LEAVE the Conservative Party and save your country!

pblakeney

webboo said:

rick_chasey said:

I literally had the discussion with the hospital about why the FIL can’t stay in hospital on a ward and instead had to go into home 3 months ago.

I am looking at a leaflet in my hand that says “unfamiliar locations” can cause an exacerbate delerium.

1 in 5 patients in hospital get it

https://www.nbt.nhs.uk/patients-carers/coming-hospital/dementia-care/patient-information-delirium

Maybe you should actually read the leaflet and what the first sentence says.

You are going to have to clarify that point.
"Delirium is a state of mental confusion that can happen if you become medically unwell."
If you are in hospital then surely you are medically unwell?

rjsterry

rick_chasey said:

Honestly. It is literally an investment. It is according to any definition an investment.

You can't just deny it's an investment because you live in it.

I think the difference is that it is not purely an investment. Whereas buying some shares is. People want some reassurance that they aren't chucking money away on a property, but beyond 'holding its value' I don't think many are buying a property they live in primarily for its growth in value above inflation.

ddraver

How do you say "outlier" in Etonian..?

https://twitter.com/BritainElects/status/1436080285309972487?s=19

webboo

pblakeney said:

webboo said:

rick_chasey said:

I literally had the discussion with the hospital about why the FIL can’t stay in hospital on a ward and instead had to go into home 3 months ago.

I am looking at a leaflet in my hand that says “unfamiliar locations” can cause an exacerbate delerium.

1 in 5 patients in hospital get it

https://www.nbt.nhs.uk/patients-carers/coming-hospital/dementia-care/patient-information-delirium

Maybe you should actually read the leaflet and what the first sentence says.

You are going to have to clarify that point.
"Delirium is a state of mental confusion that can happen if you become medically unwell."
If you are in hospital then surely you are medically unwell?

Rick implies that the environment causes the delirium in his early post rather than an underlying medical condition.

pangolin

webboo said:

pblakeney said:

webboo said:

rick_chasey said:

I literally had the discussion with the hospital about why the FIL can’t stay in hospital on a ward and instead had to go into home 3 months ago.

I am looking at a leaflet in my hand that says “unfamiliar locations” can cause an exacerbate delerium.

1 in 5 patients in hospital get it

https://www.nbt.nhs.uk/patients-carers/coming-hospital/dementia-care/patient-information-delirium

Maybe you should actually read the leaflet and what the first sentence says.

You are going to have to clarify that point.
"Delirium is a state of mental confusion that can happen if you become medically unwell."
If you are in hospital then surely you are medically unwell?

Rick implies that the environment causes the delirium in his early post rather than an underlying medical condition.

They're not there for a holiday are they, they're there because they have a medical condition. He said it made dementia worse, dementia is caused by medical conditions.

surrey_commuter

I am guessing the split on this issue is between people who have seen this disease close up and those who haven’t.

rjsterry

webboo said:

rick_chasey said:

TheBigBean said:

I have no great insight on the whole care home thing, but if it is compared to treatment for other illnesses wouldn't patients be expected to be on wards rather than in their own private rooms?

What is the difference between around the clock care from nurses with occasional doctor visits in a home with your own room or in a hospital?

You can’t have people on wards for years on end.

Also, for dementia, feeling “homely” can help with the symptoms quite a bit.

Hospitals often exacerbate symptoms and can bring on delerium which can be a catalyst for decline, so they try to keep dementia type patients out of hospitals where they can.

rick_chasey said:

TheBigBean said:

I have no great insight on the whole care home thing, but if it is compared to treatment for other illnesses wouldn't patients be expected to be on wards rather than in their own private rooms?

What is the difference between around the clock care from nurses with occasional doctor visits in a home with your own room or in a hospital?

You can’t have people on wards for years on end.

Also, for dementia, feeling “homely” can help with the symptoms quite a bit.

