Home care vs Nursing Homes in Thailand - Cost & How To

Emergency in Thailand: call 1669, the free 24-hour national medical emergency line run by the National Institute for Emergency Medicine. If you are a patient of a private hospital, its own ambulance line may be faster: save it in your phone today and write it on paper by your bed.

Reading time: about 20 minutes · Last updated: October 2026 · Researched by Elder Thai Staff

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This guide is for you if you live in Thailand, or are planning to move here, and you need more help day to day than you used to. Perhaps you have had a fall, a stroke or an operation. Perhaps your memory is slipping, or you simply no longer want to manage the shower and the stairs alone. It compares the two real options, a nursing home or care at home, with real Thai prices, and then shows you step by step how to set up home care properly. It does not replace your doctor. Where your doctor's advice differs from this guide, follow your doctor.

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1. The short answer

• One-to-one care at home gives you something a shared setting cannot: a carer whose whole attention is on you, in your own home, on your own routine. You choose the hours, you control the cost, and you can change the plan any week.
• Nursing homes in Thailand cost more than many people expect once you want English-speaking staff and more personal attention. Thai-market care homes in Bangkok start at about 15,000 THB a month for a bed in a shared room (as listed in Sanook's 2026 price comparison), and many, like Aryuwat Nursing Home, start from 19,000 THB. Homes aimed at foreigners cost far more: a room at Ban Sabai Village in Chiang Mai starts at 57,000 to 67,000 THB a month before meals and care, and one-to-one 24-hour care there adds 99,000 to 130,000 THB. Specialist dementia care at VivoCare is USD 3,500 a month.
• In any care home, attention is shared, and standards vary from home to home. The legal staffing floor in a Thai overnight care home is one carer for up to five residents (2020 ministerial regulation). Care homes are licensed as health businesses, not medical facilities. In October 2026 the government ordered on-site inspections of all 1,203 registered homes after reports of residents being caged and chained (The Nation, Bangkok Post).Thailand has many good, caring homes, and the inspections are part of raising standards. Just check before you choose.
• Home care costs what you use. It is often cheaper than a home when you need help for part of the day. If you need 24-hour cover it can cost more than a Thai-market home, but you get one-to-one attention for every one of those hours. With Elder Thai, 4 hours a day for a month (30 days) is 36,000 THB, 8 hours is 66,000 THB and 24 hours is 105,000 THB.
• Most people do not need 24-hour care at first. Do the self-check in section 3 before you pay for more hours than you need.

Not sure how many hours you need? Ask us →

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2. Nursing homes in Thailand: what the data shows

Many Thai care homes do caring, professional work, and for some people a home is the right choice. To compare fairly, this section looks at what Thai government data and news reports say about cost, staffing and standards. In short: attention in a home is shared by design, prices for foreigner-standard care are high, and standards vary from home to home, so it pays to check.

How care homes are regulated

• Since 27 January 2021, care for elderly or dependent people has been a licensed "health business establishment" under the Health Establishment Act 2016, overseen by the Department of Health Service Support (กรมสนับสนุนบริการสุขภาพ, สบส.) (government licensing page, Lexology summary).
• The 2020 ministerial standards set rules for rooms, safety and services. For overnight care homes they require one carer for no more than five residents, 90 cm between beds, an emergency call system, a defibrillator, a care assessment on arrival repeated every three months, a written contract, and prices on public display.
• The department itself stresses that "a care home is not a medical facility". Homes should not take patients whose needs are beyond them (Ministry of Public Health, 10 Oct 2026).
• A Thai law journal study argues that Thailand still has no dedicated nursing-home law, no set qualifications for the people doing the caring and no single agency following up, and that some families "lose a large amount of income but do not get quality and standardized nursing as specified in the contract."

What inspectors have found

• Kanchanaburi, October 2026: a licensed centre with 129 beds on a 50-bed licence, psychiatric patients it was not licensed for, and beds enclosed in steel cages. Its licence was revoked (Bangkok Post, The Nation).
• Nonthaburi, October 2026: one licensed home with 11 residents in nine licensed beds and two unlicensed homes, one with 58 residents in a three-storey building. Residents shouted to reporters that they had been chained. The Department of Mental Health said its first assessment found no evidence of abuse or chaining equipment (Bangkok Post).
• Bang Khen, Bangkok, November 2025: an unlicensed home charging 18,000 THB a month, run for six months by an owner who admitted he had no care experience (Bangkok Post, Department of Health Service Support).
• Lat Krabang, Bangkok, 2022: an unlicensed home where elderly residents were found chained to beds (Thai PBS).
• After these cases the government ordered on-site inspections of all 1,203 registered homes within two months, checking premises, safety, staff and whether homes stay within their licence (The Nation). Running a care home without a licence carries up to six months in prison or a 50,000 THB fine.

