Nursing Home Costs, Care Options, and Funding Guide for Elder Care in Ireland 2025

Choosing elder care in Ireland involves understanding the various care options available, the associated costs, and the funding pathways in place, as well as considering the quality of care, location convenience, and the specific needs and preferences of the elderly individual and their family members.

Understanding the Fair Deal Nursing Homes Support Scheme

The Fair Deal Scheme, managed by the Health Service Executive (HSE), is a key component of publicly supported long-term nursing home care in Ireland. It offers financial assistance to individuals requiring ongoing nursing care irrespective of age, with most beneficiaries being over 65 years old.

What the Fair Deal Covers

Approved public, voluntary, and private nursing homes.
Long-term nursing home care only; it does not cover home care, respite care, or other community-based care.
Residents contribute financially based on income and assets; the HSE covers the remaining nursing home fees.

Eligibility and Application Process in 2025

Who Can Apply?

Individuals must be ordinarily resident in Ireland.
Applicants must require long-term nursing home care, as assessed by a professional Care Needs Assessment.
There is no age restriction but the majority of applicants are seniors.
If the applicant lacks capacity, a “specified person” such as a spouse, adult child, enduring power of attorney, or appointed decision-making representative can apply on their behalf.

How to Apply

Submit the Nursing Home Support Scheme application form with proof of income, assets, and other required supporting documents to the local Nursing Homes Support Office.
The HSE conducts a Care Needs Assessment to determine the necessity of nursing home care compared to community support.
The HSE completes a Financial Assessment based on income, assets, and financial circumstances.
Decisions are typically provided within approximately 10 working days after assessment completion.
Applicants have the right to appeal assessment decisions if there are disputes regarding care needs or financial assessments.

Nursing Home Costs and Resident Contributions

Calculating Your Contribution

Your payment towards nursing home care is calculated based on:

80% of your income (including pensions, savings interest, rental income, etc.), plus
7.5% per year of the value of your non-cash assets (such as property, savings, investments),

after applying applicable deductions and allowances.

The first €36,000 of assets for individuals (€72,000 for couples) is excluded from the financial assessment.

Assets and the 3-Year Cap

A distinctive feature of the Fair Deal is the “3-year cap” on the principal private residence and certain other assets:

Your principal home and qualifying family farm or business assets are used in the financial assessment for up to three years of nursing home care.
After three years, these assets are no longer included in calculating your contribution, regardless of your continued stay.
For couples, half the combined income and assets are assessed, with contributions based on half the property value.

Nursing Home Loan for Asset-rich, Cash-poor Residents

For residents with significant property assets but limited liquidity, the Nursing Home Loan offers a way to defer the 7.5% property asset contribution.

The loan is secured by a Charging Order (similar to a mortgage) on the property.
Repayment is generally deferred until after death or the sale of the property.
In specific cases (such as a surviving spouse remaining in the home), repayment may be further deferred.
Both the resident and spouse or partner must consent to registering the loan.

Choice and Availability of Nursing Homes

Applicants may select any HSE-approved nursing home that meets their needs; this includes public, voluntary, and private homes.
If a preferred nursing home is at capacity, temporary placement in an alternative home is possible, with potential transfer later.
Payment arrangements differ: in public or voluntary homes, contributions are paid to the HSE; for private homes, contributions are paid directly to the nursing home.
Weekly nursing home fees vary depending on location, resident dependency level, and facilities:
Indicative figures include approximately €1,564 per week in public homes and about €968 per week in private homes (subject to change in 2025).

Additional Financial Supports and Tax Reliefs

Medical cards and the Drugs Payment Scheme provide supplementary health-related financial assistance separate from the Fair Deal.
Tax relief on nursing home fees may be available for expenses paid towards the care of a relative over 65 or permanently incapacitated.
The relief applies at marginal tax rates (20% or 40%) and can be claimed annually via Form Med 1 or adjusted through PAYE in hardship scenarios.
When care costs are shared among family members, each can claim relief proportionally.
If the resident contributes to their own fees, this reduces the amount eligible for relief.

Planning Considerations and Impacts on Family Wealth

The Fair Deal Scheme applies a 5-year “look back” period, during which any asset transfers or gifts may be considered in the financial assessment.
Planning strategies such as gifting assets, setting up family investment accounts, or downsizing property ideally should be done well before applying.
The 3-year cap protects your home from being included long-term in the financial assessment, potentially reducing family financial burdens.
Consulting with certified financial planners is recommended to effectively coordinate care funding within broader estate and retirement plans.
Awareness of possible waiting lists and scheme budget limitations is important, as funding availability may affect the timing of support.

Overview of Care Options Beyond Nursing Homes

While the Fair Deal Scheme focuses solely on long-term nursing home care, other elder care options exist outside of this support scheme, including:

Home care services and community supports (assessed through separate HSE programs)
Respite care (short-term relief for caregivers)
Assisted living and independent living supports

These options usually require different applications and funding arrangements separate from the Fair Deal Scheme.

Summary

In 2025, the Fair Deal Nursing Homes Support Scheme continues to be a significant support mechanism for financing long-term residential nursing home care in Ireland. Understanding the eligibility requirements, the care needs and financial assessment processes, and how resident contributions are calculated based on income and assets is essential for planning. Additional measures like the Nursing Home Loan can assist those with substantial property assets who need to defer payments, and available tax reliefs may ease financial challenges. Given the complexities involved and potential effects on family assets, seeking informed professional advice can support well-rounded decisions that balance quality care and financial considerations.

Sources

Citizens Information: Fair Deal Scheme
OPESFP: Fair Deal Scheme Ireland Complete Guide
RTÉ Lifestyle: What to Know About the Finances of Caring for Elderly Loved Ones Disclaimer: All content, including text, graphics, images and information, contained on or available through this web site is for general information purposes only. The information and materials contained in these pages and the terms, conditions and descriptions that appear, are subject to change without notice.

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