The short answer
- Book nights before the discharge dateWards often give only a few hours of notice, and the carers who are free get booked quickly. Line one up while the discharge is still being talked about, and cancel if it turns out not to be needed.
- A sleeping night covers most peopleThe carer sleeps nearby and gets up when they are needed. £130 to £145 a night. A waking night is for confusion, turning or a drain.
- Plan for it to stopThis is short-term care. Most fortnights take the same shape: four nights in a row, then every other night, and then nothing.
- It sits alongside the free helpReablement, district nurses and the physio all cover the day, but none of them stay the night. That is the gap a night carer fills.
Prices are what carers on PrimeCarers charge with our fee included. An agency charges up to £240 for a waking night and usually wants a minimum block of nights.
Build the fortnight
How many nights to book, and which nights
The pattern depends on what they were in hospital for. Pick the closest one and the fourteen nights below will change to match. Nothing here is fixed, and you can change or cancel a night with a message to the carer.
What were they in hospital for?
Four solid nights, then every other night
The hip or knee is the reason people fall in the first fortnight. Getting out of bed at 3am with a frame, in the dark, on strong pain relief is the moment that undoes an operation. Four nights of cover gets past the worst of it, and every other night after that keeps the confidence coming back.
First week home
- Night1Asleep
- Night2Asleep
- Night3Asleep
- Night4Asleep
- Night5Off
- Night6Asleep
- Night7Off
Second week home
- Night8Asleep
- Night9Off
- Night10Off
- Night11Off
- Night12Off
- Night13Off
- Night14Off
When to book a waking night instead
Make the first two waking nights if they were confused on the ward, or if the physio wants them moving every couple of hours.
What to ring someone about
Swelling, calf pain and a joint that is stiffer at week two than week one. Ring the ward or the GP rather than waiting for the follow-up.
This fortnight
6 sleeping, 8 on their own
What the fortnight costs
£780 to £870
Sleeping nights £130 to £145, waking nights £150 to £160, with our fee included. An agency charges up to £240 for a waking night.
This is a starting point rather than a care plan. The discharge nurse, the physio and the carer will all have a view, and the pattern usually shortens once the first week goes well.
Why the nights are risky
What goes wrong between midnight and six
Families brace for the daytime and are caught out by the nights. Here is the shape of a bad first night home, and what having someone there changes about each part of it.
- 10pm
Into bed, in the wrong room
A bed has often been moved downstairs, or they are back upstairs when they should not be. Getting in and out of an unfamiliar bed with a sore hip or a fresh wound is the first hurdle of the night.
- 1am
Pain relief wears off
Hospital gives medication on a clock. At home the last dose was at eight and the next is at six, and nobody warned them the middle of the night would be the worst part. Pain makes people get up, and getting up is where they fall.
- 2am
The trip to the toilet
They are half asleep, in the dark, on a strange route, sometimes with a frame they have only had for two days. Most falls in the first fortnight happen on this walk. A carer takes the walk with them, or brings a commode to the bedside.
- 3am
Confusion after an anaesthetic
Older people often come home muddled after a few days on a ward, and it is worse after dark. They may not know where they are or why their leg hurts. A familiar voice settles it in minutes. Being alone with it often ends in a 999 call.
- 4am
Nobody to ask
Is this normal? Should I take another one? Is that too much blood on the dressing? At 4am there is nobody, so people either ignore something they should not or ring an ambulance they do not need.
- 6am
A bad night becomes a bad day
There has been no sleep and a missed dose, and the person is now frightened of their own bathroom. The physio exercises do not get done, and the recovery slips a week.
The first nights home are also when a family carer takes the biggest hit. Sleeping on a sofa with one ear open, for a fortnight, while doing the shopping and the appointments in the day, is how a daughter ends up ill herself. Paying for the nights so that the family can do the days is usually the better division of labour, and because the nights stop after a fortnight it costs less than most families expect.