What this means for you

These are the worst cases, mostly unlicensed or overcrowded homes, and they do not describe the many well-run homes. A Thai PBS World documentary described how unequal Bangkok's homes are. The fair conclusion is:

1. Lower prices usually mean shared attention. At 15,000 to 25,000 THB a month you usually share a room, the staff mostly speak Thai, and one carer can legally look after up to five people.
2. Good, English-speaking homes cost 60,000 to 150,000 THB a month once you add meals and care (see section 4).
3. Even in an excellent home, "24-hour care" means a shared team. One-to-one attention is an extra. At home, one-to-one is the starting point.

If you choose a home, check its licence: ask to see it, or contact the Department of Health Service Support (how to report a home).

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3. Do you really need full-time care yet?

Before choosing a nursing home or 24-hour care, check what you can actually still do. Thai public health teams score this with the Barthel ADL index (activities of daily living), and Thailand's Department of Health uses the score to sort people into three groups (Thai Barthel form and groups, NHSO long-term care manual).

Score yourself honestly (Barthel ADL, 0 to 20)

What your score means

• 12 to 20 ("ติดสังคม", independent): you probably do not need a care home. Part-time help, for example 4 hours a few mornings a week, for the shower, shopping and medicines, is usually enough.
• 5 to 11 ("ติดบ้าน", housebound): you need daily help. 8 to 12 hours a day often covers it, with someone reachable at night.
• 0 to 4 ("ติดเตียง", bedbound): you need help around the clock: 24-hour care at home with nurse visits, or a nursing home with genuine nursing cover.

The score misses some things. Add hours if any of these are true

• You have fallen in the last six months, or you are afraid to get up at night.
• You forget medicines, leave the stove on or get lost (early dementia). A good score on the table does not mean you are safe alone.
• You need help at night: toileting, confusion, breathing.
• You have nobody in Thailand who could be with you within an hour.
• Your doctor has said you should not be alone after a stroke, operation or hospital stay.

Your doctor or a home nurse can do this assessment properly. Thai licensed care homes must do one when you arrive and repeat it every three months (2020 standards). Ask any home care provider to do the same. Elder Thai's guide to the signs you need a caregiver covers the early warning signs.

Score between 5 and 20? Part-time help may be all you need →

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4. What nursing homes really cost

Prices are as published by each home in 2025 or 2026. They change, and almost every home charges extra for medicines, nappies, oxygen and doctor visits. Always get an itemised quote in writing.

Thai-market homes (mostly Thai-speaking staff)

Homes aimed at foreigners

A worked example. At Ban Sabai, a standard room for a long stay (57,000), full board (40,000) and up to 8 hours of care (33,000) comes to 130,000 THB a month. With one-to-one 24-hour care instead, it is about 196,000 THB. That is a good home with a published price list. It shows what "foreigner-standard" care in Thailand really costs.

How this compares with care back home

For comparison only, here is what the same care costs privately in some home countries, converted at Bank of Thailand rates for 12 October 2026 (USD 33.52, GBP 44.39, AUD about 23.34, CAD about 23.41, SGD about 26.13, JPY about 0.211 and KRW 0.0249 THB, BOT exchange rates). A month is taken as 30.4 days.

How to read this. US, UK and Singapore private figures are full private prices. Australian, Canadian, Japanese and Korean figures are what a resident pays inside a public insurance or subsidy system, usually after an assessment and often a waiting list, and they are generally available only to residents of those countries. Japanese prices also exclude the care itself, which is billed separately through long-term care insurance. Even 24-hour, one-to-one home care in Thailand costs less than a shared-team nursing home bed in the US or UK.

What is usually not included: hospital stays and emergency care, specialist visits, medicines, incontinence pads, dressings and oxygen. A YouTube viewer summed up the fear well: "Dr visits, hospital stays, ER, surgery etc. NOT included". Plan for these separately whether you choose a home or care at home, and see Elder Thai's guide to health insurance in Thailand over 60.

