Care home or home care?

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.

Pros and cons of moving to a care home
Summary

There are two types:

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.
You’ll always have company.
There will often be organised activities.
No need to worry about utility bills, meals and household chores.
It’s safe and secure.
Cons

It maybe prohibitively expensive.
All your belongings will need to fit in one room.
All your belongings will need to fit in one room.
You might feel that you’ve lost some of your independence.
Pets might not be allowed.
You might not enjoy the company of the other residents in the home.
Pros and cons of receiving home care
Summary

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.
Local day centres where you can socialise and enjoy various activities, with transport available to get you there.
Pros

You get to stay in your own home.
You retain any support or social contact you enjoy with friends, family and neighbours.
The value of your home isn’t taken into account when calculating how much you have to pay towards your care.
You’ll stay close to what’s familiar to you.
You retain full control over the care and support you receive.
Cons

It can be lonely.
Despite alarm systems and regular visits from carers, you can still be at risk.
Home modifications and equipment can be unsightly and can affect the value of your property.
You might not like support workers coming into your 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.

How to fund your long-term care – a beginner’s guide
Care home costs
According to PayingForCare, a report by healthcare specialists Laing & Buisson in 2013/14) depending on where in the UK you live, care homes can cost an average of:

£29,270 per year for a residential care home, or
£39,300 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.

Use the Care costs calculator on the Paying for Care website
NHS Nursing Care Contribution
If you’re living in a nursing home and are receiving care from a registered nurse or doctor, you might be entitled to NHS Nursing Care Contribution towards the cost of treatment.

This is essentially a contribution towards your fees, paid by the NHS or your local trust.

Home care costs
Again, costs are very different depending on where you live and whether you need support during the day or at night, on weekdays or at weekends.

You should allow an average of about £15 per hour – that’s nearly £11,000 per year if you have a carer for 14 hours a week.
If you need full-time care during the day, costs start at £30,000.
If you need carers to move in around the clock, you can easily be talking about more than £150,000. In those circumstances, residential care is usually more cost-effective.
You’ll still have the cost of maintaining your house, but you have the advantage of being in familiar surroundings.

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

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