Care home or home care?

According to recent figures, nearly all of us want to receive care services at home when we get older. But sometimes you’ll need to consider going into a care home instead. How do you decide? And how much is it going to cost? And where to go when you need more information and advice?

Thinking through your care options

The most important decision to make when considering your care needs is whether you can remain in your own home or need to move into a care home.

The decision will be based on what you want and what care you need, but you’ll also need to consider how much it will cost.

Our needs change as we get older, and aspects of living independently become more difficult, such as getting up and down stairs or in the bath.

The sooner you consider what will work the better. This can help avoid rushing into a choice that is not right for you particularly in a time of crisis, such as following a stay in hospital.

It can help to answer the following, you could even write it down. It can help to priorities your needs:

1. What does ‘home’ mean to you? For example, is it comfort, security?

2. What makes a good home in later life? For example, proximity to family, GP.

3. What things might become more difficult? For example, getting in and out of bath, steep stairs or a large garden.

Elderly Accommodation Council has a useful online tool that can help you assess the suitability of your current home Housing Options for Older People.

Home care services pros and cons

Home care can include regular visits from a home care worker to help with personal care, shopping and preparing meals.

Other services include meals on wheels, monitored personal alarms and household equipment, and adaptations to help with everyday tasks.

You may be able to visit local day centers where you can socialise and enjoy various activities, with transport available to get you there.

Pros

  • The cost of care at home might be cheaper As The amount of support increases it might become cheaper to move into a care home. You also have more control over the care and support you receive.
  • You get to stay near friends and family Staying in the same neighborhood is really important to some people.
  • You can ask for more help or less. You’ll be able to tailor exactly how much help you needas your ability changes.
  • You can continue to live with your pets If you need help looking after them, you could try contacting the Cinnamon Trust who might be able to lend you a hand.
  • You might get more money for care. The value of your home isn’t taken into account when calculating how much you have to pay towards your care. It will if you move into a care home.

Cons

  • Carers are not around 24/7 This might mean you feel less safe in your home. A live in carer, an alarm system, fall detectors or a bed sensor might help you feel better.
  • Your carer may change The agency you use will likely try to send the same person every time, but may not be able to due to sickness and time off.
  • Carers might turn up late This might be because they have an emergency at their previous call. If you have a strict schedule, this might be difficult for you.
  • It could get more expensive if you need more help For example you may need a cleaner, a gardener or need hairdresser to visit.
  • Home modifications and equipment might affect the value of your property. This is especially the case if they are unsightly.
  • Quality of care can vary. You can check the quality on the Care Quality site

For more information about services to help you stay at home if you need care.

For more information about Funding to adapt your home for accessibility

Moving to a care home pros and cons

There are two types of care homes:

  • care homes without nursing care that provide help and assistance with personal care
  • care homes with nursing care that have registered nurses providing 24 hour nursing care and experienced care assistants providing personal care.

Both are places where you can live (often with a spouse) and have your care needs met by trained staff.

Some also have accommodation and support specifically designed for older people with dementia.

Pros

  • Trained staff are always on hand This means you might feel more safe and secure.
  • No need to worry about utility bills, meals and household chores It’s all sorted for you, which might mean it’s warmer, safer and cleaner.
  • You’ll always have company There will always be someone to talk to, as well as organised activities.
  • Taking medication can be supervised

Cons

  • It might be more expensive This is especially the case if you’re not eligible for local authority funding.
  • Quality of care can vary. All homes need to reach a minimum standard to be registered, but quality does vary you can check the quality on the Care Quality here
  • All your belongings will need to fit in one room. This might mean that you can’t be surrounded by all the personal items you’d like.
  • You might feel that you’ve lost some of your independence. A good home should help minimise this by helping you live independently as you can be. There might be some loss of privacy.
  • Pets might not be allowed, if they do claim to be pet friendly check what is allowed it might be that pets are ok to visit but not stay for example.
  • You might not enjoy the company of the other residents in the home.
  • Family and friends can feel guilty that they are not able to help more or visit as much

https://www.moneyadviceservice.org.uk/en/articles/choosing-the-right-care-home

Comparing the cost of care

Costs can vary around the country, but your local social services department (or Health and Social Care Trust in Northern Ireland) will be able to give you an idea of how much you’ll need to pay for services arranged through them.

Charities and disability groups are a good source of information too, but if you’re thinking of using a private home care agency or care home, you might need to make your own enquiries.

Home care costs

Costs are very different depending whether you need support during the day or at night, on weekdays or at weekends.

It’s tricky to work out what you will pay in advance but contacting some local providers can help you get more realistic costs. We’ve provided a few estimates to get you started.

