HSE Home Support Service: who qualifies and how to apply (2026)

The HSE Home Support Service gives free help at home with personal care, such as getting up, washing and dressing, to people aged 65 or over, and to some younger people with dementia or a disability. There is no means test and you do not need a medical card. You apply on a form to your local home support office, a nurse or therapist assesses your needs, and the HSE decides how many hours you get. Hours are often in short supply, so families commonly pay privately for extra care, which can qualify for tax relief.

In short

• Who it is for: people aged 65 or over who need help to stay at home or to come home from hospital. Some people under 65 also qualify, for example with early onset dementia.
• Cost: free. No medical card is needed and your income is not checked. Extra hours beyond what the HSE approves are paid for privately.
• How to apply: a 24-page HSE form, posted to your local home support office or given to the hospital discharge team. You can ask for Consumer Directed Home Support, which lets you pick the provider.
• If you are refused: write to the home support office within 20 days of the decision letter to ask for a review.
• No legal entitlement yet: the Health (Amendment) (Home Support Providers) Act 2026 (No. 17 of 2026) regulates providers, but was not in force by October 2026 and gives no right to hours.
• Paying privately: Revenue relief on employing a carer is worth up to €75,000 a year per incapacitated person, at your highest tax rate.

What HSE home support covers

Home support (still often called “home help” or a “home care package”) is mainly personal care. The HSE lists help with getting in and out of bed, dressing and undressing, and showering or shaving. The care is delivered either by HSE staff or by an HSE-approved private or voluntary provider working on the HSE’s behalf.

It is not a cleaning or companionship service, and it is not nursing. Nursing care at home, such as wound dressings, comes from the public health nurse. If what your parent needs is mostly company, shopping or housework, the HSE is unlikely to fund it, and a private agency or local voluntary services may be the answer.

Consumer Directed Home Support (CDHS)

When you apply, you can ask for Consumer Directed Home Support. If approved, you get a letter confirming a weekly amount of funding instead of a set number of hours. You choose one or more HSE-approved providers and agree the days and times with them. The number of hours the money buys depends on each provider’s rates and the times you choose. Providers cannot charge more than the rates agreed with the HSE or add extra fees.

Who qualifies

The service is aimed at people aged 65 or over who need help to keep living at home or to return home after a hospital stay. You can apply while at home, while in hospital, or while in a nursing home if the plan is to go back home. People under 65 can qualify in some cases, and the HSE gives early onset dementia and disability as examples. (For the different forms of dementia, see our general guide to types of dementia.)

There is no income test, no savings test and no need for a medical card. Eligibility turns on need, judged in a needs assessment. The HSE also looks at what family and community support is already in place, which is why a parent living with a capable adult child may get fewer hours than one living alone.

How to apply, step by step

1. Get the form. Download the home support application form from the HSE or ask your local home support office for one. In hospital, ask whoever is managing the discharge plan.
2. Decide who fills it in. Your parent can complete it, or a spouse, partner or adult child, a nominated carer, the GP, a registered nurse or another health professional can help. The declaration and consent in part 12 must be signed by your parent, or by someone legally able to act for them, such as the attorney under a registered enduring power of attorney or a court-appointed decision-making representative.
3. Post it to the local home support office. Keep a copy and note the date.
4. Needs assessment. A public health nurse, physiotherapist or occupational therapist visits. They look at everyday activities like bathing, dressing, shopping and moving around, the services already in place, the family support available, and your parent’s own wishes.
5. Decision letter. The HSE writes with the outcome. If approved, it also confirms any CDHS funding. You will usually be asked to choose from a list of approved providers, and it helps to name more than one.

If the answer is no, or too few hours

The HSE says you can write to the local home support office within 20 days of the decision letter, explaining why you disagree, and the decision will be reviewed. Be specific. Describe falls, nights up, missed medication and what the main carer can no longer do. A letter from the GP helps. If needs change later, for example after a fall or a hospital stay, ask for a reassessment rather than waiting for a review date.

Waiting lists: what to expect

Approval and delivery are not the same thing. In many areas people are approved but wait for a carer to become available. In a parliamentary question reply dated 24 July 2026, the HSE said that at 31 May 2026 (preliminary figures) 5,286 people had been assessed and were waiting for a carer: 2,041 new clients and 3,245 existing clients waiting for extra hours. No one was waiting for funding to be allocated. Waits vary by area, so ask your local home support office how long people near you are waiting.

To keep things moving:

• Apply before the crisis. A form sent while your parent is still managing is far better than one sent from a hospital ward.
• Ask for CDHS and list several approved providers, so the HSE has more options to fill the hours.
• Tell the office about any change, such as a hospital admission or respite stay.
• Bridge the gap privately if you can. Many families pay an agency for a few weeks until HSE hours start.

Is home support a legal right? The 2026 position

No. For years the Government has promised a statutory home support scheme, giving people a legal right to care at home in the same way Fair Deal gives a right to nursing home funding. That has not happened. Home support remains a service the HSE provides within its budget, which is why hours vary by area.

What has changed is regulation. The Health (Amendment) (Home Support Providers) Act 2026 was signed into law on 1 July 2026. It amends the Health Act 2007 so that home support providers will have to register with HIQA’s Chief Inspector and be inspected, as nursing homes are now. The Irish Statute Book lists the whole Act as “not yet commenced” (updated to 21 October 2026), so it needs a ministerial commencement order before it applies. Until then, the HSE’s own approval rules for providers are based on HIQA standards. The Act does not create an entitlement to a set number of hours.