Sleeping or waking
Which kind of night a discharge needs
There are two kinds of night carer and the difference is simple: one sleeps and gets up when needed, one stays awake all night. After a hospital stay most people need the first.
| Sleeping night | Waking night | |
|---|---|---|
| What the carer does | Settles them, then sleeps in a spare room or on a bed nearby. Gets up once or twice. | Stays awake all night, checking, turning, giving medication and keeping someone company. |
| Book it for | Joint replacements, most general surgery, a fall where they were clear-headed on the ward. | Confusion after an anaesthetic, someone who needs turning, a drain or catheter, being up more than twice a night. |
| A night on PrimeCarers | £130 to £145 | £150 to £160 |
| The same from an agency | A good deal more, with a minimum block of nights | Up to £240 |
| Hours covered | 10 to 12 hours, usually 9pm to 8am | 10 to 12 hours, usually 9pm to 8am |
| Needs a bed for the carer |
What the carer does
- Sleeping night
- Settles them, then sleeps in a spare room or on a bed nearby. Gets up once or twice.
- Waking night
- Stays awake all night, checking, turning, giving medication and keeping someone company.
Book it for
- Sleeping night
- Joint replacements, most general surgery, a fall where they were clear-headed on the ward.
- Waking night
- Confusion after an anaesthetic, someone who needs turning, a drain or catheter, being up more than twice a night.
A night on PrimeCarers
- Sleeping night
- £130 to £145
- Waking night
- £150 to £160
The same from an agency
- Sleeping night
- A good deal more, with a minimum block of nights
- Waking night
- Up to £240
Hours covered
- Sleeping night
- 10 to 12 hours, usually 9pm to 8am
- Waking night
- 10 to 12 hours, usually 9pm to 8am
Needs a bed for the carer
- Sleeping night
- Waking night
A sleeping night that turns into three or four wakings is not a sleeping night. A good carer will say so in the first week and ask to change the booking.
The usual mistake is booking a waking night out of worry when a sleeping night would do. The more serious mistake is the other way round: booking a sleeping night for someone who is up every hour, which is unfair on the carer and does not get anyone a night's rest. If you are not sure which side of the line you are on, waking night or sleeping night has the rule of thumb, and do night carers sleep? explains what the carer is doing while your relative is asleep.
Before they come home
What to have ready before the discharge
Wards discharge with very little notice, often at the end of the day. Everything on this list is easier to do before the phone call than after it.
Ready for the first night
0 of 10 ticked
The room
The medication
The people
The full version of this list, including equipment and follow-up appointments, is in what to do when the person you care for is leaving hospital. If the discharge has already happened and you are reading this at nine o'clock at night, emergency care covers what can be arranged at short notice.
How the nights come down
Booking the end at the same time as the start
Short-term night care goes wrong when nobody decides when it stops. Agree the shape at the start and review it once, at the end of the first week.
- 1
Nights one to three or four: every night
The blockCover every night while the pain relief is being sorted out, the district nurse is still coming and everything in the house is new. This is the part nobody regrets paying for. - 2
Review at the end of week one
10 minutesAsk the carer three things: how many times were you up, was any of it about pain, and did they seem clearer at the end of the week than the start. That conversation will tell you more about the second week than anything else. - 3
Nights five to ten: every other night
The taperAlternate nights let confidence rebuild with a safety net still in place. Many families put the cover on the nights when nobody can be reached quickly, and leave the rest. - 4
Stop, or keep one night a week
Week 3Most people stop entirely by week three. Some keep one night a week for a month, usually the one that gives a family carer a proper sleep. Nights can restart with a message if there is a setback.
There is no minimum block on PrimeCarers and notice to stop is 48 hours, so you are not paying for a fortnight you turn out not to need. That matters a great deal after a discharge, because nobody, including the surgeon, knows how the second week will go. Book what you are sure about, and add rather than cancel.
If the nights are not coming down after three weeks, the question has changed. It is no longer about recovery, and the answer is usually either more daytime help or a different kind of care. Overnight care so the family carer can sleep covers the arrangement families settle into when the nights become permanent, and seven nights a week sets out what a full rota costs and how it is staffed.
