Home Care vs. Care Home

Introduction

Choosing between keeping your loved one at home with care support or moving them into a care home is a major decision for any family. Both home care and care homes have their merits and challenges. The best choice depends on the individual’s health needs, finances, and personal preferences. In this article, we’ll compare home care versus care home living, looking at factors like cost, quality of life, social interaction, and level of care. By understanding the pros and cons of each option, you can make an informed decision that best suits your elderly loved one’s situation.

Home Care: Staying in Familiar Surroundings

Home care means the person continues to live in their own home (or a family member’s home) and receives care services there. Care can range from a professional caregiver visiting for a couple of hours a week to help with specific tasks, up to full-time live-in care for round-the-clock support. Here are some key points about home care:

Comfort and familiarity: The biggest advantage of home care is that your loved one stays in a familiar environment. They can keep their daily routine, sleep in their own bed, and be surrounded by memories and personal belongings. This can be especially important for individuals with dementia who find comfort in familiarity.

Independence: Remaining at home often allows seniors to maintain a greater sense of independence. They can decide their schedule (when to eat, when to bathe) rather than adjusting to a care home’s timetable. With the right support, they can continue hobbies or even go out to community events, which might be more flexible than
a care home’s group activity schedule.

Personalized one-on-one care: Whether it’s family providing care or hired carers, at-home care is usually one-on-one. This means attention is focused entirely on your loved one’s needs. Agencies like Prime Eldercare ensure that home caregivers are matched to the client’s personality and needs, providing tailored support. In contrast, in a care home, staff divide attention among many residents.

Family involvement: When care happens at home, family members can be closely involved. You can drop in to visit anytime, oversee the care directly, and have more control over routines and the little details of daily life. There’s no need to abide by facility visiting hours or policies on when you can see your loved one.

Flexible and scalable: Home care can be adjusted as needs change. You might start with a caregiver coming in a few times a week and increase to daily visits or live-in care as the person’s condition evolves. This scalability makes home care a versatile option. It also means you could combine home care with other services (like day care centers or respite stays) to create a balanced plan.

However, home care also has challenges:

Managing multiple carers or burnout: If family members are the primary carers, it can be tiring and stressful (as discussed in other articles). Even with paid carers, someone needs to coordinate schedules, manage the household, and ensure there’s coverage at all times (for example, what if a carer is sick one day?). Using a reputable agency can alleviate much of this management burden, as they handle scheduling and backups.

Home modifications: The house may need changes for safety and accessibility – like installing ramps, stairlifts, or grab rails (see the article on technology and home adaptations). This can be disruptive and costly, although grants are often available for necessary adaptations.

Isolation risk: Staying at home can be isolating if not carefully managed. In a care home, there’s built-in social interaction with staff and other residents. At home, if a senior lives alone, they could become lonely without regular social activities or visits. It’s important to arrange for social outings, community support (like having a day each week at a local senior club or inviting friends over), so they aren’t just alone with a caregiver all the time.

Limited immediate medical support: While home carers can handle personal care and basic health tasks, they cannot provide the on-the-spot medical attention that a nursing home can. In a care home, especially a nursing home, nurses are available quickly if, say, someone has chest pain or a sudden change in condition. At home, you rely on calling emergency services or waiting for district nurses or GP visits. That being said, many medical services (like hospice care or visiting nurses) can come to the home when needed, and technology (personal alarms, etc.) can mitigate this concern.

Care Home: 24/7 Support in a Dedicated Setting

A care home (residential home or nursing home) is a facility where the elderly live full-time and receive care from staff around the clock. Here are key points about care home living:

Full-time professional care: Care homes have staff on duty day and night. This means if your loved one needs help at 3 AM, someone is there. For individuals with high needs (like advanced dementia or serious mobility issues), this constant availability of help can be crucial. Nursing homes also have registered nurses and can handle more complex medical needs (like administering injections, managing feeding tubes, etc.) in-house.

