Moving or improving, housing options for older people in the UK

Reviewed by: Dr Jackie Gray, Public Health Expert and Retired GP
(Carents Trusted Reviewer Programme – Last reviewed March 2026)

Start with an honest look at how well home is working right now. Many families avoid this question because it feels disloyal. It is not. Being clear-eyed now prevents a crisis later.

Ask three practical questions:

• Is day-to-day life at home safe and manageable, covering meals, medication, mobility and hygiene?

• Is your relative isolated or lonely? Are they getting meaningful contact with other people most days?

• Is the cost and effort of running the home realistic over the next two to three years?

If the honest answer to all three is yes, focus on building in the right support to keep things that way. If any answer is no, it is worth exploring the full range of options below. Some moves preserve far more independence than families expect.

Before exploring the options, it is worth saying something that does not get said enough: moving home is one of the most disruptive life events anyone can go through. For older people living with frailty or dementia, that disruption can have real physical and cognitive consequences. 

The stress of a move, a change of environment and a break in routine can trigger or accelerate decline.

This does not mean a move is the wrong choice. Sometimes it is clearly the right one. But the timing matters, and the decision should not be rushed or made under pressure. If a move is on the table, weigh up the full picture: the risks of staying, the risks of moving, and what support can be put in place to make the transition as smooth as possible.

Staying in a familiar home is what most older people want. With the right mix of people, technology and adaptations it is often achievable long term.

Home care

Home care agencies can provide anything from one daily visit to check on medication to multiple visits for personal care, meals and companionship. Live-in carers move in full-time. This can be less disruptive than a care home move and often costs less than residential care, particularly outside London and the South East.

When choosing a home care agency, check it is registered with and rated by the Care Quality Commission (CQC). Ask about staff continuity too. Consistent faces matter far more than most families realise.

Home adaptations

Relatively low-cost changes make a significant difference to safety and independence: grab rails, non-slip flooring, better lighting, a stairlift, a level-access shower, a key safe for carers and door-entry intercoms.  Minor adaptations are usually provided and funded through local NHS or Council services. For more substantial changes, it is worth asking about a Disabled Facilities Grant (DFG), which can fund up to £30,000 of work such as a level-access shower, ramp or stairlift. Not everyone will qualify, but it is always worth exploring. Apply through the local authority's adult social care team.

How adaptations are funded and delivered varies across the UK. In some areas it is the local authority that leads, in others it is the NHS, and in many places it is a joint arrangement or a bit of both. What matters is that most areas will have local services with occupational therapists who can assess the home and advise on what is available and what can be provided free of charge. Your GP can refer your relative or point you towards how to access that support locally.

Technology

A growing range of technology supports independent living: fall detection sensors, GPS pendants, smart medication dispensers, video doorbells and remote monitoring apps. Many are now affordable and simple to set up. The key is making sure your relative is willing to use them, which often means involving them in the choice.

Managing the property

Staying at home also means keeping up with the property itself. Bills, repairs, heating, security, pests and garden maintenance all need someone to take ownership of them. If these are slipping, it is an early warning sign that home may become unmanageable or more help is needed to manage these jobs. Handyperson services, volunteer schemes and trusted local tradespeople can all help bridge the gap.

Moving to a smaller, single-storey home (a bungalow, flat or purpose-built apartment) is often an attractivel first step for older people who are still independent but finding their current house is hard work. It sits between staying put and specialist housing, and is often overlooked.

A ground-floor flat or bungalow removes stairs entirely, dramatically reducing fall risk. Smaller properties are easier and cheaper to heat, clean and maintain. Selling a larger family home often releases equity that can fund future care. Modern builds and purpose-built older-persons developments frequently come with accessible bathrooms, wide doorways and level access already in place.

The main challenge is supply. Bungalows are scarce in most parts of the UK, and their scarcity means they command a price premium per square foot. Transaction costs including stamp duty (following the April 2025 threshold changes), legal fees, estate agent fees and removals can easily reach £15,000 to £20,000 on a typical move, which reduces the equity released. Emotional attachment to a long-term family home is also real and should not be minimised.

