Home Care vs an Elders' Home
in Sri Lanka.
Most families in Colombo, Gampaha and Kalutara start by looking for an elders' home, because that is the option everybody knows. Professional home care in Sri Lanka is the option they usually have not priced yet — and for many parents it is the better answer. This page lays out both fairly, including when a residential home genuinely wins.
1,000+
Caregiver Profiles
Island-wide — reviewed one by one
1,500+
Families Served
Across Sri Lanka since 2020
96%
First-Match Success
Matched on 50+ factors
72 Hours
Placement Guarantee
From a completed assessment
Start here
The question is not which is better. It is how much help is needed.
Families usually arrive at this decision in a hurry. A fall, a discharge from hospital, or a daughter in Melbourne who cannot sleep. In that state the search is almost always for an elders' home, because a building is a concrete thing you can visit and point at.
However, the choice is rarely between a facility and nothing. It is between a facility and a trained caregiver in your parent's own house, for as many hours a day as the situation genuinely calls for. Once the question is framed that way, a great many families find the second answer fits better — and costs less, because they are not paying for hours nobody needs.
Sri Lanka's ageing population is growing faster than almost any country in South Asia, and the Sri Lanka Ministry of Health now treats home-based care as a core part of long-term elder support rather than a fringe alternative. Therefore the real work is measuring need honestly, before choosing a format.
- Part-day need. Meals, bathing, medication and company for part of the day — home care is almost always the cheaper and kinder answer.
- Full-day need. Someone present through waking hours — home care still usually wins on cost and continuity.
- Overnight need. Wandering, night falls, or unstable conditions — this is where a facility earns real consideration.
- Clinical need. Wounds, catheters, injections — solvable at home with a nurse, not a reason on its own to move.
What we ask first
"How many hours a day is your mother actually unsafe on her own? Not how many hours you worry — how many hours she needs someone there."
BetterHands Care Coordinators
Side by side
Care at home vs a residential elders' home.
Six factors decide almost every case. Read the middle column and the right column together — one of them will describe your family more accurately than the other.
Surroundings
Care at home
Their own house, their own bed, their own routine. Nothing familiar is taken away.
Elders' home
A shared building with fixed mealtimes, fixed visiting hours and a shared room in most cases.
Attention
Care at home
One caregiver, one person. Undivided for the hours you book.
Elders' home
Staff are shared across many residents, and the ratio falls further overnight.
Cost shape
Care at home
Hourly or daily. You pay for the care actually needed, and it scales up or down.
Elders' home
A fixed monthly fee whether the resident needs two hours of help or twelve.
Family access
Care at home
Unlimited. Grandchildren come and go, neighbours drop in, the household continues.
Elders' home
Structured visiting hours, and often a long drive for the family.
Overnight supervision
Care at home
Requires live-in or overnight cover — an added cost that must be planned for.
Elders' home
Included by default. This is the genuine structural advantage of a facility.
Adjusting to change
Care at home
Hours change with a phone call. No move, no upheaval.
Elders' home
A change in need can mean a change of facility, and another relocation.
The honest part
When a residential home is the right choice.
We place caregivers for a living, so treat this section with appropriate scepticism — and then read it anyway, because there are cases where we tell families the same thing.
Advanced dementia with night wandering
When someone leaves the house at 3am and does not know where they are, safe care means continuous supervision in a secured setting. Live-in care can cover this, but it needs two carers on rotation, and not every family home is suitable.
No family in the country at all
Home care works best with someone local who can answer a phone at short notice. Where the entire family is overseas and there is no relative or trusted neighbour in Sri Lanka, a facility's institutional accountability has real value.
A home that cannot be made safe
Steep stairs, a bathroom that cannot fit a wheelchair, an upstairs bedroom with no alternative. Sometimes the building itself is the obstacle, and modifying it costs more than moving.
The parent genuinely prefers it
Some people are lonely at home and happier among peers. It is rarer than families assume, but when a parent says it plainly and repeatedly, that answer should carry the most weight of anything on this page.
Outside those four situations, most families we assess in Colombo, Nugegoda, Dehiwala and Negombo find that elderly care services at home meet the need — at a cost they control, without moving anyone.
What it actually looks like
A day of care at home.
Families picture home care as an occasional visitor. In practice a full day looks closer to this — which is why it substitutes for residential care far more often than people expect.
Morning
The caregiver arrives before your mother wakes. Bathing and dressing at her pace, breakfast she recognises, and the morning medication taken with someone watching — not left on a table to be forgotten.
Midday
A cooked lunch, a short walk to the gate or the garden, and the physiotherapy exercises the hospital sent her home with. Her own kitchen, her own routine, her own chair by the window.
Afternoon
Company through the part of the day families most often underestimate. Conversation, a visit from a neighbour, the television programme she has watched for fifteen years.
Evening
Dinner, evening medication, and the house settled for the night. Where overnight cover is booked, a caregiver stays; where it is not, the family takes over at a handover the coordinator has agreed in advance.
