# Private Home Care versus Nursing Home - financially



## alaskaonline (14 Aug 2012)

Does anyone have experiences or knowledge of the financial difference between both? Which one do you think is more affordable? Would anyone have estimate numbers to highlight differences?

If someone doesn't have any savings and only state pension what road can the person or family take to afford the above?

Thanks so much in advance. A


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## twofor1 (14 Aug 2012)

It’s all explained here;

http://www.hse.ie/eng/services/find_a_service/older_people_services/nhss/


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## alaskaonline (14 Aug 2012)

Thanks twofor1. The link however only details the Nursing Home subject and not the Home Care. I also found some things confusing so if anyone could clarify I appreciate it a lot (all new to this):

"The Financial Assessment looks at your income and assets in order to  work out what your contribution to care will be. The HSE will then pay  the balance of your cost of care. For example, if the cost of your care  was €1,000 and your weekly contribution was €300, the HSE will pay the  weekly balance of €700. This payment by the HSE is called State Support.  The Financial Assessment looks at all of your income and assets." So reading further on with all income and assets they also include the mortgage free house if one exists correct? If I've seen it right, it's 5%. What would the total monthly individual payment be then?

And as said this compared to Home Care (full time). The HSE only offers the above to Nursing homes or also to Home Care people? Thanks


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## twofor1 (14 Aug 2012)

alaskaonline said:


> "And as said this compared to Home Care (full time). The HSE only offers the above to Nursing homes or also to Home Care people? Thanks


 
Private home care is wildly expensive, from memory I think it was €20 - €25 per hour depending on the level of care required. If 24 hour care is needed that works out at €3360 - €4200 weekly, even with tax relief it is beyond most peoples means.

The HSE might fund some hours but not this level as a nursing home bed is far cheaper.

Fair Deal examples can be found here: 

http://www.marymountcarecentre.ie/pdf/a_fair_deal_2008_guide(1).pdf


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## twofor1 (14 Aug 2012)

These are probably better examples;

http://www.dohc.ie/issues/fair_deal/...s.pdf?direct=1


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## paddi22 (14 Aug 2012)

we cared for my mum at home. A huge part of the cost was making the house invalid friendly. We had to completely renovate bathroom, get a stairlift, get a suitable bed that could lift up top and bottom, a similar chair, grab rails, ramps where needed and comodes etc. The HSE helped us out but we ended up getting higher cost items ourselves. Just another thing to keep in mind when you are adding up costs.


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## putsch (14 Aug 2012)

Mum was at home with full time carers through a private agency - it cost approx 8K per month just for care.

Now she is in a nursing home which costs about 6K per month - also private - no "fair deal". 

Home care also had higher associated costs ....food, utilities etc.......


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## alaskaonline (15 Aug 2012)

The house is already invalid friendly, everything done and sorted there. Was quoted yesterday 1300 for private home care (24h) excluding the 41% tax relief so with tax relief it works out less than 800 a week. Hence asking for experiences and comparisons between these two options. As for the "fair deal" scheme, example 2 would apply so x amount of the house value per week would be charged additionally which doesn't sound great....

At the top of my head I can think of the 1on1 pro that comes with Home Care while in a Nursing Home there isn't. None of the social activities apply as not able anymore. But to get best picture I thought it's best to ask for experiences from you guys as I'm all new to this. Thanks


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## putsch (15 Aug 2012)

There is a max limit on amount of tax relief for this - not sure if its 20k or 25k.

Also at a certain stage 1 carer is no longer enough for lifting/moving/cleaning person. Nursing Home has benefit of lots more qualified staff including nurses with experience in the area. Why not just try the home care to start?


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## twofor1 (15 Aug 2012)

alaskaonline said:


> Was quoted yesterday 1300 for private home care (24h)


 
The last home care we got was in 2008 from one of the Dublin based home care companies (Not the most expensive one). We were paying €22 per hour for day time Mon - Sat hours.

4 carers would need to do 42 hours each to cover 24/7 every week, wages, administrative costs, employers contributions, insurance, holiday pay, night shifts, Sunday /bank holidays, €1300 works out at a charge of €7.74 per hour to cover all of this and I’m sure lots of other associated costs.

