Live-in care or home care visits? How to choose
One carer living in the house, or carers who call in. What each is good at, how the costs compare, and the signs that visits have stopped being enough.
By the AnnMarie’s Care team
Published —5 min read
Short answer. Home care visits suit someone who needs help at particular times of day and is safe and content in between. Live-in care suits someone who should not be alone for long, who needs help at unpredictable times, or whose days have turned into a timetable of calls.
When families say "home care" they usually mean one of two things. Either a carer calls at the house for a visit and leaves again, or a carer lives there. Both are care at home and both are an alternative to a care home, but they are arranged, charged and lived with quite differently.
We provide live-in care, so we have a reason to prefer it. Where visits would serve someone better, we say so, and this is how we explain the difference.
What home care visits are
Home care, also called visiting care or domiciliary care, is a carer coming to the house at agreed times. The NHS describes it as anything from an hour a week to several hours a day, or at night. A common pattern is a morning call to help someone up, washed and dressed, and an evening call for supper and bed.
It is usually charged by the hour, and it can start small and grow.
What live-in care is
A live-in carer has their own bedroom in the house. They help through the day with whatever has become difficult, and they sleep there at night, on hand if something happens. They take a break each day and time off each week, and work in rotation with another regular carer. It is usually charged by the week.
Side by side
| Home care visits | Live-in care | |
|---|---|---|
| Who comes | Often several carers across the week | One main carer, in rotation with a second |
| Time | Set visits, with another call to get to | The whole day, with nowhere else to be |
| Between visits | The person is on their own | Someone is in the house |
| Nights | On their own, unless night care is added | The carer sleeps in the house and helps occasionally |
| What the home needs | Nothing extra | A private bedroom for the carer |
| How it is charged | Usually by the hour | Usually by the week |
| Starting small | Easy | Harder, though a short trial is common |
When visits are the right answer
- The help needed comes at predictable times.
- The person is safe, and happy, on their own in between.
- They value their privacy and would not want someone living in.
- There is no spare bedroom.
- Family or neighbours are close by for the rest.
If that describes your parent, start with visits. It is a smaller change and, at a few hours a week, a smaller bill, and nothing is lost by trying it first.
Signs that visits have stopped being enough
- The number of calls keeps growing: three or four a day, and there are still gaps.
- Nights have become the worry, because of falls, wandering or fear of being alone.
- Things go wrong between visits: a missed meal, missed tablets, a fall nobody saw.
- Dementia means a changing set of faces is causing distress.
- Two people in the house now need help.
- A family member is filling every gap and is worn out.
How the costs compare
A few hours of visits a week costs far less than live-in care. The comparison changes as the hours add up. Several visits a day and cover at night is a great many paid hours, and at some point a weekly live-in fee is the same or less, for a carer who is there the whole time. For a couple that point comes sooner, because live-in care is priced for the household with a supplement for the second person.
Ask each provider for a written quote against the same list of needs, and ask what happens at night and who covers the carer's breaks. Our pricing page explains how we quote, and how much live-in care costs explains what moves the figure.
If the council is paying towards care, it funds what it assesses as necessary, which may be visits and not a live-in carer. Ask what it would fund and whether a direct payment could go towards a different arrangement. Our funding guide covers this.
You can use both
It does not have to be one or the other for good. Many people start with visits and move to live-in care when the gaps become the problem. Others have a live-in carer for a few weeks after a hospital stay and step down to visits afterwards.
If someone needs a carer awake all night, that is different again: see how live-in care differs from 24-hour care.
Questions to ask yourself
- At what times of day is help needed, and can they be predicted?
- Is your parent safe alone for four hours? Overnight?
- Would they rather have the house to themselves, or company in it?
- Is there a spare bedroom?
- How much of the gap is the family filling, and how long can that go on?
Useful sources
NHS: help at home from a paid carer; NHS: getting a care needs assessment.