Notice what is absent: a move, a shared room, fixed visiting hours, and a monthly fee that does not change when the need does. For a parent recovering from surgery or living with a stable long-term condition, that continuity is frequently the deciding factor. Where clinical tasks are involved, a home nursing care placement covers them in the same visit.
If you are visiting facilities
Five questions to ask before you sign.
Use these whether or not you ever speak to us. A good residential home will answer all five without flinching, and a family that asks them makes a better decision either way.
1. What is the staff-to-resident ratio at 2am?
The daytime ratio is the one they advertise. The overnight ratio is the one that matters when your father needs the bathroom at three in the morning.
2. Is a nurse on site or on call?
On call can mean forty minutes away. For medication changes and wound reviews, that difference is the whole point of paying for care.
3. What is included, and what is billed separately?
Laundry, nappies, physiotherapy, doctor visits and transport are commonly extra. Ask for a sample invoice from an actual resident, not a brochure.
4. What happens when needs increase?
Some homes discharge residents who become too dependent. Establish that before your parent settles in, not after.
5. Can we visit unannounced?
A confident home says yes without hesitating. Any qualification of that answer tells you something worth knowing.
Ask the equivalent questions of any home care provider too. Ours are answered on the personal care at home page, and a coordinator will go through all of them on a free assessment visit.
On cost
Why the comparison is not like for like.
A residential home charges one monthly fee whether your father needs two hours of help a day or twelve. Home care charges for the hours you book. As a result, the two only converge at the very top of the need scale — around the clock, every day.
We do not publish other providers' or facilities' rates here, because we have no verifiable source for them and you should not trust a competitor's numbers quoted by us. What we can do is publish our own rates in full, so you can hold them against any quotation you have been given.
For a like-for-like figure, ask any facility for its all-in monthly fee including nursing, laundry, medication handling and extras — then compare that to the daily rate below multiplied by the days you actually need.
Transparent pricing
Membership first, then simple daily rates.
One annual membership covers coordination, payroll, and unlimited caregiver replacements. After that you pay a flat daily rate for the level of care you need.
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 and live-in support — no shift premiums, no travel supplements for any district. Hospital bystander cover is priced by shift length instead — see that service page for its packages. A free care assessment is provided before any commitment.
How to decide
Five questions that settle most cases.
Work through these before you visit anywhere or sign anything. For example, a family convinced they needed a facility often finds that question two is the only real problem — and that overnight cover solves it.
- Hours genuinely needed. Count the hours your parent is actually unsafe or unsupported — not the hours you worry about them.
- Overnight risk. Do they wander, fall, or need help in the night? This single answer decides more cases than any other.
- Clinical complexity. Wounds, catheters, injections and unstable conditions all have home solutions — but they need a nurse, not a caregiver.
- What they want. Ask them plainly. Most Sri Lankan parents say the same thing, and it is worth taking seriously.
- Family capacity. Be honest about what the household can sustain for a year, not for a fortnight.
Where we place
Care at home across Sri Lanka.
If your parent lives in the Western Province, there is almost certainly a caregiver near them already. Coverage is strongest across Colombo, Gampaha and Kalutara districts.
Colombo
Colombo 1–15, Cinnamon Gardens, Nugegoda, Wellawatte, Dehiwala
Gampaha
Negombo, Ja-Ela, Wattala, Ragama, Kadawatha
Kalutara
Panadura, Wadduwa, Waskaduwa, Horana
Kotte
Rajagiriya, Battaramulla, Nawala, Maharagama
Families who chose home
What happened next.
“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 families ask before deciding.
It depends entirely on how many hours of care a person actually needs. A parent who needs help for part of the day is almost always cheaper to support at home, because you pay only for the hours used. Round-the-clock live-in care and residential care sit much closer together on cost. The honest answer is that you cannot compare the two without first establishing the real level of need — which is what a free assessment is for.
Not automatically. A residential home has staff present overnight, which matters for someone with advanced dementia or a serious falls history. But a familiar house with a trained caregiver, grab rails and a clear medication routine is frequently safer than an unfamiliar building with a higher resident-to-staff ratio. Safety comes from the level of supervision, not the building.
Home care scales. Families commonly begin with a few hours of daytime support, move to full days, then to overnight or live-in cover as needs change. Because the arrangement is hourly, it adjusts without a move, and without the disruption that relocating an elderly person always causes.
Both. BetterHands places PHSRC-registered nurses for wound care, medication administration, catheter and stoma care, and chronic disease monitoring, alongside caregivers who handle bathing, meals and mobility. Clinical need does not by itself require a residential facility.
Start with three questions: how many hours a day does your parent genuinely need someone present, is overnight supervision required, and how much does staying in their own home matter to them. Those three answers settle most cases. A free home assessment puts real numbers against them before you commit to anything.
Not sure which way
to go?
A free assessment gives you the real hours, the real cost and an honest recommendation — including telling you when a residential home is the better answer.
1,000+
Caregiver profiles
96%
First-match success
Trained
Caregiver training
72
Hours to placement