfast in his dressing gown. Mum used to go in the shower straight after him when the other carers came at 08.30, but with the current timings she can’t do that as it takes them into lunchtime.

I’ve found a website called curamcare that has some local private carers. I thought I might contact some of them. Some have worked as HCA’s in the NHS and one was actually a RN. I wonder if anyone has any experience of the site, or how people have found their own carers?

Yes, re the savings. We’re looking at the bathroom ATM as the current shower tray has a fixed glass panel and tray is too small for a shower chair. We explored the service the council offer re survey, finding a contractor, overseeing the work etc as the online bumpf said “for a small fee”. The fee is 15% so we won’t be going that route.

We’re also in the process of getting quotes to make the front of the garage into an insulated utility area. It needs a new roof anyway, and the garage door is broken. The washing machine and tumble dryer are out there and it’s freezing in the winter.

Do you know if they would be seen as “deliberately trying to reduce their assets” if they gave some money to their grandson if there’s a genuine need, ie he has no savings and hasn’t been in full time contracted work since he got his degree 3 years ago until last March. At the moment he’s furloughed on his basic pay (BA cabin crew) and getting about £950 a month. His rent is £650. We were thinking about them putting some money into an ISA for him? They already give him £300 a month and have done for several years.

Thanks so much for the input. Really appreciate it

Are you on your local Facebook group?
I’ve seen people say “Can anyone recommend a …” and usually they get replies about who has been great.
After all, if you dad needs an hour physio, that would be easy for a young qualified mum not currently working.
It’s the same with carers. Maybe put an ad in your local paper for a trained nurse to help? You’d get far better quality of care that way.
I would have thought sorting out the garage door and the bathroom would be a good idea. With residential care homes costing £1,000+ in my area, it wouldn’t be many weeks of care! The better adapted their home is the longer they can stay there.
That’s only a lay person’s view of course.
Not sure about giving money to the grandson though. Hopefully he’ll be flying soon.

Yes I’m on several groups local to us and my parents (they live about 6 miles away from us) but one of Dad’s current carers lives just up the road from him and her mother (who was his carer briefly when we first changed to this new provider) is on the same group so a little reluctant to post on there. I’ve posted before about power cuts etc on their street before , so it wouldn’t take a genius to work out who I was, but I could certainly post on other pages and specify the area. The ad’ in the local paper sounds like an idea too.

Can I ask what the relevance of the £46k is please? They aren’t “just over” that amount. They’ve never been people to spend a lot of money on their home or luxury items. They loved their holidays (Dad was a geography teacher) and travelled abroad 3-4 times a year but haven’t been away anywhere since just before Dad broke his hip 3 years ago, so their savings are increasing . They both have their OAP’s (Mum doesn’t get the full amount) and teachers pensions, I need to look at how charges for residential homes work. Looked before but not sure it was very clear to me.

The current agency can’t provide what Dad needs (increase to 3 showers a week and shorter visits on other days to check he’s taken meds, had inhalers and put stockings on etc), but say they won’t work with other agencies. Is this usual? I can see the logic there but it makes things difficult.
The last agency we had were unreliable and one of the carers used to be on his phone (not having a conversation) whilst supervising Dad in the shower.

If a couple have over £46,000 then Social Services won’t contribute towards their care at all. Below that, there’s a sliding scale. They can pay you, but make sure it’s all done formally, via a payroll service, so SSD can’t be difficult if they get below that figure.

I contacted social services and they asked questions re independence in bathing and dressing and told me Mums only entitled to a carers assessment. Do they not use the criteria that’s covered by the AA application form? I think that has things like maintaining a safe home environment in and asks if you need help ( even if you don’t currently have help) with ADLs? I know my Mum struggles to bend to put socks and shoes on , therefore must struggle to wash and dry her feet, plus pain and neuropathy limit what she can do re home and personal care . She has memory problems and has been assessed as at moderate risk of falls by a consultant 3/4 yrs ago. As they’re self funding and given the poor service we’ve had from SS re Dad , I’m wondering if I should just apply for AA for Mum and sort some care out privately via the company who provide Dad’s care.
Any advice please?

SS called today . Support worker.
She was very reluctant to carry out even a carers assessment for Mum. " She’ll have to have a financial assessment and you’ll end up with 2 separate invoices. Better just to reassess Dad and increase his care package". At the time it didn’t feel right but she was one of those women who jabbbers on and takes 3 sentences to communicate what could be said in one.
Now I realise that surely that’s wrong and Mum should have an assessment in her own role as a carer?

Mum is legally entitled to an assessment in her own right. Go to “Quick Links” top left, go to the main site, and search for “Carers Assessment”. Or go to the LA’s own website and see what it says there.

Thanks so much BB. I’ll have a look. I’m really struggling with my own health needs ATM. All getting a bit too much and I’m feeling overwhelmed. Do you have any experience with " Social prescribers" ? Apparently GP surgery has a link worker and you can ask GP for a referral?

Never heard of a “social prescriber”. Sounds like a fancy term for not a lot?!?!
I was sent to a “life coach” at my GP surgery, made all sorts of suggestions about do this, that, and the other, not listening to me about my health issues, what I used to be like before I got ill, fit as a flea, strong as a man. Utterly useless.