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5. What home care really costs

Your caregiver: price = hours a day × number of days

Elder Thai has no fixed package. You choose the hours per day and the number of days, and you can change them as your needs change.

You do not have to book every day. Some common patterns:

• 4 hours, 3 mornings a week (about 13 days a month): about 15,600 THB a month.
• 4 hours on weekdays (about 22 days a month): about 26,400 THB a month.
• 8 hours on weekdays, 4 hours at weekends (22 + 8 days): about 58,000 THB a month.
• 24 hours for the first two weeks after hospital, then 8 hours a day for the rest of the month: 14 × 3,500 + 16 × 2,200 = 84,200 THB.

For comparison, KIN HomeCare in Bangkok publishes a monthly rate of 30,000 THB for a 12-hour Thai-speaking nursing assistant and 40,000 THB for an English-speaking one, with one staff day off a week (KIN HomeCare prices, August 2026). Ask any provider what happens on that day off (see section 7).

Everything else you may need at home

Rent or buy? Rent the bed and oxygen if you expect to need them for a few months, as rental includes delivery and pick-up. Buy small items like a commode, shower chair, grab bars and a walker. They are cheap on Lazada and Shopee, and medical supply shops near big hospitals stock them too.

Food. At home you eat what you already eat. A caregiver can cook Thai or simple Western food or order through Grab and LINE MAN. Write any diet rules (soft food, low salt, diabetic) into your care plan. In a foreigner-oriented home, full board is a real line item: 40,000 THB a month at Ban Sabai.

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6. Nursing home vs home care, side by side

Where a nursing home can be the better choice: advanced dementia with wandering at night, when the cost of two-caregiver 24-hour cover at home is too high, or when you would be very isolated at home. A specialist home with a locked garden and a team can be safer. Be honest with yourself about this.

Want to try home care first? Start with a week →

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7. Backup caregivers, shifts and days off

The biggest worry with home care is simple: what happens if your caregiver cannot come? Plan this before day one.

Thai rules on rest

Under Thai labour rules for domestic workers (Ministerial Regulation No. 14, 2012), a worker employed directly in your home must have at least one day off a week, no more than six days apart, at least 13 public holidays a year, paid sick leave of up to 30 days a year, and 6 days' annual leave after a full year. If you employ someone yourself, you are the employer and these are your duties. Elder Thai's page on self-hiring a caregiver explains what that involves. If you book through an agency, the agency handles rest days and relief, but ask exactly how.

How to design the shifts

• 4 or 8 hours a day: one regular caregiver, with a named relief caregiver who has met you, read your care plan and knows your home. Book the relief for one fixed day a week so they stay familiar.
• 12 hours (day): one caregiver. Decide what happens at night: a neighbour on call, a bed alarm, a call button (see below) or an overnight carer.
• 24 hours: either one live-in caregiver who sleeps at your home and gets up when needed, with a relief caregiver on their day off, or two caregivers on 12-hour shifts if you need someone awake all night. Two 12-hour shifts cost 2 × 2,500 = 5,000 THB a day, against 3,500 THB for one 24-hour caregiver. Choose two shifts if you are up more than once or twice a night, have dementia with night-time wandering, or need turning every two to three hours.
• Give a 24-hour caregiver a proper break. A rested caregiver is a safer caregiver. Agree in writing when they sleep and take breaks, and who covers their weekly day off.

If your caregiver cannot come

Ask your provider these questions in writing, before you start:

1. "If my caregiver is sick, how quickly will a replacement arrive?"
2. "Has the replacement already met me or read my care plan?"
3. "Who do I call at 6 am if nobody has turned up?"
4. "Can I change caregiver if we do not get along, and is there a charge?"

Keep a one-page care plan on the fridge, in English and Thai: your medicines and times, allergies, how you move and transfer, what you eat, your doctor and hospital with phone numbers, and your address in Thai. Any relief caregiver, nurse or paramedic can pick it up and carry on.

Your own backup layer: a neighbour or friend with a key, the building's security desk, and a phone on you at all times. Look at a fall-detection watch or a simple call button. Elder Thai's after-fall care page explains what to do after a fall.

How Elder Thai handles this: a replacement caregiver is always ready, so you are never left without help when your caregiver is sick or off. Our caregivers also work in shifts. No one caregiver works all the time, because an exhausted carer is the biggest risk in home care, whether you hire one person privately or rely on a stretched team. Get a caregiver with backup built in →

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8. A day with your caregiver: sample schedules

Adapt these to your own routine. Your caregiver should keep a short daily log: medicines given, food and drink, toilet, mood, walking, and anything unusual. If family abroad want updates, a daily LINE or WhatsApp message with a photo works well.