Social community: Unlike being at home, in a care home there are other residents to talk to and group activities to participate in. Many care homes schedule social events, exercise classes, crafts, games, and outings. The presence of peers of a similar age can provide companionship. Some residents thrive in an environment where they have people to chat with at mealtimes and events going on, versus living alone at home.

No household responsibilities: In a care home, all meals, cleaning, and laundry are taken care of by the facility. There’s no need for family to maintain a house or for the senior to worry about chores. This can be a relief if managing the home became too much (for example, maintaining a large house or cooking safely might be
challenging).

Safety and accessibility: Care homes are designed with accessibility in mind – there are no stairs (or there are elevators), bathrooms are fitted with grab rails and call buttons, and staff can monitor areas to reduce fall risks. For someone prone to falls or wandering, a secure care home unit might prevent accidents or getting lost outside.

Structured routine: Life in a care home tends to follow a routine (set meal times, medication rounds, etc.). For some seniors, this regular structure is comforting and ensures they get necessary nutrition, medication, and sleep on a schedule. It can be especially helpful for those who struggle with irregular routines at home.

But moving to a care home also has downsides:

Adjustment and loss of home comfort: Leaving one’s home and moving to a new environment can be emotionally difficult. It might take time for your loved one to adjust to a new room (often just a single room or a shared room), new people, and different routines. They might feel a loss of independence or sadness at leaving a family home.

Less one-on-one attention: Even in well-staffed homes, caregivers are responsible for multiple residents. The ratio might be one carer for 3-5 residents (or more), meaning care is less personalized. Your loved one may have to wait for assistance at times, for example if the staff are attending another resident.

Cost can be high: Care homes can be very expensive (as discussed in funding articles). Depending on location and the level of care, it can sometimes cost as much or more than equivalent care at home. For instance, a care home might cost £800 a week, and a similar budget could potentially fund a live-in carer at home. It’s important to compare costs based on the care needed. For couples, care homes charge per person, whereas one live-in caregiver at home might care for both at once, which can be more economical.

Less independence: In a care home, residents must follow the facility’s schedule to an extent (for meals, bath times, etc., though good homes try to be person-centered). There may also be rules (like set visiting hours, or not being able to make your own tea whenever you want for safety reasons). Some seniors feel a loss of autonomy in a care home setting.

Possibility of institutional feel: While many care homes strive to be homely, there’s no getting around that they are institutions to some degree. Sharing spaces (dining room, lounge) and having different carers on shift can feel less personal than the privacy of one’s own home.

Comparing Costs

Cost is often a decisive factor:

Home care costs: Home care costs depend on the amount of care needed. If only a few hours a day are required, home care will generally be cheaper than a care home. If 24-hour care is needed, hiring private round-the-clock carers or a live-in carer might end up costing similar to a care home (as we saw in funding discussions). However, if family members provide some care, or if the person doesn’t need night supervision, home care can be tailored to be more affordable than a full-time care home.

Care home costs: Care homes charge a comprehensive fee that covers accommodation, food, and care. This fixed cost can simplify budgeting, but remember it is charged continuously whether or not the services are used (e.g., if the resident is relatively independent, you still pay the full fee). In home care, if the person goes into hospital or on holiday, you wouldn’t pay for care during that period (aside from perhaps a retainer for a live-in carer), whereas a care home still charges to hold the room.

Ancillary costs: At home, there will still be household bills (utilities, maintenance, groceries) in addition to care costs. In a care home, those are included, but you might have other charges (like for hairdresser services, outings, or private medications). It’s worth doing a side-by-side comparison of the full monthly costs in both scenarios.

Importantly, check what funding or benefits might offset costs. Some people choose home care because they can get Attendance Allowance and perhaps some council-funded hours, making it manageable. Others opt for care homes when council funding will cover a portion of it. Each case is unique.

Quality of Life and Well-Being

When deciding, consider where your loved one will have the best quality of life:

Emotional well-being: Would they be happier remaining at home, or are they craving more social interaction that a care home might provide? Some seniors dearly want to stay in their own home; others might feel reassured being in a place with peers and activities.

