Differences: Home Care vs. Nursing Home

More than 440,000 Swiss people used the services of a Spitex in 2021. This compares to around 153,000 people who lived in a Swiss retirement home. But how does this big difference come about? What exactly are the differences between Spitex and residential care?

The place of residence

The most important difference between these two points is obvious: the place of residence. Those who opt for the support of Spitex staff live in their own four walls. In this way, clients retain their independence for as long and as far as possible. They determine their own daily routine and can stick to established routines.

Spitex specialists visit their clients at home at previously agreed regular intervals. There they take care of a wide variety of things, including:

• taking medication correctly and on time
• wound care
• Measuring blood pressure
• taking blood samples

The exact measures to be taken are discussed in advance with the clients and the doctors treating them. The care plan drawn up in this way ensures that it is safe for the client to remain in their own home without any health risks arising.

Through their actions, Spitex employees promote the maintenance or improvement of their clients' abilities. It is by no means a question of relieving them of as many tasks as possible. Rather, they should be seen as supporters who, where possible, help their clients to help themselves.

However, at a certain point, clients may no longer be able to stay at home. This is the case, for example, if they need round-the-clock care. If 24-hour medical monitoring and care is required, the Spitex specialists reach their limits. Moving to a care home is then the right choice.

There, clients receive comprehensive care day and night. In return, however, they have to say goodbye to their familiar surroundings and all the memories of their home.

This is often not easy for senior citizens. This is why they often want to delay the move to a care home for as long as possible. Even if furniture cannot be taken with them, or only to a limited extent, there is always room for personal items and mementos.

Another major difference is self-catering. The rooms in care homes do not have kitchens, but at most refrigerators. Independent preparation of meals is therefore not possible there. Meals are eaten together with other residents at fixed times. Care homes establish routines that are intended to provide stability for the clients.

The same applies to socializing during meals and other activities. In this way, staff prevent residents from becoming isolated and lonely. Loneliness in old age is a widespread problem - even in Switzerland. One in three senior citizens in this country often feels lonely.

This can have a negative impact on mental health, which in turn can affect physical well-being. Thanks to joint activities in the care home, staff can counteract this. However, if care is only provided by Spitex, there is no such regular interaction.

If we delve a little deeper into the matter, we come across somewhat more hidden differences between Spitex and residential care. This includes determining the need for care.

Nursing home staff use certain tools to determine care needs. These provide for a differentiation into twelve care levels based on the physical and mental state of health. Clients in care level 1 are entitled to up to 20 minutes of care and support per day. Care level 12, for its part, is associated with at least 220 minutes a day.

The need for care is initially determined at the beginning of the stay and again after six months. Further reviews are carried out annually, at the express request of the patient or in the event of serious changes in their condition.

In Spitex, the assessment of needs is more performance and client-oriented. The focus here is not on care levels, but rather on the services themselves. This enables more transparent billing of services.

A care professional determines the needs together with the client in consultation with the attending physicians. Together they determine which services are to be provided and to what extent. Public and private Spitex organizations proceed in the same way.

The costs of a stay in a care home can be divided into three areas:

1. Pension costs
2. Support costs
3. Care costs

The first two items are paid for by the clients themselves. The care costs, on the other hand, are divided by three. Compulsory health insurance, the municipality or canton and the care home resident each pay a share. However, the latter pay a maximum of CHF 21.60 per day.

How high the actual costs are depends on the care level. As a rule, CHF 9 is charged per level and day. For care level 12, this results in a maximum daily amount of CHF 108. If it is higher, the public purse will pay for it.

Spitex also divides the costs incurred into three categories, albeit different ones:

1. Basic care
2. Treatment care and examinations
3. Clarification, advice and coordination

In accordance with Art. 7a KLV, compulsory health insurance covers the costs as follows:

• CHF 54.60 per day for basic care
• CHF 65.40 per day for treatment care and examinations
• CHF 79.80 per day for clarification, advice and coordination

The clients themselves pay a patient contribution in addition to their deductible and retention fee. The amount varies from canton to canton, but may not exceed CHF 15.95 per day. Other costs are covered by the canton or the municipality. Services that are not prescribed by a doctor are paid for in full by the clients themselves.

Spitex is always the right choice when support is all that is needed. This is the case, for example, when certain everyday tasks can no longer be carried out independently. Spitex is also the right contact if medical support is required from time to time.

If, on the other hand, comprehensive care is required almost around the clock? Then a move to a care home should be considered.

Not quite there yet? Then we at OPAN® will be happy to support you in your search for a suitable Spitex organization. All you need is your zip code or the zip code of the relative you are looking for. Any Spitex organizations that come into question will then appear and you have the choice.

We will be happy to explain to you in detail how our platform for online patient registration for Spitex services works. Just get in touch with us!