A bandage that wraps the elderly up in knots

Being forced into a nursing home because you cannot look after yourself is distressing enough without the added burden of worrying whether you are going to have to sell your house to pay for it. Charities for the elderly have long felt that this practice is wrong - and deeply upsetting for those who experience it.

Being forced into a nursing home because you cannot look after yourself is distressing enough without the added burden of worrying whether you are going to have to sell your house to pay for it. Charities for the elderly have long felt that this practice is wrong - and deeply upsetting for those who experience it.

Finding a solution to the problem of long-term care has been an age-old concern for government. Yet the proposals revealed last week have made the situation more confused and complicated than ever before.

The key change is that nursing care - in a home - will be free for the elderly from October next year. The Government estimates that this will benefit 35,000 people, saving them £5,000 a year from the overall cost of staying in a nursing home. Some £900m will also be spent on rehabilitation services for those who leave hospital.

So far, so good. But the Government has alienated charities by rejecting recommendations made by the Royal Commission that personal care in a home - feeding, bathing and help with dressing - should also be free. By leaving this out of the equation, the Government excludes around 500,000 people who need personal care but will have to continue paying for it, according to Help the Aged.

From April, for the first three months personal and nursing care will be free in a home; after that residents will be assessed by nursing staff to determine whether their needs are medical or personal. This produces further problems, namely the difficulty of accurately assessing someone's care needs.

There are also some reservations about the three-month moratorium. Lynda Cox at Skandia says that at the moment local authorities have the power to ignore the value of a home for up to six months, so the elderly will find themselves worse-off.

Also, those with assets over the means-tested limit will still have to pay for their own residential care costs. The threshold has been raised to £18,000, linked to inflation, compared with £16,000 at present.

But this is hardly generous. With the property rises we have seen in recent years, few homes are worth so little. Some 40,000 people are forced to sell their homes every year, and this is unlikely to change under the new threshold.

The Government's answer is to extend its interest-free loans for care fees in the hope that fewer old people will have to sell their homes. But anyone with a home who wants to ensure that its value is not used up in paying fees will still need to look at long-term care investment and insurance products as a central part of their retirement planning.

At least there is an end to the uncertainty. But it is scant consolation for those who were worried about the possibility of having to meet their own costs now knowing for certain that they have to.

* m.bien@independent.co.uk