Nobody tells you: what you can ask for when the hospital says care home

The most consequential decision a family makes about an older relative is often taken in a hospital corridor, inside about forty-eight hours, by people who have not slept in a week. Families ring us from those corridors most weeks, and the same sentence comes up: nobody told us we could ask for anything else. Here is what to ask, and the one thing worth having in writing before the discharge meeting.

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Why it can feel like the decision has already been made

One daughter flew back to the UK after her mother was suddenly diagnosed with a form of dementia in hospital and assessed as unable to decide where she lived. By the time she landed, the ward conversation had settled on a care home.

Nobody tells you about it either. Nobody will sit down and tell you what they are actually entitled to.

It is worth being fair about why this happens. Ward and discharge teams work under real pressure, and they describe the options they can arrange quickly. A residential placement is something a hospital can organise. Care at home that a family arranges itself, or funds through a direct payment from the council, sits outside what most wards can set up for you, so it often does not come up. Nobody is keeping it from you, but if you want it discussed, you have to raise it.

So say, in the meeting, that the family wants to explore going home, and ask what would have to be true for that to be safe. That one question turns a placement discussion into a planning discussion.

Ask exactly what is being funded, and the date it stops

Many families do not know that short-term support after a hospital stay is normally free. It may be called reablement, intermediate care or a discharge package, and it typically runs for up to six weeks while someone recovers and longer-term needs are assessed. A granddaughter managing her grandmother’s repeated admissions for heart trouble assumed she would be paying privately from day one. She only had to ask the ward.

What catches people out is the ending. One woman arranging care for her mother after a pelvic fracture had been told to expect six weeks and got four, with almost no warning.

They just stopped it that day. This is the last day. You will not get any more visits.

So ask four things, and note who answered you:

• What is this support called, and who is providing it?
• How many weeks is it funded for, and what is the end date?
• Who reviews it before it ends, and when?
• What is meant to happen the day after it stops?

Families also tell us the agency delivering their free weeks then offered to carry on at private rates. That may be the right answer, but the free package and the private arrangement are two separate decisions. Our guide to what to do when the person you care for is leaving hospital covers the sequence.

Ask whether the money can follow the person home

Local authority funding and direct payments

After a needs assessment and a financial assessment, a council may fund some or all of the care someone needs. What rarely gets explained on a ward is that the money does not have to be spent on services the council picks. It can be taken as a direct payment and used to arrange care at home, including a live-in carer, instead of a residential placement. See our guide to local authority funding for care in your own home and our piece on the six things nobody tells you about direct payments.

Also ask what the financial assessment counts. When care is provided in someone’s own home, the value of that home is not treated the way it is for a permanent residential placement. That distinction changes the arithmetic completely, and it was exactly what the daughter above had been agonising over.

Why should Mum sell her home to fund her care when she worked all her life to be able to get there?

Ask the council to confirm in writing what the assessment includes for each option. One son told us it took him over a year to grasp that council help with residential fees can be a loan repaid from the estate rather than a grant. Councils are stretched, and their staff will usually put things in writing if you ask plainly and give a reasonable deadline.

NHS continuing healthcare

If someone’s needs are primarily health needs rather than social care needs, they may qualify for NHS continuing healthcare, which is not means tested and can fund care at home. The assessment takes time. One daughter told us hers stalled when the assessor went on leave, leaving her to run her father’s rota while working thirteen-hour shifts. Her advice, and ours: keep a dated log, ask who is coordinating the assessment, ask what the timeline is, and ask who covers if they are away.

If you hold power of attorney, say so in the room

A registered lasting power of attorney for health and welfare gives the attorney standing in decisions about where someone lives, once that person no longer has capacity to decide for themselves. Bring the document to the meeting and ask for it to be recorded in the notes. Plenty of families hold one and never mention it, because nobody asks.

It helps to understand what a capacity assessment is. Capacity is decision-specific: someone can lack capacity to manage money and still be able to say where they want to live. One daughter feared an assessment would be used to move her mother into residential care against the family’s wishes. What steadied her was hearing that a label does not erase a person.