Hospitals often exacerbate symptoms and can bring on delerium which can be a catalyst for decline, so they try to keep dementia type patients out of hospitals where they can.

rick_chasey said:

TheBigBean said:

I have no great insight on the whole care home thing, but if it is compared to treatment for other illnesses wouldn't patients be expected to be on wards rather than in their own private rooms?

What is the difference between around the clock care from nurses with occasional doctor visits in a home with your own room or in a hospital?

You can’t have people on wards for years on end.

Also, for dementia, feeling “homely” can help with the symptoms quite a bit.

Hospitals often exacerbate symptoms and can bring on delerium which can be a catalyst for decline, so they try to keep dementia type patients out of hospitals where they can.

You appear to have made this stuff up. Delerium is medical condition brought on usually by an acute infection not by the environment. Hospital can exacerbate confusion and familiarity with one’s environment will cause less distress. Most people with dementia probably can’t tell you how they feel so how can they feel homely even if there is such a thing.

F*** knows why you are arguing the toss on this point, but the bit in bold is nonsense. Dementia doesn't immediately remove the ability to communicate. People with dementia are more comfortable when in familiar surroundings. A hospital is about as unfamiliar and disorientating as it gets and just the fact of being there can worsen outcomes. Unfamiliar surroundings are a contributing factor.

rjsterry

surrey_commuter said:

I am guessing the split on this issue is between people who have seen this disease close up and those who haven’t.

Quite.

Jezyboy

surrey_commuter said:

I am guessing the split on this issue is between people who have seen this disease close up and those who haven’t.

A few weeks with a poorly relative in hospital who was placed next to a dementia patient was more than close enough.

Before that I just thought dementia was old people getting a bit forgetful in their dotage, which I guess is one description of it, but is rather a mild one.

webboo

rjsterry said:

webboo said:

rick_chasey said:

TheBigBean said:

I have no great insight on the whole care home thing, but if it is compared to treatment for other illnesses wouldn't patients be expected to be on wards rather than in their own private rooms?

What is the difference between around the clock care from nurses with occasional doctor visits in a home with your own room or in a hospital?

You can’t have people on wards for years on end.

Also, for dementia, feeling “homely” can help with the symptoms quite a bit.

Hospitals often exacerbate symptoms and can bring on delerium which can be a catalyst for decline, so they try to keep dementia type patients out of hospitals where they can.

rick_chasey said:

TheBigBean said:

I have no great insight on the whole care home thing, but if it is compared to treatment for other illnesses wouldn't patients be expected to be on wards rather than in their own private rooms?

What is the difference between around the clock care from nurses with occasional doctor visits in a home with your own room or in a hospital?

You can’t have people on wards for years on end.

Also, for dementia, feeling “homely” can help with the symptoms quite a bit.

Hospitals often exacerbate symptoms and can bring on delerium which can be a catalyst for decline, so they try to keep dementia type patients out of hospitals where they can.

rick_chasey said:

TheBigBean said:

I have no great insight on the whole care home thing, but if it is compared to treatment for other illnesses wouldn't patients be expected to be on wards rather than in their own private rooms?

What is the difference between around the clock care from nurses with occasional doctor visits in a home with your own room or in a hospital?

You can’t have people on wards for years on end.

Also, for dementia, feeling “homely” can help with the symptoms quite a bit.

Hospitals often exacerbate symptoms and can bring on delerium which can be a catalyst for decline, so they try to keep dementia type patients out of hospitals where they can.

You appear to have made this stuff up. Delerium is medical condition brought on usually by an acute infection not by the environment. Hospital can exacerbate confusion and familiarity with one’s environment will cause less distress. Most people with dementia probably can’t tell you how they feel so how can they feel homely even if there is such a thing.

F*** knows why you are arguing the toss on this point, but the bit in bold is nonsense. Dementia doesn't immediately remove the ability to communicate. People with dementia are more comfortable when in familiar surroundings. A hospital is about as unfamiliar and disorientating as it gets and just the fact of being there can worsen outcomes. Unfamiliar surroundings are a contributing factor.