4 hours (morning help)

8 hours (daytime)

Everything in the 4-hour plan, plus: lunch together, an afternoon rest, a trip out (market, temple, park, café, bank), a hospital or clinic visit with the caregiver as hospital companion and translator, a second exercise session, and dinner prepared before they leave.

12 hours (day, 8:00 to 20:00)

The 8-hour plan, plus: dinner together, evening medicines, evening wash and getting ready for bed, and a safe-night check before leaving: phone charged by the bed, night light on, clear path to the toilet, commode or urinal within reach if needed.

24 hours (live-in)

The 12-hour plan, plus: help to the toilet at night, turning every two to three hours if you are bedbound (to prevent pressure sores), night medicines, and calling for help if you are unwell. The caregiver sleeps near you and has an agreed rest break during the day.

Activities that help (not just tasks)

• Moving every day: short walks, chair exercises, physio homework. Staying mobile is the best protection against falls.
• Mind: cards, puzzles, reading aloud, music you like, video calls with family.
• Out and about: a weekly outing, even 30 minutes in a mall or park.
• Thai life: cooking a simple Thai dish together, a temple visit, a gentle massage, only after your doctor says it is safe (avoid strong traditional pressing and stretching if you have fragile bones or have had recent surgery).
• For memory problems: a fixed routine, old photos, music from your youth, and calm, short sentences. See memory care at home.

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9. Your doctor and nurse backup

A caregiver is not a nurse or a doctor. Build a medical layer around your caregiver.

1. Pick one hospital and register now, before you need it. Get a hospital number (HN), take your medical records and medicine list, and save its emergency and appointment numbers. Ask if it has a home care unit or home visit service: many private and university hospitals do.
2. Nurse visits for clinical tasks. Wound dressings, catheter changes, injections and tube feeds are nursing tasks. Book a visiting nurse (from about 1,200 to 2,390 THB a visit, see section 5) or Elder Thai's private nurse at home and nurse health monitoring.
3. A doctor who comes to you. In central Bangkok, clinics such as PrimeCare send a doctor to your home or hotel, usually within one to two hours. In Pattaya, Phuket and Chiang Mai, ask your hospital or a local clinic whether it does home visits.
4. Telemedicine for small problems. Apps such as MorDee connect you to a Thai doctor by video from 375 THB. Many hospitals run their own video clinics for existing patients. Your caregiver can hold the phone and show the doctor a rash or a swollen ankle.
5. Physiotherapy at home after a fall, stroke or operation: about 1,300 to 1,800 THB a session (OLDK, KIN HomeCare). Ask the physio to teach your caregiver the exercises so you can practise every day. After a stroke, see stroke recovery care.
6. Emergencies: 1669. Free, 24 hours. Have your address written in Thai next to the phone (see the box below).

When to call

Call 1669 now if you or your caregiver notice: - sudden weakness or numbness in the face, arm or leg, a drooping face or slurred speech (possible stroke); - chest pain, or sudden severe shortness of breath; - a fall with a head injury, or a fall after which you cannot get up or cannot put weight on a leg; - sudden confusion, or being very hard to wake; - vomiting blood or black stools.

Call your doctor or hospital today if: - you have a fever, a new cough or burning when you pass urine (in older people infection often shows up as new confusion); - you are eating or drinking much less than usual, or not passing much urine; - a red, broken or painful patch of skin appears on the hips, heels or bottom (an early pressure sore); - you have had a fall, even if you feel fine; - you have missed or doubled a medicine dose.

What to say to 1669 (Thai): ต้องการรถพยาบาล มีผู้สูงอายุไม่สบาย ที่อยู่คือ ... (tong-gaan rot pa-ya-baan, mee poo-soong-ah-yoo mai sa-bai, tee-yoo kue ...) "I need an ambulance, an elderly person is unwell, the address is ...". Write your full address in Thai below it.

