Home care or a care home? How to decide

We provide home care, so you would expect us to say home care is always the answer. It is not. There are people for whom a good care home is the right choice, and we have told families that to their faces. What follows is the comparison we would want if it were our own parent, with the trade offs laid out plainly.

What each one actually is

Home care means carers come to the person’s own home for visits, from a single 30 minute call a week up to several visits a day. Live in care is home care taken further: a carer lives in the home and is on hand day and night. A care home is a move to a residential setting with staff on site around the clock, meals provided, and other residents for company. Nursing homes are care homes with registered nurses on the staff.

Where home care tends to win

Familiarity. The person keeps their own bed, their own kettle, their own view from the window. For someone living with dementia this matters enormously, because familiar surroundings reduce confusion and distress.

Routine on their terms. Getting up when they want, eating what they like, watching what they choose. Care homes run to a timetable because they have to.

Continuity. With a small team of regular carers, the person sees the same faces. In a home, staff turnover and shift patterns mean a wider cast.

Cost, at lower levels of need. A few visits a week is far cheaper than a residential place. The gap narrows as needs increase.

Couples stay together. If one partner needs care and the other does not, home care keeps them under the same roof.

Where a care home tends to win

Round the clock staff. If someone needs help at unpredictable times through the night, a care home has someone awake and on site. At home, that means waking night care or live in care, which is a bigger commitment.

Company on tap. For a person who is lonely and sociable, a good home offers people to talk to all day. A carer visiting three times a day cannot replace that.

Complex nursing needs. Some conditions need a nurse on hand rather than on call. A nursing home provides that as standard.

The house itself. Steep stairs, a bathroom upstairs, a bedroom that cannot take a hospital bed. Sometimes the building is the problem, not the person.

Family exhaustion. If a spouse or child is at the end of their tether and there is no way to give them enough respite at home, a move can be the kindest option for everyone.

Questions that usually settle it

Does the person want to stay at home, and have they said so? What happens at night, and how often? Is the house safe, or could it be made safe with equipment and small changes? Who else is in the picture, and how are they coping? What can the family afford for the next three years, not just the next three months? And if you tried home care first and it was not enough, would anything be lost by then moving to a home?

That last question matters. Care at home is reversible. A move into a care home, with the house sold, usually is not. Where there is doubt, most families try home first.

Frequently asked questions

Is home care safe for someone who lives alone?

For most people, yes, with the right visit pattern, a pendant alarm, and a plan for what happens if a carer arrives and cannot get an answer. We talk through exactly that at the first meeting.

Can home care cope with dementia?

Very often, and frequently better than a move, because familiar surroundings help. As dementia progresses the visit pattern usually needs to grow, and at some point live in care or a specialist home may become the right step. We will tell you when we think that point is approaching.

What does live in care cost compared with a care home?

They are often in the same range. Live in care costs more if two carers are needed or if the person needs waking nights, and less if the person is largely independent and mainly needs someone present.

Can we start with home care and change our minds?

Yes, and that is exactly what we would suggest where there is doubt. Nothing is lost by trying home care first.

Weighing it up? Ring us on 0118 391 3542 or arrange a free initial meeting. If we think a care home would serve you better, we will say so.

Questions about care?

Our team can talk you through costs, funding and what might be available for your family. Call 0118 391 3542, it's free, and there's no pressure.