I’m arguing the toss because a change to unfamiliar surroundings and change of environment do not cause dementia or delerium or make it worse. They just make it much more apparent or show you how severe it actually it is.

rjsterry

webboo said:

rjsterry said:

webboo said:

rick_chasey said:

TheBigBean said:

I have no great insight on the whole care home thing, but if it is compared to treatment for other illnesses wouldn't patients be expected to be on wards rather than in their own private rooms?

What is the difference between around the clock care from nurses with occasional doctor visits in a home with your own room or in a hospital?

You can’t have people on wards for years on end.

Also, for dementia, feeling “homely” can help with the symptoms quite a bit.

Hospitals often exacerbate symptoms and can bring on delerium which can be a catalyst for decline, so they try to keep dementia type patients out of hospitals where they can.

rick_chasey said:

TheBigBean said:

I have no great insight on the whole care home thing, but if it is compared to treatment for other illnesses wouldn't patients be expected to be on wards rather than in their own private rooms?

What is the difference between around the clock care from nurses with occasional doctor visits in a home with your own room or in a hospital?

You can’t have people on wards for years on end.

Also, for dementia, feeling “homely” can help with the symptoms quite a bit.

Hospitals often exacerbate symptoms and can bring on delerium which can be a catalyst for decline, so they try to keep dementia type patients out of hospitals where they can.

rick_chasey said:

TheBigBean said:

I have no great insight on the whole care home thing, but if it is compared to treatment for other illnesses wouldn't patients be expected to be on wards rather than in their own private rooms?

What is the difference between around the clock care from nurses with occasional doctor visits in a home with your own room or in a hospital?

You can’t have people on wards for years on end.

Also, for dementia, feeling “homely” can help with the symptoms quite a bit.

Hospitals often exacerbate symptoms and can bring on delerium which can be a catalyst for decline, so they try to keep dementia type patients out of hospitals where they can.

You appear to have made this stuff up. Delerium is medical condition brought on usually by an acute infection not by the environment. Hospital can exacerbate confusion and familiarity with one’s environment will cause less distress. Most people with dementia probably can’t tell you how they feel so how can they feel homely even if there is such a thing.

F*** knows why you are arguing the toss on this point, but the bit in bold is nonsense. Dementia doesn't immediately remove the ability to communicate. People with dementia are more comfortable when in familiar surroundings. A hospital is about as unfamiliar and disorientating as it gets and just the fact of being there can worsen outcomes. Unfamiliar surroundings are a contributing factor.

I’m arguing the toss because a change to unfamiliar surroundings and change of environment do not cause dementia or delerium or make it worse. They just make it much more apparent or show you how severe it actually it is.

Nobody said it causes dementia. Granted a sample of one, but I have seen the effect that just moving to another bedroom had on my father in law. We can split hairs over whether his dementia was clinically worse or he was 'just' less happy in himself (and told us so) but it boils down to much the same. Given you started your point by suggesting people with dementia can't tell you how they feel, let's stop this here.

rick_chasey

Anyway, I only brought it up to illustrate that just because it's not treated in hospital doesn't mean it's not an illness.

It's a better way for caring for the patients. A more "homely" setting can make things easier for everyone, even if they still need around the clock nursing care.

pblakeney

Anyone done a cost comparison of going into a care home and hiring 3 (or whatever number required) nurses working shifts?
I think the hardest part of that is if the patient is a danger to themselves or others.
As I see it there are 3 levels of care and when you get to the third there isn't many options.
1. Home visits to treat the patient.
2. Full time care in the home (if possible) or moving into a care home out of choice.
3. Moving into a care home as the other options are not viable/patient too far gone.

Hospitals are not really the place for palliative care.

surrey_commuter

pblakeney said:

Anyone done a cost comparison of going into a care home and hiring 3 (or whatever number required) nurses working shifts?
I think the hardest part of that is if the patient is a danger to themselves or others.
As I see it there are 3 levels of care and when you get to the third there isn't many options.
1. Home visits to treat the patient.
2. Full time care in the home (if possible) or moving into a care home out of choice.
3. Moving into a care home as the other options are not viable/patient too far gone.

