Understand care options for your parent.

Choosing the right kind of care.

How do I know when home is no longer enough — and it's time for assisted living or an EMS?

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There is no single threshold. Look at three things together: safety (repeated falls, dangerous forgetfulness like leaving the gas on), autonomy (washing, dressing, eating), and medical load (the level of nursing care actually needed). When the current setup no longer covers the real risk, you move up one step — ideally before a crisis forces it.

What is the difference between assisted living (résidence / IEPA) and an EMS?

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An IEPA is housing: an independent flat with a 24h alarm and social support, where any care still comes from Spitex/IMAD exactly as it would at home. An EMS is a medicalised, full-service residence for heavy care needs, dementia or end of life. Many families jump straight from home to EMS and skip the intermediate option that would have fit better.

Does a 24h live-in carer really cost CHF 4,000–7,500 a month?

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That range is realistic only if the arrangement is legal. In Geneva a live-in carer is a domestic employee with a binding minimum wage, and "24h" cannot mean one person around the clock — labour law requires rest and replacements, so it usually takes two people or an agency. Budget for the employer obligations (social charges, insurance, work permit), not just the headline hourly rate.

Is Spitex covered by insurance, and how is it different from a private carer?

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Prescribed nursing care (Spitex/IMAD) is financed through LAMal — a fixed federal contribution per hour, a capped daily co-payment, and the canton covering the rest. Practical help (cleaning, errands) is not covered by LAMal and is billed on an income-based tariff. Private carers fill what public Spitex doesn't — night presence, full 24h support — and are largely out of pocket except the prescribed-care portion.

What does a day-care centre do, and who is it for?

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A day-care centre takes your parent for the day — excellent for social life, and officially a respite measure for the family carer. It suits cognitive decline or an isolated parent, and lets a parent stay home longer. Expect waiting lists in Geneva.

My parent refuses all help. Can we make them accept care or move?

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If your parent still has capacity to decide, no — Swiss law lets a lucid person make choices the family disagrees with, and you cannot impose Spitex, a doctor or an EMS. The levers are the family doctor, a neutral third party like Pro Senectute, and introducing help in small steps. Only when capacity is impaired and there is real danger can a situation be reported to the TPAE.

How much do the different options cost per month, roughly?

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As 2024–2025 Geneva ranges: Spitex CHF 50–80/hr (largely covered); private 24h carer CHF 4,000–7,500; day-care CHF 90–180/day; assisted living CHF 4,000–9,000; EMS CHF 7,000–12,000+ gross, of which the family typically nets CHF 5,500–9,500 after insurance and canton. The real number depends on which benefits you activate — that's what we work out in the review.

Can we change our mind later if we pick the wrong option?

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Yes — care is a sequence of steps, not a one-way door. Many families move from home with Spitex, to assisted living, to an EMS as needs change. The key is to keep the next step ready (for example opening the EMS application early) so you never have to decide in an emergency.