Carers – The UK’s unsung heroes – What can we give back?

The UK’s 7m unpaid carers are amongst the most giving people we know.

They are all around us, caring for mums, husbands, daughters, sons, brothers, grans, friends….the list is endless, and they do this free of charge and unconditionally because they have an emotional connection with the person they care for.

Anyone can be a carer, a 7 year old boy helping his mum with her cancer treatments, a 90 year old woman supporting her husband with dementia, a 30 year old dad caring for his daughter born with cerebral palsy or a 60 year old woman caring for her dad who is old and frail.

3 in 5 of us will be a carer at some point, carers are all around us, propping up our health and social care systems, preventing winter deaths, keeping people out of our stretched A&E departments, providing a wide array of nursing and personal care tasks and ensuring people with care needs don’t become lonely and isolated.

Along with caring, unpaid carers have their own lives to lead at school, at work, with family and in the community, but they just keep on giving, sometimes at great personal cost to their own health and wellbeing. In fact the economic value of their gift is estimated at around £135bn every year, and its growing as our demography changes and we all live longer.

So, we should all ask ourselves, what can we give back to carers?

This blog was produced by @LuenThompson, who is the Director or Marketing and Communications at the @CarersTrust.

Vascular Dementia – Helpful questions and answers

What is Vascular Dementia?

Vascular Dementia (VD) is a condition caused by a lack of sufficient oxygen and nutrients to the brain, causing the cells within the brain to eventually die. The blood vessels that carry blood to the brain become diseased – they are often weakened and leak, or can become blocked, decreasing their effectiveness in delivering vital oxygen and nutrients to the brain. Of the various identifiable types of dementia, VD is the second most-common form, with approximately 150,000 sufferers in the UK.

Here is a useful video that providers a brief outline of what Vascular Dementia is.

How is it caused?

There are two primary reasons why the condition may develop.

Cause 1 – The most common cause is the degeneration of tiny blood vessels deep within the brain, this is called Subcortical Dementia.  The tiny bloody vessels can thicken, which in turn reduces the blood supply to those cells, causing them to degenerate and eventually die. The nerve fibres around the affected blood vessels are also harmed, reducing their effectiveness. The disease of the tiny bloody vessels can also affect other areas of the brain, including the base, if blood vessels are blocked here it could cause small infarcts – also known as an ischaemic stroke.

Cause 2 – The second most common cause of VD is following a stroke. Strokes occur when the blood supply to the brain is suddenly cut-off, this can be as a result of a blood clot (an ischaemic stroke) or less commonly, where a blood vessel ruptures and bleeds into the brain (a haemorrhagic stroke). Around 1 in 5 people who suffer a stroke will develop dementia on top of the side effects of the stroke itself. Most people who have suffered a stroke will have another and therefore the risk of developing dementia increases with each stroke event as more of the brain becomes damaged.

How can it affect someone?

The symptoms of VD can vary from person to person, often dictated by the root cause of the dementia, whether it be as a result of vascular disease, or following a stroke. The speed in which the symptoms can take hold can also vary, the damage following a stroke is often instantaneous, whereas the effects of vascular disease can develop over time.

Early symptoms and effects can include:

  • Problems concentrating on tasks – this could be shown in activities such as planning, making decisions or problem solving.   They may also struggle to follow instructions, and their thought process may be slower.
  • Mild memory loss.
  • Problems with articulating what they want to say – their speech may become less fluent as they concentrate on finding the words.
  • Easily frustrated – this is often a result of the issues highlighted above.
  • Depression and sudden changes in mood – the depression is often as a result of the sufferer becoming aware of the cognitive effects (listed above).
  • Weak bladder – this is associated with subcortical VD sufferers, and can be accompanied by a weakness on one particular side of their body.
  • Dizziness or tremors.

As the disease progresses (stroke-related VD often will become worse following each new stroke episode; whereas subcortical VD will worsen gradually), long term symptoms and effects include:

  • Severe confusion and memory loss – day to day tasks become harder and sufferers are likely to need support on a daily basis.
  • Problems with communication and comprehension.
  • Changes to their personality and behaviour – they can become aggressive, irritable and easily agitated.
  • Suffer delusions and hallucinations.