Retirement villages are larger developments specifically designed for older people, typically from age 55 or 60 upwards. They range from small clusters of purpose-built homes to substantial developments of hundreds of properties with extensive shared facilities: restaurants, gyms, swimming pools, hairdressers, libraries and organised activities. Properties may be houses, bungalows or flats. Some schemes offer care on site; others arrange it separately.

The appeal is a sociable, maintenance-free lifestyle in a community of peers. However, retirement villages come with significant financial complexity that families frequently underestimate. Most properties are sold leasehold, with ongoing service charges, and may include event fees (sometimes called exit fees or deferred management charges) payable on resale. In some schemes these can amount to 20 to 25% of the resale value after five years.

Some developers are moving away from exit fees: Churchill Living announced in August 2025 that it was scrapping them. But many schemes still apply them. Always seek independent legal and financial advice before purchasing, and ask for a written example showing total costs over five and ten years.

Sheltered housing is usually a development of self-contained flats or bungalows built specifically for older people (typically from age 55 or 60 upwards). Most schemes have a scheme manager available during office hours, a 24-hour emergency alarm, communal lounges and regular social activities such as coffee mornings and film nights. The scheme manager does not provide personal care, but can summon help and keep an eye on residents' wellbeing.

Sheltered housing can be rented from a council or housing association (costs typically range from around £300 to £700 per month depending on location, plus a service charge of £150 to £400 per month or more in London) or bought on the open market. Buying in a sheltered scheme means buying a leasehold, so check service charges, ground rent, exit fees and whether the freeholder is well-run before committing.

Extra care housing, sometimes called assisted living, enhanced sheltered housing or housing with care, is a step up from sheltered housing. Your relative has their own self-contained flat with their own front door, but on-site care staff are available 24 hours a day. Meals, domestic help, laundry and personal care can all be provided. Other on-site facilities are often provided eg restaurant, communal areas and gardens as well as entertainment facilities.

Support packages can be increased as needs change, making it a flexible option for people who want to stay as independent as possible but know they will need more help over time. 

Unlike sheltered housing, extra care is regulated and inspected by the Care Quality Commission (CQC), so you can check inspection ratings before choosing a scheme. It tends to cost more than sheltered housing but less than a care home, particularly in the early years when care needs are lighter.

Important Note: Extra Care Housing Service Charges

Service charges are one of the most important things to understand before committing to an extra care property, whether buying or renting. They rarely pause if circumstances change. If your relative has a long hospital stay, moves on to a care home, or dies and the property is awaiting sale, the charges continue. Families are often caught off guard by this: they are already paying for a care home or hospital, and service charges on the empty property keep coming in on top. If the property takes months to sell, those costs add up quickly.

There is also a capital risk for buyers. Property values in extra care and retirement leasehold developments do not always hold up in the same way as the general housing market. Some buyers find they sell for less than they paid, while having covered years of service charges in the meantime. This combination of falling resale value and ongoing charges is a concern that comes up regularly in the Carents Lounge community. It does not affect every scheme, but it is a real enough risk that anyone buying in should take independent financial advice and ask the developer directly for resale data on comparable properties in the same development.

Homeshare is a practical and increasingly popular option for older people who want to stay at home but would benefit from companionship and some light-touch support. The older person (the householder) provides a room rent-free to a younger person (the sharer), in exchange for around 10 to 15 hours of household help per week, covering tasks such as shopping, cooking, cleaning, laundry and gardening, plus overnight presence for reassurance and security.

Homeshare is arranged through approved providers who vet both parties carefully, make considered matches, draw up a legal licence agreement and monitor the arrangement on an ongoing basis. Homeshare UK (homeshareuk.org) is the national network of approved providers. There is no exchange of money between householder and sharer, though the sharer usually contributes to household bills up to a capped amount.

Homeshare does not replace personal care. Sharers are not carers and do not provide medical or intimate personal care. It works best for people who are largely independent but lonely, anxious at night, or struggling with household management. Research by Share and Care Homeshare found that 96% of householders report that homeshare positively impacted their overall quality of life, and that falls reduced significantly once a sharer was in residence.

For some families, moving an older relative into the family home, or building a dedicated space for them, is the right answer. Done well, it can provide excellent care, closeness and mutual support. Done without enough planning, it can place enormous strain on everyone involved.

