The Fair Deal scheme remains the most common way Irish families fund long-term care — but it's also the most misunderstood. Here's a plain-English guide to how it actually works, what it really costs, and how home-care alternatives compare.
If you've started looking into long-term care for a parent, you've almost certainly come across the Fair Deal scheme — officially the Nursing Homes Support Scheme. It's the HSE-administered framework that allows Irish people to move into a nursing home with the State covering a large portion of the cost. In 2024 alone, around 23,000 people were supported by Fair Deal, and the scheme is almost universally the first option families are pointed toward.
But here's what most families don't realise until they're deep into an application: Fair Deal is a financial assessment, not a care plan. It tells you how much you'll contribute toward a nursing home — it doesn't ask whether a nursing home is what your parent actually wants.
For many families, once they see the real numbers, the answer is no.
The Fair Deal scheme provides financial support for people who need long-term nursing home care. You apply through your Local Nursing Homes Support Office, which conducts two parallel assessments:
If approved, the HSE pays the difference between your assessed contribution and the cost of the nursing home you've chosen.
Important nuance: Fair Deal approval doesn't guarantee you a bed in the nursing home of your choice. Homes have waiting lists, and the scheme only covers approved providers. A recent Nursing Homes Ireland survey found that nearly 6 in 10 Irish people are concerned their loved ones won't be able to secure a local nursing home place when they need one.
The contribution is calculated as 80% of your assessable income plus 7.5% of the value of your assets, per year. Assets include the family home, but the principal private residence is capped at 3 years' contribution (or the person's spouse's lifetime).
Here's what that looks like for a typical pensioner:
| Income / Asset | Amount | Annual contribution |
|---|---|---|
| State pension | €14,500 | €11,600 (80%) |
| Savings | €60,000 | €4,500 (7.5%) |
| Family home (capped at 3 yrs) | €350,000 | €26,250 per year, for 3 years |
| Total contribution Year 1 | €42,350 |
That's roughly €815 per week coming out of the estate, before any top-up costs. And the HSE's contribution, on top of that, is capped at the negotiated rate for the home — which in a private home in Dublin can sit around €1,400–€1,800 per week.
What families often miss: if the nursing home charges for "additional services" — things like hairdressing, social activities, newspapers, Wi-Fi — these are billed on top and not covered by Fair Deal. Irish Consumer Protection Commission data shows these extras commonly add €200–€500 per month.
Money is the obvious factor, but the Fair Deal process introduces three trade-offs that aren't on any HSE brochure:
Once the 3-year cap on the principal residence kicks in, the 7.5% annual charge stops accruing on the family home. But the value already charged is a debt against the estate. When the property is eventually sold, the HSE is paid first. For many families, the assumption that "the family home will pass to the kids" is quietly undone the moment Fair Deal is signed.
Fair Deal covers around 430 approved nursing homes nationally. If there's a specific home your family has a relationship with — or your parent wants to stay close to a particular neighbourhood — availability at that home in that moment becomes the deciding factor. Since 2018, 77 nursing homes have closed in Ireland, and 2,600+ beds have been lost. Supply is tight.
Once someone is in a Fair Deal placement, moving back home often isn't practical. Care routines, medication management, social networks, and the practical logistics of disposing of home-care equipment mean that for most families, Fair Deal is a one-way door.
None of this means Fair Deal is wrong. For seniors with complex medical needs requiring 24/7 nursing oversight, it's the right choice. But for the much larger group of seniors who simply need more support than they currently have — it's worth pausing before assuming a nursing home is the default.
Over the last five years, a combination of AI monitoring technology, improved home-care worker availability, and the HSE's own Statutory Home Support Scheme (currently being rolled out) have made keeping a parent at home a genuinely viable alternative for the majority of Irish families.
A practical home-care setup typically combines three things:
Let's use the numbers from earlier — a pensioner with a €350k home, €60k savings, and a €14.5k State pension — and model two scenarios over 3 years.
| Fair Deal (private nursing home, Leinster) | Home care with SmartGuardian | |
|---|---|---|
| Annual family contribution (Year 1) | €42,350 | €1,428 (€119/month SmartGuardian) |
| Plus: home-care hours (10 hrs/wk @ €25) | N/A | €13,000/year |
| Plus: one-off home adaptations | N/A | ~€5,000 (Year 1 only) |
| HSE top-up on nursing home (Year 1) | ~€30,000–€50,000 | N/A |
| "Additional services" in nursing home | €2,400–€6,000/year | N/A |
| Real family spend, Year 1 | ~€47,000 | ~€19,500 |
| Real family spend, Years 2–3 | ~€44,000/year | ~€14,500/year |
Over three years, Fair Deal costs this family roughly €135,000. Home care with technology costs roughly €48,500. That's a €86,500 difference — enough to fund a significantly higher level of home-care hours, or to simply preserve for the family.
And critically: in the home-care scenario, the family home isn't being charged against each year. It stays in the family.
The decision shouldn't be made on cost alone. Here's a practical framework:
The middle path most families don't realise exists: start with home care and monitoring. If needs escalate, you can still apply for Fair Deal later. The reverse — leaving Fair Deal to go home — is rarely practical. Home care first buys you optionality.
If you'd like to understand what a home-care setup would look like for your specific situation, our team offers a free 15-minute callback. We'll talk through your parent's needs and give you an honest read — including whether home care is actually the right fit or whether Fair Deal would serve them better. No obligation.
You can also read our full 2026 guide to nursing home costs in Ireland, or our guide to having the "the talk" with your parents about future care.
Take the 2-minute assessment and we'll send you a personalised recommendation — or skip straight to a 15-minute callback if you'd rather just talk it through.