Hospital Discharge Care
HourlyShort-term
Not an overnight service
- Usually for
- Someone leaving hospital who cannot manage alone at first
- Main alternative
- Reablement, or a longer-term package
Families arranging care for the first time are usually handed several terms at once, often in a hospital corridor, and expected to know which one they need. This page puts the main types of home care side by side so you can see how they differ, how each is normally charged, and which situations each one suits.
Nothing here is a recommendation. Agencies assess before care starts and will tell you what they think is needed, so treat this as a way to follow the conversation rather than a decision you have to get right in advance.
10 of 10 care types shown.
| Care type | How it's charged | Duration | Overnight presence | Usually for | Main alternative |
|---|---|---|---|---|---|
| Hospital Discharge Care | Hourly | Short-term | No, this is not an overnight service | Someone leaving hospital who cannot manage alone at first | Reablement, or a longer-term package |
| Companionship Care at Home | Hourly | Ongoing | No, this is not an overnight service | Older people living alone where loneliness is the main concern | Day centres, befriending services |
| Dementia Care at Home | Hourly | Ongoing | Overnight cover is available if arranged separately | People at any stage of dementia, supported at home | Residential dementia care |
| Parkinson's Care at Home | Hourly | Ongoing | Overnight cover is available if arranged separately | People whose medication timing and mobility need support | Nursing home care |
| Stroke Recovery Care at Home | Hourly | Reducing over time | No, this is not an overnight service | People recovering after a stroke, alongside NHS therapy | Inpatient rehabilitation |
| Respite Care at Home | Hourly or daily | Varies | Overnight cover is available if arranged separately | Giving an unpaid family carer a break | Residential respite, day services |
| Palliative Care at Home | Hourly or daily | Varies | Overnight cover is available if arranged separately | Someone with a serious, life-limiting illness | Hospice inpatient care |
| Waking Night Care at Home | Per night | Varies | Yes, overnight cover is included | Someone needing active help during the night | Live-in care, or sleep-in if needs are lighter |
| Sleep-in Care at Home | Per night | Ongoing | Yes, overnight cover is included | Someone who needs reassurance overnight rather than active care | Waking night care, or a monitoring alarm |
| Live-in Care | Daily | Ongoing | Yes, overnight cover is included | Someone needing support across day and night | Residential care home |
Tick means overnight cover is included. Dash means overnight cover is available if arranged separately. Cross means this is not an overnight service.
This is the comparison families find hardest, partly because the three are often used interchangeably in conversation when they mean quite different things.
Waking night care. A carer is present and awake for the whole night. They are there to do things: help to the bathroom, reposition someone who cannot move themselves, give or prompt medication, and respond immediately to distress or a fall. This is the right option where the night genuinely requires activity, for example advanced dementia with night-time wandering, someone at high risk of falls, or a person in the later stages of a life-limiting illness. It is normally charged as a flat rate for the night rather than by the hour.
Sleep-in care. A carer sleeps in the home, in a bed provided for them, and can be woken if help is needed. The value is the reassurance of someone being there, not continuous care. It suits situations where nights are usually uneventful but the risk of being alone is unacceptable, for example after a fall, during a period of confusion, or where a family carer needs to sleep properly. Agencies vary in how many night-time interventions a sleep-in arrangement is expected to cover, so ask what happens if the person needs help repeatedly. Also normally a flat nightly rate, and lower than waking nights.
Live-in care. A carer lives in the home and provides support across the day and night, with agreed daily rest breaks. It is a continuous arrangement rather than a night service, and it is the closest home-based alternative to moving into a care home. Charged as a daily rate.
A practical way to choose: if the nights need work done, look at waking nights. If the nights need someone present, look at sleep-in. If the days need as much support as the nights, look at live-in.
Most people do not fit neatly into one category, and care packages are commonly built from more than one. Dementia care during the day with waking night support overnight is a common pattern. So is respite care layered on top of an existing package to give a family carer a fortnight off. So is palliative care delivered through a live-in arrangement in someone's final weeks.
An agency can usually cover several of these types with the same team, which is worth confirming when you enquire, since continuity of carer matters more than the labels.
Care needs rarely stay still. It is normal to start with a few visits a day and increase, or to start with intensive support after a hospital stay and reduce as someone recovers. A good agency reviews the package regularly and adjusts it rather than leaving it fixed. If you are choosing between agencies, ask how quickly they can scale a package up or down, because that flexibility often matters more in the second year than anything on the price list.
CareAH lists CQC-registered home care agencies across England, free for families, with no account needed. You can browse home care agencies by city and county, read about each care type in detail, or start with our guide to what to do when your loved one needs care.
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