What treatments are available?

Sadly the brain damage caused by VD cannot be treated to stop the degeneration, nor can it be reversed. However, with careful and managed support an individual with VD can continue to live well.

Caring for a loved one with VD can be hard, but these simple tips can help you support your loved one and give them some much-needed structure when they need it:

  • Establish a routine – this will help them feel less agitated.
  • Keep them occupied – it is important to help keep their mind and body active (where possible), whether it be a short walk, social activities or something as simple as tending to plants. This helps add structure to their day to day lives, as well as providing a sense of purpose.
  • Don’t be afraid to communicate with your loved one – though they may struggle to comprehend you, it is important they do not feel isolated and a smile or arm around the shoulder can help you both feel comfortable.

As well as taking on the care yourself, there are many different types of external support available, and family and friends of those with the disease are encouraged to explore these options. UK Care Guide was founded to offer honest and reliable support for anyone needing care for themselves or a relative – and our website contains a wealth of information about ongoing care, the costs of care (including our handy Care Calculator) and your options for care for your loved one.

Thanks to the UK Care Guide for their recent Blog Article.

Paying for your care costs – Be cautious about giving away your property

A blog by Dr Brian Sloan, a legal academic specialising in family and property law.  In this blog, Brian comments on the delayed cap on care costs and cautioning against giving away your property prior to going in to care.

The delay in the cap on care costs

The Care Act 2014 facilitates a cap on the amount that any one individual in England is expected to contribute towards his or her social care costs. This would be a contrast to the current situation, whereby someone with assets (sometimes including a home) of more than £23,250 can be expected to meet the full costs of care. In July 2015, however, the Government announced that the cap would be delayed until April 2020.

Limitations on the effect of the cap on care costs

It is important to realise that there were to be several significant limitations on the cap’s effect even before it was delayed, as I discuss in this paper. These are:

1 – the cap was to be set at the high level of £72,000 in April 2016.

2 – it was to cover only the cost of meeting ‘eligible needs’, broadly equivalent to ‘critical’ or ‘substantial’ needs under the pre-Act system, and not ‘low’ or ‘moderate’ ones, leaving much to depend on the outcome of local authority assessments.

3 – costs counting towards the cap were likely to be based on what it would cost the local authority to provide the relevant care, which may be below what an individual would pay for that care.

4 – the cap would exclude ‘general’ or ‘daily’ living costs in a care home, which were likely to be around £12,000 per year.

Your property

Whatever the cap’s limitations, it would have left some people with more property to leave to their family and dependants, and might have reduced the risk that the social care system would impose an ‘individual and excessive burden’ in a particular case, breaching the European Convention on Human Rights’ protection of the right to peaceful enjoyment of possessions.

The Local Government Association have said, however, that ‘local government funding will…be under enormous pressure in the coming years as Departments make…savings as part of the Government’s deficit reduction plan’, and any diminution in the funding entering the care system risks prejudicing those who cannot afford to pay for care.

The significant continuing liability to pay for social care might tempt people to give away their property in anticipation of care costs.

Be wary of giving away your property before you go in to care

But, as I suggest in this paper, caution is required. Aside from the need to ensure that a potential care recipient keeps enough property to support him- or her-self, local authorities have wide powers to reverse the effect of disposals of property for the purpose of reducing liability to pay for care.

They can do this either by deeming a care recipient still to have property of which he or she has deprived herself, or by pursuing the recipient of such property. While the Government’s guidance to local authorities considers it ‘unreasonable to decide that a person had disposed of an asset…to reduce…charges for their care…if at the time…they were fit and healthy’, this is not obvious from the legislation itself.

If you are looking for ways to pay for your care costs, there is a useful guide here as to the alternative options to property you can consider.

What will happen next?

It remains to be seen whether and when the cap on care costs will be implemented. Even if it is given effect, however, it will not remove the controversy surrounding paying for social care in a context where health care is generally provided free at the point of delivery.

@briandsloan and http://www.law.cam.ac.uk/people/academic/bd-sloan/409