Reablement and daytime visits
Who else is helping, and what none of them cover
After a discharge there can be five different people involved in a week. Knowing what each one does makes it obvious what is left over, and what is left over is almost always the night.
Reablement or intermediate care
Free where offered, up to 6 weeks
District nurses
Free, by referral
The physiotherapist
Free after most operations
Daytime care visits
£20 an hour
Family
The appointments and the shopping
The night carer
£130 to £160 a night
Reablement is worth pushing for. In England, short-term reablement or intermediate care after a hospital stay is provided free by the NHS or the council for up to six weeks where a service is available, and asking for it costs nothing. It rarely covers nights, and it is usually short visits rather than long ones, so most families end up with a mix: reablement or district nurses for the clinical parts, daytime visits for washing, meals and the exercises, and a night carer for the hours nobody else covers. Funding for post-hospital care sets out what can be paid for and by whom, and post-operative rehabilitation and convalescent care covers the longer recovery.
What it costs
A fortnight of nights, next to the alternatives
A night of care looks expensive on its own, but a fortnight of it costs less than most families expect, because it stops. These are the four ways families cover the first two weeks home, and what each one costs.
- 4 sleeping nights£520The block most people book after a joint replacement, then nothing.
- 7 sleeping nights£910A week of cover then a taper, which is where most fortnights land.
- 2 waking + 7 sleeping£1,210After a fall with confusion on the ward.
- Live-in for 2 weeks£2,240Days and nights covered by one carer. Worth it when the days are as hard as the nights.
PrimeCarers rates, August 2026, our fee included. Sleeping nights £130 to £145, waking nights £150 to £160.
If the days are as hard as the nights, do the sum for live-in care rather than adding visits to nights. A fortnight of live-in care covers every hour of the day and costs about £2,240, while seven sleeping nights plus two hours of daytime visits a day comes to roughly £1,470. Live-in care is the usual answer after a big operation in someone's eighties, and can I hire a live-in carer temporarily? explains how short a booking can be.
Questions
Questions families ask after a discharge
Three to seven for most people. After a hip or knee replacement families usually book four nights in a row and then every other night for a week. After general surgery three nights is common. After a fall, especially where there was confusion on the ward, a week to ten days is more realistic. Nights on PrimeCarers are booked one at a time, so you can add or drop them as the fortnight goes.
A sleeping night covers most discharges: the carer sleeps nearby and gets up once or twice for the bathroom or pain relief, at £130 to £145. Book a waking night at £150 to £160 if they were confused on the ward, need turning through the night, have a drain or a catheter, or are up more than twice a night.
Not usually. Reablement or intermediate care after a hospital stay is free where it is offered in England, for up to six weeks, but it is daytime visits rather than overnight cover. NHS continuing healthcare can fund care including nights where someone has a primary health need, and it is worth asking the discharge team for a checklist. Most short-term night care after a discharge is paid for privately because it has to start the same week.
Often the same day, and reliably within 48 hours if you message two or three carers rather than one. The thing that delays it is waiting for the discharge date to be confirmed before looking. Shortlist carers while the discharge is being talked about and confirm the date afterwards.
Settles the person for the night, gives medication that is due, helps them to the bathroom or manages a commode, keeps the wound and the dressing under an eye, watches for a temperature or new confusion, and makes a note of the night for the family, the day carer or the district nurse. They are not nurses, so anything clinical goes to the district nurse, the GP or 111.
Yes. On PrimeCarers you agree nights directly with the carer, so a single night is a normal booking, with no minimum block and 48 hours’ notice to stop. Agencies generally want a week or more, which is the main reason a short discharge booking costs so much more through one.
For a night or two it is fine, if you can sleep. Over a fortnight it usually backfires: a family carer doing days and nights runs out in the first week, and that is when things get missed. The arrangement that holds up is family doing the days and appointments, and a paid carer doing the nights.
Then the question is no longer about recovery. Talk to the GP, because delirium after a hospital stay, a urine infection, pain that is not controlled and new confusion all look the same at 3am and all have different answers. On the care side it usually means either more daytime help or moving to a longer arrangement rather than more nights.