Can my home carer also drive me to appointments?

Yes if it's in their contract and they have a valid Spanish licence. Most agencies require the family to provide the car and cover fuel/parking. Some carers refuse to drive — agree this before hiring.

Can a non-Spanish carer work legally?

EU citizens yes; non-EU need a work permit (autorización de trabajo). Many Costa Blanca home carers are Latin American (Colombian, Venezuelan, Ecuadorian) with valid residency — agencies handle the legal check.

Will my private health insurance cover home care?

Sanitas Mayores, Adeslas Plus Plenitud and DKV Senior have add-on policies that cover 60-200 hours of home care per year. Standard policies do not.

Are home-care fees tax-deductible?

Yes if you have a recognised dependency grade — under the IRPF medical-expense rules. The carer must be invoiced (factura) or paid via the formal empleados de hogar regime.

What's the alternative when home care isn't enough?

When a resident needs lifting, has nighttime falls or wanders due to dementia, home care usually transitions to a residencia mixta. Plan the move before a crisis hospital admission forces it.

Assisted living

Home Care in Spain — Atención a Domicilio for Retirees

Home care (Servicio de Ayuda a Domicilio, SAD) lets you stay in your own home with help that scales from a few hours of cleaning to 24-hour live-in care. It's the option most Costa Blanca retirees use — and the cheapest if you only need a few hours of support per day.

Last updated 1 March 2026

What home carers actually do

Spanish home carers (auxiliares de ayuda a domicilio) cover personal care (washing, dressing, toileting, medication reminders), light housework, meal preparation, accompanied shopping and appointments, and companionship. Trained ones can do mobility transfers and basic wound care. They do NOT inject insulin, change catheters, manage IVs or do anything classified as 'health act' (acto sanitario) — those require a DUE (qualified nurse).

Live-in carers (internas) are the workhorse of Spanish elder care: they live in the home, get 2 hours off per day plus 36 hours off per week, and cost €1,200-€1,800/month plus board. Demand vastly exceeds supply on the Costa Blanca — book through a reputable agency, not a noticeboard ad.

2026 typical hourly and monthly rates

Service	Hourly	Monthly equivalent
Private agency carer (Alicante area)	€16–€22/hr	€800-€2,800 (1-4h/day)
Self-employed (autónoma) carer	€13–€17/hr	€650-€2,100 (1-4h/day)
SAD subsidised (means-tested, public)	€2-€10/hr co-pay	€80-€400
Live-in carer (interna)	—	€1,200-€1,800 + room & board
Live-in nurse (DUE 24h)	—	€3,500-€5,500
Night-only carer (cuidador de noche)	€18-€26/hr	€2,200-€3,200 (10h nights)

The public SAD service — who qualifies and how

Every town hall (ayuntamiento) runs a Servicio de Ayuda a Domicilio. To apply you need: padrón at that address, recognised dependency grade (or social-services report for non-dependent seniors), and a means-tested co-pay declaration. Hours range from 3-20/week. Waiting lists in Alicante: 3-9 months. Quality varies wildly by municipality — Alfaz del Pi, Dénia and Jávea have excellent SAD; Benidorm and Torrevieja are slower.

If you have a Grade II/III dependency, you can also choose the Prestación Económica de Cuidados en el Entorno Familiar — a direct payment (€200-€450/month) that lets a relative care for you and contribute to their own social security as a cuidador no profesional.

Reputable agencies on the Costa Blanca

✦Cuideo / Sanitas Mayores — large national platform, vetted carers, English-speaking coordinators.
✦SeniorAssist (Albir/Alfaz) — Nordic-owned, Norwegian/Swedish/English staff.
✦Eulen Servicios Sociosanitarios — large public-private operator, used by many town halls.
✦Aiudo — Madrid-based but covers Costa Blanca, app-based booking and scheduling.
✦Cruz Roja Alicante — Red Cross teleassistance and home visits, very affordable.
✦Independent gestoras (e.g. Pilar Garrigós, Marina Alta) — boutique service for high-needs cases.

Equipment and adaptations

✦Hospital bed rental: €80-€150/month (Eulen, Ortopedia Plantío, farmacias).
✦Stair lift install: €3,500-€7,000 (Stannah, Otis Gen2).
✦Walk-in shower conversion: €3,000-€6,500.
✦Mobile telecare pendant (teleasistencia): €18-€35/month, free if you have dependency grade.
✦Mobility scooter: €1,200-€3,500 (Apex, Invacare).
✦Many adaptations are 30-50% subsidised via the IVI ayudas a la accesibilidad — apply through your social worker.

Important legal stuff when hiring directly

Empleada de hogar contract is mandatory

If you hire a carer directly (not through an agency), you become their employer under the Sistema Especial de Empleados de Hogar. You must register with Social Security, withhold IRPF if salary exceeds the threshold, pay holiday and severance, and provide a written contract. Failure exposes you to a €6,000-€10,000 fine plus back payments. Use a gestor — it costs €40-€70/month and removes the risk.

Assisted living

When home care can't keep up.

Aging in place

Design your home for the long haul.

Long-term care planning

Budget for 5-15 years of care.

Healthcare: prescriptions

Medication management at home.

Healthcare insurance

Policies with home-care add-ons.

Cost of living: housing

Cost of staying in your own home.