Paying for private home care, and the tax relief

Private home care agencies set their own prices, and families often buy extra visits on top of HSE hours, or full care while waiting. Ask each agency for its hourly rate, minimum visit length and weekend rates.

Relief for employing a carer

Revenue gives tax relief on the cost of employing a carer for yourself, your spouse or civil partner, or a relative who is totally incapacitated by physical or mental infirmity. Key points:

• It covers carers you employ directly and the cost of care agencies, including commercial home care providers.
• The maximum is €75,000 a year for each incapacitated person, given at your marginal (highest) rate of tax. You need to have paid tax to benefit.
• If two or more relatives share the cost, they can split the relief, but the total cannot go over the cap.
• You cannot claim for any part funded by the HSE or a local authority, or for someone employed as a housekeeper only.
• If you claim it, you cannot also claim the Incapacitated Child Tax Credit or Dependent Relative Tax Credit in respect of the carer you employ.

Example. Siobhán pays an agency €12,000 a year for care for her mother, who has advanced dementia and is totally incapacitated. Siobhán pays tax at 40%. The relief could reduce her tax bill by up to €4,800 (€12,000 x 40%). Claim through myAccount, or ROS if self-employed.

Home nursing

If a doctor certifies that constant care by a qualified nurse is needed at home, payments to that nurse can be claimed as health expenses. General health expenses get relief at 20%. Nursing home fees, by contrast, get relief at your highest rate, up to 40%.

Help for the family carer

If a relative provides at least 35 hours of care a week, they may qualify for Carer’s Allowance (€270 a week in 2026 for a carer under 66) and the annual €2,000 Carer’s Support Grant. See our guide to Carer’s Allowance and the Carer’s Support Grant for the means test and how to apply.

When a nursing home is the next step

Home support works best when the gaps between visits are safe. Signs it may no longer be enough include:

• Your parent needs help at night, or two people to move them, and the hours cannot cover it.
• Repeated falls, hospital admissions or missed medication despite the care in place.
• Dementia has reached the stage where your parent is at risk alone, for example wandering or leaving the cooker on.
• The main family carer is exhausted or unwell.

Long-term nursing home care is funded through Fair Deal. You pay 80% of assessable income plus 7.5% a year of assets above €36,000, and the HSE pays the rest. See Fair Deal explained for the rules and nursing home costs in Ireland for prices. If the family home is the main asset, the nursing home loan lets that part be paid after death. Funding only starts from the approval date, so apply as soon as a move looks likely. Then use our checklist for choosing a nursing home and read the home’s HIQA inspection reports.

If Carer’s Allowance is being paid, it continues for 12 weeks after your parent moves into a nursing home full time.

Mistakes to avoid

• Waiting for a crisis to apply. Home support and Fair Deal both take time. Apply early.
• Understating needs at the assessment. Describe your parent’s worst days, not their best.
• Missing the 20-day review window after a refusal or a low offer.
• Not keeping receipts for private care. Revenue relief needs them, and you can claim back up to four years.

Frequently asked questions

Is HSE home support means tested?

No. The HSE Home Support Service is free. You do not need a medical card and the HSE does not check your income. What you get depends on a needs assessment and on staff being available locally. If you want more hours than the HSE approves, you pay for the extra hours yourself, usually to a private agency.

How many hours of home support can you get from the HSE?

There is no fixed number. The hours are set after a needs assessment by a public health nurse, physiotherapist or occupational therapist, and they take account of help already available from family and the community. Many people get short visits for getting up, washing and going to bed. Hours can go up or down when your needs are reviewed.

Is there a waiting list for home support in Ireland?

Often, yes. The HSE told the Dáil that at 31 May 2026 (preliminary figures), 5,286 people had been assessed and were waiting for a carer to be assigned, including 2,041 new clients. Nobody was waiting for funding, so waits come from a shortage of carers in the area, not from lack of approval. Apply early, ask to be told when you are approved, and ask the office how long people in your area are waiting.

Is there a legal right to home care in Ireland?

Not yet. Home support is provided by the HSE but there is no statutory entitlement to it. The Health (Amendment) (Home Support Providers) Act 2026 was signed on 1 July 2026 so that HIQA can register and inspect providers, but it had not been commenced by October 2026. It does not give anyone a right to a set number of hours.

Can I get tax relief on private home care in Ireland?

Yes, if the person cared for is totally incapacitated. Revenue allows relief on the cost of employing a carer, directly or through an agency, up to €75,000 a year for each incapacitated person, at your highest rate of tax. You cannot claim for any part funded by the HSE or a local authority, or for a housekeeper only.

Can you apply for home support from hospital?

Yes. Ask the person managing the discharge plan for the home support application form as early as possible in the hospital stay. If you are approved while in hospital, support can start when you go home, and your needs are assessed again shortly afterwards. The HSE advises asking early to help avoid delays in going home.

Sources

• HSE: Home Support Service for older people
• HSE: How to apply for the Home Support Service
• HSE: After you apply for the Home Support Service
• HSE: Choosing an approved home support provider
• Irish Statute Book: Health (Amendment) (Home Support Providers) Act 2026, commencement status
• HSE: Reply to PQ 54735/26, people waiting for home support (24 July 2026)
• Revenue: Employing a carer, amount of relief
• Revenue: Employing a carer, restrictions
• Revenue: Health expenses
• Citizens Information: Carer’s Allowance
• HSE: Fair Deal financial assessment

General information, not legal, tax or financial advice. Figures for 2026, checked October 2026.

Reviewed by The Care Panel team on 29 October 2026. This guide is general information about care in England, not legal, medical or financial advice. Rules and rates change; check with your council or an adviser before making decisions.