I’m curious to know how this service can be provided for this price.


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## elcato (15 Aug 2012)

I looked into both last year and opted for Nursing home even though my mother was not all gone on the idea. Since getting up and running and six months in she is enjoying it. Every now and then she mentions home but underneath I am satisfied that she likes the idea. She gets help getting dressed/undressed am and pm. She has company and if any emergency arises she likes the idea of a nurse being within arms reach at all times. She is quite happy to snooze in a chair during the day and gets endless cups of tea and all meals. The cost is 4.2k per month but has been reduced now due to the fairdeal scheme and is down to 1.5k pm. We set up a weekend shift rota to make sure someone takes her out every Saturday and Sunday so she has the best of both worlds. Prior to the move she had a nurse come in to get her up and spend four hours with her in the daytime - cost was 1.6k pm with extras bringing it up to 2k. She then sat at home till I was finished work or someone called and generally was in bad form because of this. We always said we'd give it a try and if she wasn't happy we would revert to homecare (The cost of FT homecare was 1.8k per week but was tax deductable as you say). I don't see us having to do this though as she is well settled. Given that the cost of NH is about 4k and full time homecare is similar, why not try this approach and see what happens.


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## terrysgirl33 (15 Aug 2012)

Wasn't the tax relief on medical expenses reduced to 21% (or thereabouts)?


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## alaskaonline (16 Aug 2012)

If someone in the family is on the 41% tax bracket, there will be a tax relief of 41% available (took this info from the Revenue site, hospital and Home Care Team)

The company I spoke to would have two carers coming in, one doing day the other night time and then possibly switching week on and off.



> I’m curious to know how this service can be provided for this price.



As I said I'm all new to this. Heard of the company on the radio the other day cause they're expanding their business. And they also provide the HSE with their carers so they are an approved and recognized business. If you employ per hour it works out dearer in a long run apparently. As said, I'm all new to this and hence asked for experiences and price comparisons. Thanks for everyone who contributed so far.


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## twofor1 (16 Aug 2012)

alaskaonline said:


> As for the "fair deal" scheme, example 2 would apply so x amount of the house value per week would be charged additionally which doesn't sound great....
> 
> At the top of my head I can think of the 1on1 pro that comes with Home Care while in a Nursing Home there isn't. None of the social activities apply as not able anymore. But to get best picture I thought it's best to ask for experiences from you guys as I'm all new to this. Thanks


 
Bear in mind this charge can be deferred, and a charge of 15% of the value less €36K would be put against the house for whenever it is eventually sold.

In this case your weekly contribution would then only be 80% of state pension. (Assuming there are no other income or assets)

If you choose to pay the 5% value of the house, it is only payable for the first three years, thereafter your weekly contribution would revert to 80% of state pension indefinitely and there would be no charge against the house.

Putting the financial aspect aside, we felt there was very little stimulus for an elderly sick person in their own home with a carer and thought our relations needs could be far better catered for in a nursing home, even though they might not be able to actively participate, one could watch and listen.

Mass is on daily for those who wish to attend, we know my relation would want this. Soft music plays in the background in the large day room overlooking the lovely gardens, singsongs aromatherapy, simple games and other activities to suit the patients abilities are carried out in the afternoons.

Medication is given as prescribed and Patients are washed, dressed, fed in a professional manner and treated with respect by regular staff, who we have got to know well and have every confidence in.

Hairdressing, chiropody, physiotherapy are all available in house, Doctor Visits weekly and is on call 24/7. 

My relation has been living in the nursing home nearly three years now and I have no doubt in our case anyway it was the better option.


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## dewdrop (16 Aug 2012)

In regard to tax relief at 41% i assume this refers only to that part of your income that is taxed at 41%?


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## elcato (17 Aug 2012)

> In regard to tax relief at 41% i assume this refers only to that part of your income that is taxed at 41%?


Yes. But if the cost is shared between multiple family mambers each can claim on their own part of the cost.


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