Health needs: If your loved one has a progressive condition, think about future needs. Home care can often handle quite advanced care (especially with professional carers or district nurse support), but very complex medical conditions might eventually require nursing home care. On the other hand, moving a person with dementia from home to an unfamiliar care home can be disorienting, so families sometimes delay a move as long as possible.

Social connections: At home, you can arrange for friends, family, or neighbors to visit, and use community resources (like local senior centers or church groups) to keep them engaged. In a care home, socializing is on-site with other residents and staff. If your loved one already has a strong local network, staying home keeps them near that network. If they are isolated at home, a care home might give them a new social circle.

Couples considerations: If one spouse needs care and the other is reasonably well, home care can allow them to stay together at home. Care homes will accommodate couples too, but that means both moving out of home (unless one just visits daily, which can be hard). Home care can be a way to support one person without disrupting the life of the healthier spouse too much.

Making the Decision

Here are steps and considerations to help make the decision:

Assess needs: If you haven’t already, get a professional assessment of your loved one’s care needs (e.g., from the GP or a social services care assessment). This will clarify what level of support is required (and might highlight if staying at home is feasible or if a care home is strongly recommended).
Trial at-home care: If leaning towards home care but unsure, you could start home care services while keeping the option of a care home open. See how your loved one responds to having carers at home. Many agencies, like Prime Eldercare, can increase services gradually so you can test what coverage feels right.
Visit care homes: If considering a care home, visit a few. Observe the environment, talk to staff, maybe have your loved one visit for lunch or a day if they are open to it. A respite stay (short-term stay) can even be arranged in many homes, which acts as a trial period. This can give you and your loved one a feel for care home life without long-term commitment.
Involve your loved one: Where possible, involve the senior in the decision. Even if cognitively impaired, gauge their feelings. Sometimes fears can be addressed (for example, if they worry about being abandoned in a home, emphasizing that family will visit often and their room can have familiar items might help).
Consider the home situation: Is the current home suitable for long-term care (e.g., can modifications make it safe)? Is there family nearby to help? If someone lives in a very remote area, getting carers might be harder than if they lived near services.
Financial planning: Crunch the numbers for both scenarios. What can you afford long-term? If funds might run out in one scenario, that could influence the decision (for example, if you can afford home care for now but not if 24/7 is needed, would a move later be more disruptive than moving now? Or vice versa).

How Prime Eldercare Can Help

If you’re torn between home care and a care home, consult experts. Prime Eldercare offers guidance to families weighing these options. Our care advisors can:

Conduct a care needs assessment and home safety evaluation to see if your loved one’s needs can be met safely at home with our home care services.

Provide transparent cost projections for different levels of home care, so you can compare with care home fees.

Offer trial services or respite care at home, which can delay or even avoid the need for a care home by providing intensive support during challenging times.

If a care home is ultimately the best decision, Prime Eldercare can assist with that transition too (for instance, we could provide a caregiver to accompany your loved one during the initial days in a home to help them settle, or we can connect you with reputable care homes in our network).

The goal is to ensure your loved one gets the right care, in the setting that makes them most comfortable and content. Prime Eldercare supports families whether they choose to keep care at home or decide on residential care.

Conclusion

There is no universal answer to the home care vs. care home dilemma – the “right” choice is deeply personal and case-specific. Home care allows seniors to stay in the comfort of their home and maintain independence, which can greatly enhance their happiness and dignity. Care homes provide a safe, structured environment with ready access to care and companionship, which can be reassuring for high needs and for those who enjoy socializing.

Take into account your loved one’s wishes, the practicality of care at home, and the quality of care available in local care homes. Some families use home care for as long as possible and then transition to a care home when needs become too great; others opt for a care home sooner to take advantage of the social environment and comprehensive care.

Whatever you decide, regularly re-evaluate as health circumstances change. And remember, you’re not alone in figuring this out. Lean on healthcare professionals and care services like Prime Eldercare for advice. With thoughtful consideration, you can make the choice that provides the best care and quality of life for your loved one.