Hospitals are not really the place for palliative care.

in my sample size of one by the time a care home was the only option there was little difference in cost

pblakeney

surrey_commuter said:

pblakeney said:

Anyone done a cost comparison of going into a care home and hiring 3 (or whatever number required) nurses working shifts?
I think the hardest part of that is if the patient is a danger to themselves or others.
As I see it there are 3 levels of care and when you get to the third there isn't many options.
1. Home visits to treat the patient.
2. Full time care in the home (if possible) or moving into a care home out of choice.
3. Moving into a care home as the other options are not viable/patient too far gone.

Hospitals are not really the place for palliative care.

in my sample size of one by the time a care home was the only option there was little difference in cost

Good to know, even if not good news.
I was thinking the "hotel" costs would be higher. Die at home or lose the home then.

surrey_commuter

pblakeney said:

surrey_commuter said:

pblakeney said:

Anyone done a cost comparison of going into a care home and hiring 3 (or whatever number required) nurses working shifts?
I think the hardest part of that is if the patient is a danger to themselves or others.
As I see it there are 3 levels of care and when you get to the third there isn't many options.
1. Home visits to treat the patient.
2. Full time care in the home (if possible) or moving into a care home out of choice.
3. Moving into a care home as the other options are not viable/patient too far gone.

Hospitals are not really the place for palliative care.

in my sample size of one by the time a care home was the only option there was little difference in cost

Good to know, even if not good news.
I was thinking the "hotel" costs would be higher. Die at home or lose the home then.

you still have to sell the home to pay for your at home care, presumably they would visit you under the arches

pblakeney

surrey_commuter said:

pblakeney said:

surrey_commuter said:

pblakeney said:

Anyone done a cost comparison of going into a care home and hiring 3 (or whatever number required) nurses working shifts?
I think the hardest part of that is if the patient is a danger to themselves or others.
As I see it there are 3 levels of care and when you get to the third there isn't many options.
1. Home visits to treat the patient.
2. Full time care in the home (if possible) or moving into a care home out of choice.
3. Moving into a care home as the other options are not viable/patient too far gone.

Hospitals are not really the place for palliative care.

in my sample size of one by the time a care home was the only option there was little difference in cost

Good to know, even if not good news.
I was thinking the "hotel" costs would be higher. Die at home or lose the home then.

you still have to sell the home to pay for your at home care, presumably they would visit you under the arches

You missed my point.
If your children are lucky you will not need that level of care and will die at home.
If you need that level of care then the home has gone bye bye*.

*Unless you have planned well in advance to meet all legal and tax conditions. Not to mention trust. I know of one guy who sold his mothers house from under her once he had control and put her in a dingy flat.

ddraver

He wasn't called Stevo was he..?

orraloon

Uh oh, is that shortfall the Toryboi alterego doing the anti-like? 😊

(Toryfanboi club gonna toryfanboi club, is what they do)

pblakeney

ddraver said:

He wasn't called Stevo was he..?

Nope. He is a Pat.
A Toryfanboi though.

surrey_commuter

Yorkshire County Cricket Club released the report into their racist failings minutes after the Test Match was called off, obviously seeing it as a chance to bury bad news.

I feel it belongs in this thread as it is such a cvntish thing to do it must be tied to Boris’s circus.

Stevo_666

ddraver said:

He wasn't called Stevo was he..?

Funny you mention that ddr, as my old dear died 2 years ago after a 5 year battle with dementia. She was in a care home for the last 2 of those after my old man died from from a stroke/pneumonia. I used the family home as a base so I could visit anytime that I could (265 mile drive so just popping over after work not practical). The house was sold some time after she died.

My folks did have the good sense to change their ownership of the house from joint tenants to tenants in common and willed their respective halves of the house directly to me. That way, if the council come calling for care money, they can only take the half that belongs to the parent that needs care. I would recommend anyone with 2 surviving parents who own their own home make the same arrangements to protect their inheritance.

surrey_commuter

Stevo_666 said:

ddraver said:

He wasn't called Stevo was he..?

