24-Hour Home Care Services in Sri Lanka
for Aging Parents.
What round-the-clock care actually involves, when it is genuinely warranted, and the cheaper arrangements worth weighing first. Most families who ask about live-in care need something smaller, and we would rather say so than sell you the largest option.
Not someone awake all night
The most common misunderstanding
What 24-Hour Care Actually Means.
Families almost always picture something different from what they are buying, so it is worth being exact.
What it is
- A caregiver who lives in the house full time
- Present around the clock, sleeping there overnight
- Available if your parent needs help in the night
- Handling meals, personal care and daily routine
- Cover arranged for their days off, in advance
- One consistent person your parent gets to know
What it is not
- Somebody sitting awake all night watching
- A nurse, unless you have specifically arranged one
- Medical supervision equivalent to a hospital
- Two people covering alternating twelve-hour shifts
- Something that can start tomorrow without an assessment
- The right answer for a parent who is simply lonely
The distinction that matters most is the night. A live-in caregiver sleeps in the house and gets up if needed, which covers the great majority of what families are actually worried about — a fall on the way to the bathroom, confusion at 3am, somebody being alone if they are unwell.
If your parent genuinely needs continuous waking supervision, say so at the assessment. That is a different and more intensive arrangement, and it should be specified rather than assumed.
When It Is Warranted and When It Is Overkill.
Usually warranted
- After a fall, particularly a second one
- Dementia that creates night-time wandering or confusion
- The first weeks after a hospital discharge
- A parent living alone who is unsteady on their feet
- Where a spouse who was the carer has died or become ill
- Conditions needing help at unpredictable hours
Usually overkill
- Loneliness, where companion care serves better
- A parent who is managing but you worry from afar
- Wanting reassurance rather than meeting a specific need
- Help required only at set times of day
- A house with no room for somebody to actually live
- A parent who would find constant presence intrusive
The right-hand column matters more than it looks. Live-in care arriving before it is needed is one of the most common reasons a parent refuses help outright, and a refusal now makes the conversation considerably harder in six months when it becomes necessary.
Families overseas are particularly prone to over-providing, for understandable reasons. When you cannot see the situation, the safest-feeling option is the largest one. It is frequently the wrong one.
The Practical Realities Nobody Mentions Upfront.
Somebody is going to live in your parents' house. These are the things worth settling before day one rather than during week two.
Where they sleep
A spare room is the straightforward answer. Where none exists, it needs solving before placement — it materially affects who will accept the position and how sustainable the arrangement is.
Days off and cover
Everybody needs time off. Agree in advance whether a second caregiver rotates in or the family covers, so nobody discovers the gap on the first weekend.
Meals and household costs
A live-in caregiver eats in the house. Settle who provides food and how it is handled, because unspoken assumptions here cause more friction than pay ever does.
Privacy, both ways
Your parent loses some privacy and so does the caregiver. Clear boundaries about rooms, visitors and downtime make the difference between a placement that lasts and one that quietly fails.
The household routine
A caregiver joining an established household should adapt to it, not replace it. Meal times, television, visitors and religious observance should carry on as they were.
Language and background
Matching on language matters more with live-in care than with visits, because this is somebody your parent will speak to every day rather than for two hours twice a week.
What a Day Actually Looks Like.
Live-in care is mostly unremarkable, which is the point. A rough shape of an ordinary day, so you know what you are paying for.
Early morning
Up before your parent. Medication prepared, breakfast started, and a quiet check on how the night went — whether they slept, whether they got up, whether anything hurt.
Morning
Washing and dressing at whatever pace suits. This is the part most families worry about and most parents dread; done well it is unhurried and largely invisible.
Midday
Lunch, medication, and usually the most active part of the day. Short walk, sitting outside, or an errand if your parent is up to it.
Afternoon
Rest, television, visitors. A caregiver is present rather than hovering. For many parents this is the stretch that used to be the loneliest.
Evening
Dinner, evening medication, and the welfare update written up and sent while the day is still fresh — meals, medication, mobility and mood.
Overnight
The caregiver sleeps in the house. If your parent gets up, calls out, or is unwell, somebody is there within seconds rather than nobody being there at all.
Nothing on that list is dramatic, and that is precisely what families are buying. The value of live-in care is not in any single task — it is that somebody is there for the bits between the tasks, which is where falls, confusion and quiet deterioration actually happen.
The day also flexes to the household rather than replacing it. If your father has eaten at seven for forty years, he continues to. If your mother wants the afternoon to herself, she gets it. A caregiver who imposes a routine tends not to last, and rightly so.
What you receive from all of this is the evening update. It is deliberately mundane — ate well, took everything, slept through, in good spirits — and its usefulness is cumulative. One is worth little; sixty of them show you exactly what is changing.
Cheaper Arrangements Worth Weighing First.
Three of these solve the actual problem for a good number of families, at a fraction of the monthly cost.
Night care only
If the night is what worries you — and for most families it is — cover the night and leave the day alone. Considerably cheaper and often entirely sufficient.
Night care at homeHalf-day blocks
A fixed four to six hour block each day covering the period where help is actually needed. Suits parents who manage mornings but struggle by afternoon.
Half-day home careCompanion visits
Two or three visits a week. The cheapest arrangement that puts an accountable person in the house on a schedule, and the easiest to accept.
Companion careThe daily rate is identical across all of these at a given staff level. What changes is how many days you are paying for, which is why night-only or half-day arrangements come out so much lower over a month.
Hours also extend without changing caregiver. Starting with nights and moving to live-in later keeps the same familiar person in the house, and that continuity is worth more to an older person than most families anticipate.
