Is live-in care or a care home better for a couple?

Neither is right in general. A couple who are both fairly independent, in a home with a spare room, often do better staying put with a live-in carer. A couple who both need a lot of hands-on nursing help, or whose home simply cannot take a carer, are often better served by a care home built for that level of need. Live-in care for couples sets out the wider picture this page narrows down to.

With live-in care, staying together is built in. One carer lives in your home and works from a single plan that names what each of you needs, at whatever times of day you each need it. Couples with different sleep patterns covers how one carer manages two different routines in practice, and the same carer can usually cover different personal care needs too, provided neither of you needs two people to move safely.

With a care home, it depends on the home, so ask directly rather than assume. Rooms built for two people to share are far less common than single rooms, so demand for them tends to be high and availability low. Where a shared room is not available, most homes offer rooms on the same corridor instead, which keeps you close but is not quite the same room. Where one partner's needs move into nursing care and the other's do not, some homes place you in different wings, and in the hardest cases a home may only be able to take one of you. Care homes explained and the nursing home versus care home distinction are worth reading before you visit any home.

One live-in carer costs roughly the same whether they look after one person or two, so a couple typically pays about a fifth more than a single person would, not double. A care home charges for the place, so two residents comes close to two full fees, whether or not you end up sharing a room. That is why live-in care sits well below every care home option on the ladder above: the couple's living costs are carried once by a single carer's week rather than twice by two separate fees.

Where your needs differ by more than a little, the middle rows matter more. A separate carer for each of you, or one of you at home while the other moves into a nursing home, both cost more than one carer managing you together, but usually far less than two nursing-home fees.

Run your own numbers rather than relying on averages: is live-in care cheaper than a care home? has a calculator that takes your home, bills, pensions and savings and works out how long your money lasts under each option.

A care home gives you other people around every day without having to arrange it, which some couples find is what they were missing at home, especially if one of you had become the other's only regular company. It also lifts the weight of running a home: neither of you has to think about meals, cleaning or household bills once you have moved in. Live-in care does not create that company on its own; it depends on you keeping up visits, clubs or a place of worship, though a carer can take on the household tasks even while you keep the house itself.

Where the gap is wide, families usually choose between three routes: one carer managing both of you, which works up to a point but has a ceiling once one of you needs two-person care; a live-in carer for the lighter partner at home alongside a nursing home place for the other; or both of you moving to a care home that offers different levels of care under one roof, which some but not all homes provide. None of these is a failure. They are different ways of getting each of you the help you specifically need once one arrangement stops fitting you both.

1. 1

   Write down what each of you needs help with

   Today

   Be specific: washing, medication, moving around, company. This is the most useful document for either a care home conversation or a live-in carer search, and it usually shows how close or how far apart your needs are.
2. 2

   Look at both options with the same list

   This week

   Search for live-in carers near you and, separately, visit or call two or three care homes with the list from step one, asking the checklist questions above about staying together.
3. 3

   Talk to your GP or council if either of you has a changing condition

   Before you commit

   A needs assessment or, where relevant, a request for an NHS Continuing Healthcare check costs nothing and gives you a professional view of the care needed.
4. 4

   Try live-in care first if your home allows it

   Reversible

   A live-in arrangement can be ended with notice rather than requiring you to give up a tenancy or sell a home, so it is a lower-risk way to test whether staying together at home still works.