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10. How to set up home care, step by step

1. Assess. Do the self-check in section 3 and ask your doctor what level of help is safe.
2. Choose the hours. Start lower if you are unsure. You can add hours in a day; it is harder to cut them back once you are used to them.
3. Prepare your home. Clear the path from bed to toilet, remove loose mats, add night lights, grab bars by the toilet and shower, a shower chair and a non-slip mat. Rent a hospital bed if you are mostly in bed. Keep daily items between waist and shoulder height.
4. Meet the caregiver first. A trial day is normal. Check they can talk with you comfortably and that they can safely do the thing you most need, whether that is a shower, a transfer or a walk.
5. Write the care plan (one page, English and Thai) and put it on the fridge.
6. Agree the backup in writing: relief caregiver, day off, what happens on sick days (section 7).
7. Set up the medical layer: registered hospital, a nurse for clinical tasks, telemedicine, 1669 (section 9).
8. Review after two weeks. Too many hours? Too few? Are you safe at night? Adjust.
9. Keep paperwork for insurance. Receipts, care plans and doctor's notes. Some insurance plans cover home nursing after a hospital stay. Ask yours.

If you are moving to Thailand for care: sort your visa and insurance first, then book the first two weeks of care to start the day you arrive, so you are never alone in a new place. Choose a condo with a lift, a walk-in shower and a hospital within 15 to 20 minutes. Elder Thai's guide to Bangkok neighbourhoods for retirees is a good place to start.

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11. Questions people ask

"What do you all pay?"

Here are real published examples, per month. A Thai-market home in Bangkok, shared room: 15,000 to 19,000 THB. A Thai home with medical care and rehab: 34,000 to 75,000 THB (Aryuwat). A foreigner-oriented home in Chiang Mai: about 130,000 THB with full board and 8 hours of care (Ban Sabai). Home care with Elder Thai: 36,000 THB for 4 hours a day, 66,000 THB for 8 hours, 105,000 THB for 24 hours, plus your own rent and food.

"I'm on my own in Thailand. Is home care safe?"

It can be, with the right hours, a backup plan and a medical layer. Many people living alone start with 4 hours each morning and a call button for the rest of the day. If you are not safe alone at night, you need either 24-hour care at home or a residential home. Do not try to manage that alone.

"What if my caregiver gets sick or burns out?"

This is the real weak point of hiring one person on your own: when they are ill, exhausted or on leave, you have nobody. With Elder Thai a replacement caregiver is always ready, and caregivers work in shifts so no one works all the time. See section 7.

"My family is abroad. How will they know I'm OK?"

Ask for a daily message from your caregiver and a weekly summary. Give one family member permission to speak with your caregiver and your doctor.

"Are care homes in Thailand checked by the government?"

Yes. They must be licensed by the Department of Health Service Support and meet the 2020 standards. Inspections have been patchy, and the government ordered all 1,203 registered homes inspected in October 2026 (The Nation). Ask any home for its licence.

"Can I use Thai public long-term care?"

Thailand's community long-term care scheme run by the National Health Security Office (NHSO manual) is built around the Thai universal coverage scheme, which generally covers Thai citizens. As a foreigner, plan on private care and private insurance.

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12. Get a caregiver

If you have read this far, you probably already know what you need: someone reliable, every day you need them, in your own home. That is what Elder Thai does.

Elder Thai sends a trained, English-speaking caregiver to your condo, house, hotel or serviced apartment in Bangkok, Pattaya, Phuket and Chiang Mai. Your caregiver works to a written care plan and speaks Thai with doctors, pharmacies and drivers for you.

What your caregiver does: - help with showering, dressing, the toilet and getting in and out of bed (personal care); - medicine reminders, meals, light housework and laundry; - walks, exercises from your physio, outings and company (companion care); - hospital and clinic visits as your companion and interpreter (hospital appointment companion); - nights and round-the-clock care (overnight care, live-in caregiver); - care for memory problems, Parkinson's, stroke recovery, bedbound care and end of life (memory care at home, Parkinson's, stroke recovery, bedridden care, palliative care); - short breaks for a family carer (dementia respite care).

Backup is built in. A replacement caregiver is always ready if yours is sick or off, and our caregivers work in shifts so nobody works all the time and burns out. You get a rested caregiver every day, not one person stretched past their limit.

What we do not do: replace your doctor or hospital, or perform medical procedures. Registered nurses handle clinical tasks such as injections, dressings and catheters when your plan needs them (private nurse at home).

How pricing works: you choose the hours per day and the number of days. There is no fixed package and no long contract.

Many people start with 4 hours a few mornings a week and add more only when they need it. See hourly care for short visits.

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