  • £14,000 per year, for 14 hours of care a week, we’ve used UKHCA estimate on what Councils should pay as a minimum £18.93 per hour in the UK. So, if you are self-funding you may pay more than this.
  • If you need full-time care during the day, costs could be more than double the above.
  • If you need carers to move in around the clock and you have complex needs, it could cost about £83,200 per year, according to The live-in Care Hub 2016 report. In those circumstances, residential care is usually more cost-effective. If you don’t have complex needs fees should be less, typically £41,000-£65,000 per year.

You’ll still have the cost of maintaining your house, but you have the advantage of being in familiar surroundings.

In England you can use Which? Cost of care calculator to get an estimate of Homecare costs in your area.

Care home costs

According to, a report by healthcare specialists Laing & Buisson in 2018, care homes costs can range from:

  • £27,000 to £39,000 per year for a residential care home, or
  • £35,000 to £55,000 per year if nursing is required.

Remember, you might have to pay extra for things like trips out, hairdressing and some therapies – check what’s included in the care-home fees.

How to fund your long-term care

You could end up paying for all of your care, some of it or nothing at all. Make sure you claim for help you are eligible for.

How to fund your long-term care – a beginner’s guide Including claiming the funding you’re eligible for.

Case studies

Care homes

“When Joan died suddenly, I realised how much I’d relied on her. After my stroke, she was always the one who looked after me.

“At first, I was determined to stay at home and although I got loads of help from the council, I soon realised that it wasn’t working for me.

“The house seemed so big and empty without Joan, and because my walking’s really bad, I spent every day on my own in front of the telly. I got so lonely – felt like giving up.

“So, I sat down with the family and talked it through. I was worried that selling the house meant the kids wouldn’t get much of an inheritance but they told me not to be stupid.

“Well, I’ve been in Beechacre for nine months now, and it’s turned out to be the perfect solution. I’ve got my own room – much more modern and easier to manage than the old house – and with staff on hand day and night I feel really safe.

“The best thing is I’ve got lots of people to talk to, and there are plenty of organised activities to keep me occupied.” – Jim

Read our guide on Choosing the right care home

Care at home

“Dad has lived in the house since he was first married. It’s home for the whole family. But when Dad had his stroke, we were faced with some difficult decisions – our hearts said he should stay at home but our heads said a care home was probably best.

“That was until we looked into the options. It’s amazing what the council can provide – everything from ‘meals on wheels’ to someone to cut his lawn. Carers come in twice a day to prepare his main meal and do the little things he can’t manage, like having a bath.

“Dad would be lost without them and they give us the peace of mind of knowing he’s got someone coming in every day. He’s also got a falls alarm and a panic button for the rest of the time.

“It all costs, but because the value of the house is excluded from the calculations, we were surprised to find that Dad gets some financial help from the council.

“There will probably come a day when he has to go to a care home, but for the moment he gets a lot of pleasure from pottering about in the garden and talking to the neighbours.” – Dawn

Read our guide on Care services to help you stay in your own home

Moving in with family

Moving in with family can work well, but it can have a significant impact on everyone’s lifestyle. If you can afford other options such as a care home, this could be less stressful for everyone.

It’s important to be realistic and make sure you all have the same expectations. It is important to understand that support is available.

Here are some things to consider when thinking about moving in with your family:

  • If your family members are claiming benefits, will these be affected? What about council tax?
  • Will you pay rent or help towards bills for rent and utilities?
  • Will the home need to be adapted? Who will pay for this?
  • Are you eligible for support in adapting your home or getting home care support?
  • Have you thought about family issues? Do you all get on? What if the couple split up? What happens if it stops working?
  • What sort of care will you need and who will be able to provide this for you?

Your family should want the best for you, but it’s still important to protect yourself by getting independent legal advice. A formal agreement drawn up can help protect you and them.

It might seem awkward to discuss these things, but it’s better to discuss possible scenarios before you’re make changes that could be costly and stressful. Thinking about this in advance might help to reduce stress and help you make affordable choices. Check out our talking with older people about money guide, for hints and tips. https://www.moneyadviceservice.org.uk/en/articles/talking-with-older-people-about-money

Respite care, Intermediate care and sheltered housing

Introduce and link to this page https://www.moneyadviceservice.org.uk/en/articles/long-term-care-services-at-a-glance#care-homes

Useful contact and further information

  • If you want to increase your basic knowledge of housing and care option in later life you can download and print this from Silverlinks.
  • Which? have some very helpful pages on Later Life Care
  • Check out the AgeUK website to help you make a decision between a care home and care at home.
  • Look at housingcare.org to find suitable accommodation and services for older people or talk to a FirstStop adviser to discuss your options on 0800 377 7070 (Monday to Friday, 9am -5pm).

In Northern Ireland

  • Find further details on residential care and nursing homes on the nidirect websiteopens in new window.

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