What Overseas Families Should Know Specifically.
Live-in care is requested more often by families abroad than by those in Sri Lanka, and the reason is not clinical. It is that somebody sleeping in the house removes the specific fear of a parent being alone and unwell at an hour when you are asleep and unreachable.
That is a legitimate reason to choose it, provided you are honest that you are buying reassurance as well as care. Both are real needs. What matters is that your parent is not having a stranger move in purely to settle your anxiety when a night arrangement would have done.
The reporting matters more here too. With a live-in placement you are relying on one person entirely, so written updates after every day are not optional — they are the only way you would notice if the arrangement were drifting.
And insist on unlimited replacements. A live-in mismatch is far more disruptive than a visiting one, because it is somebody living in your parents' home. Any provider capping replacements is placing that risk on you.
What it costs
Membership first, then simple daily rates.
Live-in care is charged at the same daily rate as any other placement at that staff level — what changes is that you are paying for every day. Published rates, no shift premiums and no travel supplements.
BetterHands Annual Membership
LKR 20,000
One-time annual registration fee
- Unlimited caregiver replacements at no additional cost if you are not satisfied
- Payroll management and caregiver administration
- Ongoing coordination and support from the BetterHands team
- Access to all services covered under the BetterHands membership
Step two — daily service rates
Duties below are what each role normally provides — your care plan is tailored during the free assessment.
Caregiver
Daily living support and companionship
LKR 4,500/day
Most families start here — a parent who is managing, but should not be alone all day.
- Friendly conversation and companionship
- Bathing and personal care assistance (if required)
- Medication reminders and general supervision
- Simple meals and refreshments
- Short walks and light activities (if appropriate)
- Day-to-day assistance and emotional support
Nursing Assistant
Personal care plus basic clinical support
LKR 6,000/day
Common where diabetes, blood pressure or early-stage dementia needs daily monitoring.
- Everything in the caregiver role
- Vital signs monitoring (BP, blood sugar, SpO₂)
- Medication reminders and administration support
- Basic wound and continence care
Professional Nurse
Complex medical and post-operative needs
LKR 9,000/day
Usually after a hospital discharge, a stroke, or where wounds and IV care are involved.
- Everything in the nursing assistant role
- PHSRC-registered clinical nursing
- Wound care, injections, and IV therapy
- Catheter, NG tube, and post-operative care
Daily rates are charged in addition to the one-time annual registration fee of LKR 20,000. The same daily rates apply to day care, night care, live-in, and hospital bystander support — no shift premiums, no travel supplements for any district. A free care assessment is provided before any commitment.
A one-way transfer for the caregiver is arranged at the start of placement.
Families we look after
Trusted with the people who raised us.
“BetterHands transformed my mother's quality of life. The caregivers are professional, compassionate, and treat her with so much dignity. Our whole family is relieved and grateful.”
Chamari W.
Colombo 07
“After my father's heart surgery at Lanka Hospitals, the nursing team from BetterHands provided exceptional post-operative care at home. They were thorough, kind, and always on time.”
Roshan & Dilini P.
Nugegoda
“My grandfather was very lonely after being discharged from hospital. His BetterHands companion has become a true friend — he is happier and more engaged than he's been in years.”
Priya N.
Kandy
Common questions
Questions About 24-Hour Care in Sri Lanka.
No, and this is the most common misunderstanding. It means a caregiver lives in the house and is present around the clock, sleeping there overnight and available if needed. If your parent genuinely requires someone awake through the night, that is a different arrangement and should be specified.
In the house, in a spare room where one exists. This is worth resolving before placement rather than on the first day. Homes without a spare room can sometimes be adapted, but it materially affects who will accept the placement.
Cover is arranged so the house is not left empty, either through a rotating second caregiver or a scheduled arrangement agreed in advance. Any provider who cannot answer this question clearly has not thought it through.
Per day it costs the same daily rate as any other placement at that staff level. What changes is that you are paying for every day rather than selected days, so the monthly total is higher than two or three visits a week.
Most often after a fall, where dementia creates night-time risk, following a hospital discharge, or where a parent lives alone and is no longer safe unattended overnight. Loneliness alone is usually better served by companion care.
Yes, and most families should. Night care, half-day cover, or a few companion visits are all cheaper starting points, and hours can extend without changing caregiver — which matters more to an older person than families expect.
BetterHands nurses are registered with Sri Lanka's Private Health Services Regulatory Council. Nothing here is medical advice — decisions about the level of care should follow your parents' treating doctor.
Check it yourself
Sources and further reading
Entitlements and health guidance change. These are the official sources — go to them rather than taking our word for it.
Buy the arrangement they need, not the one you fear.
Live-in care is the right answer for a meaningful number of families, particularly after a fall or where dementia makes nights unsafe. It is also the option overseas families reach for first, and frequently more than the situation requires.
A free assessment settles which it is. Somebody visits, looks at the house and the stairs, reads the medication list, and tells you what is actually needed — including if that is nights only, or a few visits a week.
We would genuinely rather place the smaller arrangement and have it accepted than the larger one and have it refused in week two.
If live-in care does turn out to be right, it is worth knowing that it rarely stays static. Families commonly begin with a live-in placement after a fall, then reduce to daily visits once mobility returns, then increase again years later. The arrangement should follow the need rather than the other way round, and nothing here locks you into a level of care you have outgrown.
Not sure how much care
they actually need?
The free assessment answers exactly that. A 15-minute call first, scheduled for your hours — and an honest answer, even when it is less than you expected.
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