What types of care are available for older people?
By sima kornbluth · Published 2025-10-28 · Last reviewed 2026-09-18
Older people in the UK can get help at home (visiting home care, live-in care and short-term reablement), housing with support such as extra care housing, and care homes offering residential, nursing or dementia care. Respite and day centres give carers a break, and the NHS funds some care in full. A free council needs assessment is the best place to start.
The main types of care for older people in the UK are help at home (visiting home care, live-in care and short-term reablement), housing with support (sheltered and extra care housing), care homes (residential, nursing and dementia care), and short breaks such as respite and day centres. NHS services such as continuing healthcare and hospice care sit alongside these. The right option depends on your relative's needs, wishes, safety and finances, and a free council needs assessment is the best starting point.
This guide explains each type, who it suits, and how it is usually paid for.
Where should you start?
Ask the council's adult social care team for a needs assessment. It is free, and anyone can ask for one, whatever their income. The assessment looks at what your relative can and cannot manage, and at the support that might help, from equipment to care at home or a care home. If your relative looks after someone, or you care for them, ask for a carer's assessment too.
Care is then means-tested. The council looks at income and savings to decide who pays. Some NHS care is free regardless of money.
Care at home
Visiting home care
Also called domiciliary care, this is help from paid care workers who visit at set times, from one short visit a day to several longer ones. The NHS guide to homecare explains that carers can help with washing, dressing, meals and medicines. Agencies in England must be registered with the Care Quality Commission (CQC).
Suits: people who want to stay at home and need help at predictable times.
Live-in care
A care worker lives in your relative's home and provides support throughout the day, with breaks. It can support people with high needs, including dementia, and lets couples stay together.
Suits: people with significant needs who strongly prefer to stay at home and have a spare room for the carer.
Reablement and intermediate care
Short-term support to help someone regain skills and confidence after an illness, fall or hospital stay. In England, the NHS lists this among care you can get for free, usually for up to six weeks.
Suits: people recovering after hospital, or to prevent a hospital admission.
Equipment, adaptations and alarms
Grab rails, stair rails, bathing aids, key safes and personal alarms can make a big difference. In England, eligible people usually get minor adaptations costing under £1,000 free, and larger works may qualify for a Disabled Facilities Grant (not available in Scotland, which has its own schemes).
Housing with support
- Sheltered housing: self-contained flats for older people, usually with a warden or alarm service and communal areas. Personal care is not usually included.
- Extra care housing (assisted living): your relative has their own flat, with care staff on site who can provide personal care, often 24 hours. The care is regulated; the housing is not.
- Retirement villages: larger schemes with a range of facilities, often privately owned.
Suits: people who want their own front door but need more security or support than they get at home.
Care homes
The NHS guide to care homes describes two main types:
- **Residential care homes** provide accommodation, meals and personal care, such as help with washing, dressing, going to the toilet and taking medicines.
- **Nursing homes** also have qualified nurses on duty at all times, for people with complex medical needs.
Many homes also offer dementia care, in a residential or nursing setting, with staff trained in dementia and an environment designed for people with memory problems. Check that the home is registered for the type of care your relative needs, and read its latest inspection report.
Suits: people whose needs can no longer be met safely at home, or who are isolated and want company and round-the-clock help.
Short breaks and day support
- Respite care: a short stay in a care home, or extra help at home, so the usual carer can have a break. The NHS page on carer breaks and respite lists the options.
- Day centres: activities, meals and company for part of the day, sometimes with transport.
- Sitting services: a trained volunteer or care worker sits with your relative for a few hours.
Care funded by the NHS
- NHS continuing healthcare (CHC): in England, people whose needs are mainly health needs may have their care fully funded by the NHS, at home or in a care home. It is not means-tested. See the NHS guide to continuing healthcare.
- NHS-funded nursing care: in England, if your relative lives in a nursing home and needs care from a registered nurse, the NHS pays a flat weekly rate to the home towards their nursing care.
- End-of-life and hospice care: NHS palliative care and hospice care are free.
Scotland, Wales and Northern Ireland have their own arrangements for NHS-funded care.
How is care paid for in each nation?
- England: care is means-tested by the council. In 2026/27, people with capital above £23,250 usually pay in full. The home is ignored for care at home, and for a care home in some situations.
- Scotland: personal care is free for everyone assessed as needing it. Care home accommodation costs are means-tested.
- Wales: there is a maximum weekly charge for care at home, and a single, higher capital limit for residential care.
- Northern Ireland: the Health and Social Care Trust assesses needs and charges; care home capital limits are similar to England's.
Attendance Allowance, which is not means-tested, can help pay for care for people over State Pension age (Pension Age Disability Payment in Scotland).
This is general information. For advice on paying for care, ask the council, or seek independent advice from Age UK, Citizens Advice or a regulated specialist adviser.
How do you choose between options?
Think about:
- Needs now and in future. Is your relative's condition likely to change?
- Their wishes. What matters most to them: home, independence, company, being near family?
- Safety. Are there risks at night, or with falls, medicines or wandering?
- Carers. Can family carers sustain the current arrangement?
- Money. What will each option cost, and for how long can it be paid?
- Quality. Check inspection reports and visit or meet providers.
Frequently asked questions
What is the difference between a residential home and a nursing home?
Both provide personal care and accommodation. A nursing home also has registered nurses on duty 24 hours a day for people with medical needs. Nursing homes usually cost more, but in England the NHS pays a contribution towards the nursing part for eligible residents.
Is live-in care cheaper than a care home?
It depends on your relative's needs and the arrangement. For a couple, or someone who needs one-to-one support, live-in care can be comparable; for others it may cost more. Get written quotes for each option.
Can my parent get free care at home?
Some care is free: reablement for up to six weeks in England, and minor equipment and adaptations for eligible people. In Scotland, personal care is free for those assessed as needing it. Other care at home is means-tested, but the home your relative lives in is not counted.
Who regulates care services?
The CQC in England, the Care Inspectorate in Scotland, Care Inspectorate Wales, and RQIA in Northern Ireland. All publish inspection reports.
Key takeaways
- Care ranges from help at home and live-in care to housing with support and care homes.
- Start with a free council needs assessment, and a carer's assessment for family carers.
- Residential homes provide personal care; nursing homes add 24-hour nursing.
- Some care is free: reablement, minor adaptations, NHS continuing healthcare and hospice care.
- Funding rules differ between England, Scotland, Wales and Northern Ireland.