The inequities of long-term care - in microcosm

We probably all have our suspicions of the flakiness of State long-term care provision, but it generally takes a personal experience to bring it all home.

I was struck recently, whilst reading the CII's CF8 Study Guide, by the enormous gulf that exists between the theory of State provision (including the infamous 'Continuing Care' appraisal process) and the actual reality on the ground.  It really does seem as if we have a system which the various non-integrated care providers manipulate for all its worth, in order to avoid footing the bill for an individual's care.

Take my wife's Uncle.  A retired GP, with nary a day on the sick for his entire life, he succumbed to a particularly vicious form of Alzheimers' disease, which rendered him fit only for institutional care, within a frighteningly short timescale.  What functionality he has left, is a product of a cocktail of anti-psychotics, but he (temporarily) is at least relatively happy in a local home specifically designed from the ground up for Alzheimers' sufferers.

This is a man who one could not describe as ever having been a drain on the National Insurance system - and in fact a very significant net contributor to it over his lifetime.  And yet, the moment his condition became stabilised by medication, the 'free' care under the Continuing Care system was withdrawn.  Now, the baton was taken up by the Social Services - and what a difference for the family, on the receiving end.

First off, the full State Pension plus attendance allowance disappeared in its entirety.  Next, two-thirds of his occupational pension was taken, forcing his wife to continue working into retirement.  Thirdly, to add insult to injury, Social Services determined that the 'Alzheimers' Home' was too expensive, and instead are going to send my wife's Uncle 'somewhere else' - where the only criteria is that it is cheaper.

There is no consideration as to what is appropriate for the patient - Social Services have made it quite clear that the issue is quite irrelevant to them.  The only consideration is one of cost (a saving of £100 per week), where the focus is on incarceration instead of care, and of course real people with real needs become, in effect, the political football of two care-providers (NHS and Social Services) who both know well how to play the game, so they avoid footing the bill.

It occurred to me how important it is for our clients to be aware of this uncivilised and demeaning world that we enter when we become vulnerable in our old age.  Whatever the 'system' does or does not deliver for those in need, the stark fact is that it does not 'care' about the vulnerable.  It merely 'cares' about balancing budgets, and if our clients are going into retirement without a realistic idea of the real costs of long-term care, then we (as IFAs) are doing them a profound disservice.

Are you talking to your clients about long-term care planning?