She is not totally gone. She is there. It is just a label.

Fair questions to ask: which specific decision is being assessed, what is being done to support the person to make it themselves, and whether their own wishes have been written down. The background is in our explainer on mental capacity, the Mental Capacity Act and DoLS. These are points to raise with a solicitor or the ward’s safeguarding lead, not legal advice.

Ask what home would actually need to work

This is where the conversation stops being abstract. A daughter whose mother had spent six weeks in hospital after a stroke rang us torn. Her mother now needed a hoist and continence pads, and the offer was four short visits a day. Her worry was the long gap between the last visit and the first.

She does not want to go to a care home, but she does not want to be sat in a dirty pad for a long time.

The useful questions are specific, and an occupational therapist or discharge nurse can usually answer them before anyone leaves the ward:

• What equipment is being ordered, and what date does it arrive? Beds, hoists and rails often lag behind the discharge.
• Which type of hoist, and does the moving and handling plan call for one carer or two? The equipment chosen changes the staffing needed, and the cost.
• What does the night realistically look like, and who covers it?
• What does the discharge summary say about medicines, and who reviews them at home?
• What therapy is expected at home, and who checks it happens?

That last one matters. A son coordinating from several hours away found his father, in his eighties and recovering from knee surgery, sent home to an equally elderly partner with no care plan.

The danger is he is just going to fester in that chair downstairs.

What he arranged was modest: someone twice a day to get his father up and down the stairs and check the physiotherapy happened. If the honest answer is that home will not work, that is a legitimate conclusion too, and we have written about bringing a parent home, and when not to.

The cost comparison that surprises people

Families usually assume home care is the expensive option. In 2026, agency visits commonly run at £25 to £35 an hour and agency live-in care starts from around £239 a day. Self-employed carers engaged directly typically charge £18 to £25 an hour, and live-in carers booked through our platform roughly £130 to £190 a day. Private arrangements are usually cheaper than agency care, though that is not guaranteed.

The arithmetic surprises people once visits stack up. One son was paying roughly £4,000 a month for three short double-up visits a day.

For £4,000 a month, you could get a live-in carer to be there full time.

Whether two carers are genuinely needed is a moving and handling judgement for the professionals who assessed the person, but it is a fair question for the occupational therapist. For the fuller picture, see whether live-in care is cheaper than a care home and our breakdown of what home care actually costs across seven real bills.

Speed is the other worry when a bed is needed back. Carers can often be found and interviewed within days, and we have written about how an urgent live-in placement gets filled. On who these carers are: PrimeCarers checks a carer’s identity, right to work and DBS documents, and carers complete our onboarding before they can apply for work. Work booked through PrimeCarers is covered by PrimeCarers’ insurance; work arranged outside the platform is not, so a carer needs their own public liability cover.

PrimeCarers is an introductory platform and does not provide, manage, supervise or clinically assess care. Clients remain responsible for checking carer documentation, interviewing carers, checking suitability for their specific needs, and agreeing the scope of care directly with the carer.

What to do next

1. Get the funding position in writing before the meeting. Ask what is funded, by whom, for how many weeks, and the exact end date. Note who told you and when.
2. Say you want to explore going home. Ask what would have to be true for that to be safe, and ask for the answer to be recorded in the notes.
3. Bring any power of attorney document and ask for it to be logged. If a capacity assessment is planned, ask which specific decision it covers.
4. Ask the council about a direct payment and a carer’s assessment. Request written confirmation of what the financial assessment counts at home compared with a residential placement, and agree a date to speak again.
5. Line up cover for the day the free support ends, not the week after. Start about two weeks out. You can post a job describing the routine you need and see who is available locally before committing.

One daughter, weighing all this up, put it best: whatever happens, at least you can say you tried to get her home. Families who ask these questions early end up with more options and fewer regrets.

Related reading

• Direct payments: the money is yours, and six things nobody tells you
• What home care actually costs: seven real bills, broken down
• The stain on the carpet will trigger a memory: bringing a parent home, and when not to
• Post hospitalisation care: funding a smooth recovery
• Can an elderly person be forced into care in the UK?