The key is honesty before committing. Think carefully about who provides care overnight and at weekends, how privacy will be maintained for everyone, what happens if care needs increase significantly, and how costs, bills and responsibilities will be shared from the outset.

Annexes and extensions (granny flats and garden annexes)

Building a dedicated self-contained annexe (often called a granny flat) in the garden or as an extension of the main house is a popular option that gives genuine independence alongside close family support. A good annexe includes a bedroom, bathroom, kitchen and sitting room. It allows your relative to have their own front door, their own routine and their own space, while being only steps away from the family.

Building costs vary widely. A new detached timber-frame or modular annexe typically costs from around £80,000 to £120,000. A conversion of an existing garage or outbuilding can be done for less. Most annexes require planning permission as they constitute self-contained living accommodation. Always check with your local planning authority before committing. Some prefabricated structures can be installed under the Caravan Sites Act without full planning permission, but legal advice is strongly recommended.

Council tax on the annexe may be exempt or reduced (50% discount) if it is occupied by a dependent relative or as a secondary residence for a household member. Check with your local authority. A well-built annexe can increase the main property's value by 15 to 30% according to Checkatrade, though this varies considerably by location and specification.

Adapting the main house

If a separate annexe is not feasible, adapting the main house can make shared living work. This might mean converting a ground-floor room into a bedroom, installing a wet room downstairs or widening doorways. A Disabled Facilities Grant for some may be available for some of these works.

A care home provides accommodation, meals and 24/7 personal care support in a fully staffed residential setting. A nursing home adds qualified nurses on site and is appropriate for people with complex health conditions, advanced dementia or medical needs that cannot safely be managed at home or in other settings. The distinction matters: not all care homes can accommodate nursing-level needs.

How much does a care home cost?

In early 2025, the average weekly cost for a private-pay resident ranged from around £1,076 in the North East to £1,710 per week in London, which is equivalent to roughly £56,000 to £88,000 per year. Nursing homes are typically £1,200 to £1,871 per week nationally. Those with assets below £23,250 (in England) may be eligible for local authority funding following a care needs and financial assessment. However, the means-tested threshold has remained largely unchanged for years, meaning many people who expect support find they must self-fund initially.

Choosing a care home

Visit in person, more than once and at different times of day. Look for staff who seem relaxed and engaged with residents, clean and warm communal spaces, meaningful activities on most days, consistent staffing and low turnover, and prompt response to call bells. Ask specifically about staffing levels at night, how they support people with dementia, and what happens if your relative's needs increase significantly. Check the most recent CQC inspection report before visiting.

Making a housing decision for an older relative is one of the most emotionally demanding tasks a family faces. These practical steps help to keep the process manageable.

1. Involve your relative as much as possible

Even if cognitive changes make full involvement difficult, the older person's preferences, fears and values should shape the decision. What matters most to them: being close to family, having their own space, keeping their cat, staying in their local area? These are not minor preferences. They are the things that will determine whether a new arrangement actually works.

2. Write the options down

Put the realistic choices, costs and key risks on paper, or in a shared document. Writing it down makes it easier to discuss calmly, helps everyone see the trade-offs clearly and makes it easier to involve other family members constructively.

3. Test before committing

Before making a major move, test the alternative first. If the question is whether home is safe, increase support for six to eight weeks, add key adaptations, and then review: sleep quality, falls, medication management, mood and carer strain. This is far less stressful than making a large decision under pressure.

4. Visit more than once

Whether looking at a care home, sheltered scheme, retirement village or extra care development, visit at different times of day and on a weekday. Talk to residents independently if possible. Ask about staffing at night, call bell response times and what happens when care needs increase. If looking at a care home, there may be an option for a short one week trial for respite care to help you make your decision.

5. Protect family carer wellbeing

Carents consistently underestimate how much they are doing and how much it is costing them emotionally and practically. You are looking for the best overall mix of safety, connection and dignity, not a perfect solution. Share tasks within the family, be honest about capacity limits and take breaks. A carer who burns out cannot care.

Reviewed by Dr Jackie Gray, March 2026