Funny you mention that ddr, as my old dear died 2 years ago after a 5 year battle with dementia. She was in a care home for the last 2 of those after my old man died from from a stroke/pneumonia. I used the family home as a base so I could visit anytime that I could (265 mile drive so just popping over after work not practical). The house was sold some time after she died.

My folks did have the good sense to change their ownership of the house from joint tenants to tenants in common and willed their respective halves of the house directly to me. That way, if the council come calling for care money, they can only take the half that belongs to the parent that needs care. I would recommend anyone with 2 surviving parents who own their own home make the same arrangements to protect their inheritance.

As always thanks for the tax advice - does that mean that you think Boris’s social care revolution will not happen or that it will not work as intended?

Stevo_666

surrey_commuter said:

Stevo_666 said:

ddraver said:

He wasn't called Stevo was he..?

Funny you mention that ddr, as my old dear died 2 years ago after a 5 year battle with dementia. She was in a care home for the last 2 of those after my old man died from from a stroke/pneumonia. I used the family home as a base so I could visit anytime that I could (265 mile drive so just popping over after work not practical). The house was sold some time after she died.

My folks did have the good sense to change their ownership of the house from joint tenants to tenants in common and willed their respective halves of the house directly to me. That way, if the council come calling for care money, they can only take the half that belongs to the parent that needs care. I would recommend anyone with 2 surviving parents who own their own home make the same arrangements to protect their inheritance.

As always thanks for the tax advice - does that mean that you think Boris’s social care revolution will not happen or that it will not work as intended?

No so much that. You're right, it may not impact a lot of people re care fees going forwards unless their assets are low but worth doing anyway for the reason below (and in case care fees policy changes again in the longer term). You can also have any other assets owned by either parent willed to the kids btw.

It is still a good strategy anyway for most people as it can also mitigate inheritance tax. If care fees stay capped then there are likely to be more valuable estates around around that would catch IHT and the set up allows you to use 2 lots of IHT allowance. (That wasn't really an issue for me as my parents lived in Redcar).

kingstongraham

What proportion of estates do you think pay inheritance tax?

Stevo_666

kingstongraham said:

What proportion of estates do you think pay inheritance tax?

Google is your friend
https://sproullllp.co.uk/how-many-people-actually-pay-inheritance-tax/

Clearly a lot higher in London and the SE.

pangolin

4% is surprisingly low. I wonder what the % would be if nobody took steps to avoid it. (i.e. perhaps 8% would have paid some but half got around it?)

Stevo_666

pangolin said:

4% is surprisingly low. I wonder what the % would be if nobody took steps to avoid it. (i.e. perhaps 8% would have paid some but half got around it?)

Hard to say. The tenants in common and will change route is accepted planning - HMRC do not challenge it. No idea how commonly used it is.

Although having to pay care fees is possibly the largest contributing factor to the low percentage.

kingstongraham

Stevo_666 said:

pangolin said:

4% is surprisingly low. I wonder what the % would be if nobody took steps to avoid it. (i.e. perhaps 8% would have paid some but half got around it?)

Hard to say. The tenants in common and will change route is accepted planning - HMRC do not challenge it. No idea how commonly used it is.

Although having to pay care fees is possibly the largest contributing factor to the low percentage.

Most people not having household wealth over £1 million might have something to do with it, too.

Stevo_666

kingstongraham said:

Stevo_666 said:

pangolin said:

4% is surprisingly low. I wonder what the % would be if nobody took steps to avoid it. (i.e. perhaps 8% would have paid some but half got around it?)

Hard to say. The tenants in common and will change route is accepted planning - HMRC do not challenge it. No idea how commonly used it is.

Although having to pay care fees is possibly the largest contributing factor to the low percentage.

Most people not having household wealth over £1 million might have something to do with it, too.

Only for couples. Although it's not something I'm too concerned with as my parents are no longer around.