Household help for people over 80: non-profit home care delivers the same hours as in 2011, for 44% more people

The scissors: care grows, household help stands still

In 2011 non-profit home care billed 5,168,252 care hours and 2,313,752 hours of household help for people aged 80+. In 2024 it was 8,591,257 care hours (+66%) and 2,346,642 hours of household help (+1.4%). In no year in between was household help more than 5% below or 3% above its 2011 level. Over the same period the number of people aged 80+ living at home grew from 315,975 to 454,243. Per person aged 80+ at home, non-profit home care therefore provides 29% less household help than in 2011.

The cantons: from 18 hours to under 3

Per person aged 80+ not living in a nursing home, all home-care providers together billed an average of 8.4 hours of household help in 2024. The most in Basel-Country (18.2), Basel-City (15.0), Zurich (10.8) and St. Gallen (10.8), the least in Obwalden (2.8), Neuchâtel (3.0), Uri (3.8), Glarus (3.9) and Bern (4.0). In 19 cantons the figure is lower than in 2011. It roughly halved in Neuchâtel (−52%), Ticino (−50%) and Bern (−46%), and also fell sharply in Uri (−44%), Thurgau (−44%) and Geneva (−39%).

It rose in seven cantons, most in Basel-Country (+104%), Nidwalden (+99%) and Schwyz (+90%). In Basel-Country it was mainly private firms, whose hours for people aged 80+ rose from 32,474 to 245,160; for Nidwalden and Schwyz the FSO does not publish the split for both years. The statistics count hours in the canton where they are delivered: providers active in several cantons fill in one questionnaire per canton and split their hours themselves. The split is not exact, especially between neighbouring cantons. Both Basels together reach 17.1 hours per person aged 80+ at home in 2024 (+39% on 2011).

Where the canton pulled out, the hour got dearer

Bern. With its 2014 savings package (Angebots- und Strukturüberprüfung, adopted in November 2013), the canton of Bern cut its contributions to the household and social-support services of home care. The cantonal home-care association then advised its members to stop guaranteeing supply in this area. Average revenue of Bern's non-profit home care per hour of household help rose from CHF 34.21 (2011) to CHF 55.31 (2024). Its household-help hours for people aged 80+ fell from 248,660 to 102,145 (−59%). Private firms grew from 85,095 to 136,584 hours but did not make up the loss.

Basel-City. At the end of 2020 the canton's service mandate with Spitex Basel for household help expired and was not renewed. Since then the canton pays only through supplementary benefits. Spitex Basel charges CHF 57 an hour for household help and support, with a minimum of 90 minutes; before, clients paid at most CHF 45 themselves (written question in the cantonal parliament, answered by the Basel-City government on 27 August 2025). Non-profit household-help hours for people aged 80+ in the canton fell from 89,914 (2020) to 57,078 (2024), −37%. The government writes that it has "no indications of undersupply".

Nationally, average revenue of non-profit home care per hour of household help rose from CHF 30.83 to CHF 37.41 (+21%); private firms reached CHF 50.41 in 2024. An average price is not a tariff: many organisations charge by income.

What supplementary benefits pay today

People on supplementary benefits can already have household-help costs reimbursed, under rules each canton sets. For a private person who does not live in the same household, 19 of the 24 cantons with a fixed hourly rate pay at most CHF 25 an hour. Zurich pays the most, CHF 34, for people on old-age (AHV) supplementary benefits. Schaffhausen sets no fixed rate but refers to locally customary wages. Glarus has not reimbursed private household helpers at all since 2023, only providers with a cantonal service agreement. The annual cap is usually CHF 4,800, 192 hours at CHF 25, 4 hours a week over 48 weeks. An employed household helper at the minimum wage of the federal standard employment contract for domestic work (CHF 20.35 plus 8.33% holiday pay; binding from 5 hours a week) costs about CHF 23.91 an hour with employer contributions, at a usual wage of CHF 30 about CHF 35.25. Geneva has a higher minimum wage (CHF 24.59): with holiday pay and employer contributions an hour there costs at least CHF 29.19, while EL reimburses at most CHF 25.

From 2028: 4 hours a week as the benchmark

In June 2025 Parliament amended the Supplementary Benefits Act (business 24.070). From 1 January 2028 every canton must pay people on supplementary benefits who live at home flat amounts for emergency call systems, household help, meals and escort and transport services, together at least CHF 11,160 a year. Once the need is established, the flat amounts are paid in advance with the benefit, no longer against invoices. For household help the Federal Social Insurance Office names a benchmark of CHF 6,720: 4 hours at CHF 35 a week, CHF 560 a month. Only the total of CHF 11,160 is binding; the cantons may split it differently. St. Gallen is the first canton to put a draft out for consultation: it provides three levels for household help, CHF 2,100, 4,200 or 6,720 a year, depending on need.

Measured against today's home care, that is a lot; measured against today's supplementary benefits, it is not: 4 hours at CHF 35 over 48 weeks is 192 hours a year, the same number most cantons already reimburse for a private household helper (CHF 4,800 at CHF 25). What is new is the higher hourly rate, a minimum amount in every canton and payment as a flat amount. In 2024 all providers billed an average of 57 hours of household help a year per client aged 80+, 1.1 a week. The least in Obwalden (0.5), Appenzell Outer Rhodes (0.6) and Grisons (0.7), the most in Basel-Country (2.1). How many hours the flat amount actually buys depends on the price: at the Spitex Basel tariff it is 2.5 hours a week, at the average revenue of non-profit home care 3.7, with a directly employed helper at a CHF 30 wage 4.0 and at the minimum wage 5.9.

What the data do not say

Who fills the gap. We tested whether cantons with less home-care household help have more private households registering a household employee with the AHV. They do not: there is no relationship between household help per very old person and registered households per 1,000 households (correlation −0.06). Whether the gap is filled by relatives, cleaning companies, undeclared work or not at all cannot be said from public data.

What the statistics count. The home-care statistics cover non-profit and public organisations and, since 2010, private firms and self-employed nurses, based on cantonal lists. Cleaning companies without a home-care licence and households that employ directly are missing. The number of private firms offering household help rose from 134 (2013) to 306 (2024). Whether some of them were active earlier and were only added later cannot be checked. The non-profit series is stable.

Cases, not people. The FSO counts clients per service and provider. Someone receiving household help from two providers counts twice. Hours per client are therefore rather too low and the share of very old people with household help rather too high. In Neuchâtel the number of cases fluctuates strongly (2019: 1,488, 2023: 309); the hours are more stable and show the same decline. In home care, "household help" also includes social support.