What does elderly care cost?

Paying for care for the elderly is a complicated business. How much it costs and then who pays for care home fees or home care costs will depend on how much medical care is needed and how much money the individual has.

Care at home

Not very helpfully, every single local authority funds different levels of domiciliary care - so you could live across the street from someone who has a different council and get vastly different types of care for the same degree of need. Some local authorities will fund someone to come in and help you get dressed, others will pay to put up handrails or subsidise stairlifts. The government would like to end this postcode lottery but, for the time being, what is paid for by your local authority may be as much a matter of their policy as of your ability to pay.

In order to decide your eligibility for care, you should get a section 47 assessment of your care needs. Armed with that, you are then in a position to get a financial assessment. Anyone with assets of more than £23,250 (in England, Wales and Northern Ireland; in Scotland it's £24,750) not including the value of the home (for domiciliary care) may well be expected to pay for themselves - but you must be left with at least the basic amount of Pension Credit plus 25%.

Care home costs

Care home costs must be paid for by the person requiring care if they have assets of more than £23,250, usually including their home. (Your home isn't counted if your spouse or, for example, a disabled child, is living there.) If you fall into this category, or think you may, again it's probably a good idea to get care home fees advice from Paying For Care.

Below this level, the local authority will cover the costs. The cost of residential care can vary hugely by location and depending on whether you require nursing care or not. Your care needs assessment will have determined if you require nursing care - if you do, this can be a lot more expensive. Even though you may not need nursing care now, of course this could change.

On average you can expect to pay more than £27,200 a year for a residential care home, rising to over £37,500 a year if nursing is required.

The cost of care is not the same in all parts of the UK, with significant regional variations - a more than £10,000 average annual difference between Northern ireland, the cheapest area, and London, the most expensive.

Costs that you may still need to meet on top of a care home’s bill might include:

• Clothing, toiletries and personal items
• Trips and treats
• Telephone calls

If your care is fully funded by your local authority, you are allowed a Personal Expense Allowance to cover items like these. When looking for a home it is important to be clear what is included in the fees and what isn’t.

See our care home fees calculator to work out what your own liabilities are likely to be.

If you are worried about paying for care, you should speak to an impartial specialist care fees advisor.

Continuing care

If there is a need for medical care, it may be entirely paid for by NHS as continuing care, although this is fairly rare. This nursing care will be carried out by nurses at a nursing home.

Eligible individuals are likely to have complex medical conditions requiring a lot of support, need highly specialised nursing and be near the end of their life with a rapidly deteriorating or terminal condition.

How to find out what you'll need to pay for

A local authority should carry out two assessments. A health (Section 47) assessment will determine what the nursing care needs are and a financial assessment will determine what personal care you'll be eligible for under means testing.

The NHS will pay up to £108 in nursing contributions if the person needing care is judged to have medical needs.
Anyone with assets over £23,250, normally including their home, will have to fund their own care.

If you'd like to find out more about what to consider, how to plan and how to pay for care, visit the website of the not-for-profit organisation PayingForCare.