From your own home to a care home

Quality of care, costs and availability must all be taken into considerationParents often joke about nearing care home age when getting out of the car requires a grunt or two, while their children likewise quip that they should be treated well because it is they who will be choosing their parent’s retirement homes. But when that time comes, what matters most? Quality and prices differ from home to home, with the cheapest costing over €1,000 per month plus other expenses not covered, such as medication, physiotherapy, senior nappies, tissues, shampoo and soap, bottled water, snacks, fruit and a visiting hairdresser, to name but a few, which significantly add to the monthly bill. Given that the average monthly salary in Cyprus is €2,500 gross – averaging €2,100 net – while the minimum wage would bring just over €900 home per month, it is no surprise that for a lot of people homes are out of reach. But there are other ways to cover the expense. State pensions are not enough on their own as they average around €800 per month, while the social pension is around €420 per month. Low income pensioners receive a substantial subsidy from the state, which covers the difference between the pension and the cost of the home. For individuals who do not qualify for subsidies, the cost is covered out of their own pocket. Some may pay the homes which in some cases exceed €5,000 per month for the basics, while others may opt to employ fulltime domestic help. In any case, finding a care home is not that easy and one may be placed on a waiting list for those with good ratings. When choosing a care home for a loved one, people weigh what is more important. A modern, white-washed home may tick a few boxes, but others have said they were glad to choose a cheaper option in an old house where the staff made their family members feel cared for and included. COST VS QUALITY Antonis had been looking for a home for his mother and had visited quite a few. The one the family settled on initially cost €1,100 plus anything extra per month and was later increased to €1,200. “Some are expensive because they offer single rooms, they have a restaurant and the residents can order the food they like,” he explained. But Antonis disagreed that the ones charging around €5,000 per month did so for the luxuries provided. “Those are so expensive because they are specialised, they offer rehabilitation and constant monitoring. Not everyone needs that.” Irene said the family was paying €1,200 a month for her father and she was very happy with the home, which provided home cooked meals. “We have to take in adult nappies, but the home arranges for the medication and we pay it at the end of the month.” The only thing Irene was not too pleased about was that the home bathed the residents just twice a week and cleaned them with wet wipes on other days. However, residents were happy and chatty, and loved the owner. Other homes also have a twice-a-week schedule for baths. But for Aliki, this is a small price to pay. “I had an aunt and cousin in a home together. We were paying €1,700 a month for my aunt because she was not mobile and €1,500 for her daughter who is intellectually disabled. We tried a couple of homes before settling on the last one.” Aliki was concerned about her relatives in one of the homes, as they were strapped to a chair. “The staff did it for the old people’s safety, but I didn’t like it. After my aunt died, I was told that they shut my cousin in her room because she wanted attention all the time. So, we moved her and now we feel she is receiving the attention and care she needs.” Lefteris agreed it was important to find a home that “feels right”. His mother was in a home which took care of almost everything. “It is a community care home and the prices are low. But it is not just that. We didn’t have to take anything in.” He explained that the home had a Gesy doctor coming in and the family could opt to switch to that doctor, who would visit the patients regularly. The home also employed a nurse who was responsible for purchasing the medication and administering it at the right times. “We were charged for any extra medication at the end of the month. The home also purchased senior nappies in bulk and charged us low prices for the number used during the course of a month. And there was a visiting hairdresser and manicurist/pedicurist.” Lefteris said that in the five years his mother was in the home until she died, she always looked clean and groomed. “The food was also good and the rooms were spotless. The residents had hospital beds and the home also arranged for entertainment.” One thing those who spoke to the Cyprus Mail had in common was that all their loved ones needed some time to adjust. “The first week at any home is hell,” Irene said. THE LAW By law, carers must be able to communicate in the language the residents speak and have at least a high school diploma. They must also provide proof of their qualifications, a medical certificate and clean criminal record. Buildings should be earthquake- and fire-resistant, hygienic and prove safe wiring. A room in a care home should not be smaller than 5sqm for each resident, excluding the wardrobes and sink. There should be no more than four beds in a room and they should be at least 1m apart. Emergency buttons must also be installed next to each bed and in bathrooms. If there are more than ten people residing in a home, they should have at least 2sqm each in the dining and entertainment areas. Every four residents should share at least one bathroom or shower, one sink and a toilet, equipped with handles and space for wheelchairs. Residents must have their own wardrobes and bedside table, as well as an armchair. Care homes must have a fenced outside area that provides easy access for cars, as well as lifts big enough for a wheelchair or trolley if there are more than one floors. Windows must be easy to open and close, and doors must be wide enough to accommodate a standard-sized wheelchair. Furthermore, care homes must maintain a comfortable indoor temperature and be kept clean at all times, with one cleaner per 45 residents. The care home must keep a record of the residents’ personal details, medical history and treatment. During the day, there should be one carer per ten residents who are self-sufficient and per five who are bedridden. During night hours, the ratio is 1:15 and 1:7 until 10pm and 1:25 after 10pm. Homes with over 30 residents should employ a chef. Whether there is a chef or not, dietary requirements should be met. The care home should provide entertainment and creative occupation, as well as access to telephones. Religious beliefs should also be respected. Individuals who fails to meet the requirements of the law face a €300 fine or up to six months in prison or both. STATE INFO According to the available 2024 list, there are 99 retirement and care homes across Cyprus. Of these, three are state-owned, 35 are community-run and 61 are private. On visiting the webpage of the subsidy scheme for accommodation and care in elderly homes, one is met by a big red banner reading: “Application Submission for Beneficiaries (SEF) is closed. You cannot submit an application.” Furthermore, the Cyprus Mail contacted the Social Welfare Services, which are responsible for retirement homes, to find out how often the homes are inspected and how they plan to solve the lack of availability problem. Calls were not returned and the email with questions was not answered. LIVE-IN CARE Home care service offices operate in all hospitals and most health centres across the island and are free. There are also private companies offering care services, with prices depending on the services required, and helpers can be hired for about €10 to €15 per hour. If looking to hire live-in migrant domestic workers, the minimum gross salary is €460, but the monthly cost is typically over €800 when one includes wages, insurance and living costs. However, not every household is eligible to hire a domestic assistant, as the minimum required annual gross income ranges from €24,000 for couples with no children to €42,000 for a family with three or more children.