Foreign Caregiver or Institutional Care? Qualifications, Process, and How to Choose at a Glance
When an elderly person requires long-term care, there are two common paths: hiring a foreign live-in caregiver at home, or moving into an elderly welfare institution. The former requires the care recipient to undergo a professional assessment such as the Barthel Index, meet eligibility criteria, and complete the employment process with the Ministry of Labor. The latter involves choosing a licensed institution for nursing, long-term care, residential care, or dementia care. The two options differ in care staffing, cost structure, living environment, and suitability for levels of disability. The following summarizes the eligibility and process for hiring a foreign caregiver, as well as a comparison of the two choices, for neutral reference by family members and does not constitute medical or legal advice.
Foreign Caregiver vs. Institutional Care: How to Choose
The two paths differ in care model, cost, and suitable candidates. Decisions can be based on the elderly person's level of disability and the family's daytime care capacity:
- Foreign live-in caregiver: one-on-one care at home, requires the care recipient to meet eligibility and complete employment procedures; costs include monthly salary plus room and board and related fees
- Institutional care: group care, must choose a licensed nursing/long-term care/residential/dementia care institution; monthly fees vary by institution type
- Key considerations: level of disability, need for professional medical care, family's ability to provide daytime care, budget, and home space
Eligibility and Exemptions from Barthel Index (Latest 2025)
To hire a foreign live-in caregiver, the care recipient generally must be assessed as eligible. In recent years, exemptions from the Barthel Index have been expanded:
- Original rule: those assessed by the Barthel Index (ADL) and meeting a certain level of disability are eligible
- Since October 2023: those who have used long-term care home/day care or family foster care for at least 6 months, have specific severe illnesses, or are 80+ with mild disability or above, are exempt from the Barthel Index
- Since August 2025: those aged 80+ are all exempt; those aged 70–79 with cancer stage II or above are exempt; those rehiring and aged 75+ are exempt
Process and Timeline for Hiring a Foreign Caregiver
From assessment to the caregiver's arrival typically takes weeks to months. It is advisable to plan early and pay attention to deadlines at each stage:
- Process: medical assessment/meet eligibility → apply for recruitment permit → foreign recruitment or transfer from local employer → obtain employment permit
- First-time hiring: start several months before the need; renewal: apply within a certain period before the current employment expires
- Can be done through a licensed agency or directly via the Direct Hiring Service Center
FAQ
What is the difference between hiring a foreign caregiver and moving into an institution? How to choose?
A foreign live-in caregiver provides one-on-one care at home, requiring the care recipient to pass an eligibility assessment, with the family acting as the employer handling hiring and management. Moving into an institution means entering a licensed elderly welfare facility for team-based, 24-hour institutional care with nursing and care staff. Generally, the main considerations are the level of disability, home care space and manpower, budget, and the elderly person's wishes. It is recommended to decide after an assessment by the Long-Term Care Management Center and on-site visits.
What are the qualifications for applying for a foreign live-in caregiver?
The care recipient must undergo a professional assessment at a medical institution designated by the Ministry of Labor. Based on age and disability level: under 80 years old, requires full-time care (Barthel Index score below 35); 80 to under 85 years old, requires severe dependence or full-time care (Barthel Index score 60 or below); 85 years and older, requires mild dependence (Barthel Index with only one disability). (Source: Ministry of Health and Welfare)
Is the Barthel Index assessment mandatory? Are there exemption methods?
Not necessarily. Since October 2023, multiple exemptions have been expanded: for example, those who are long-term care service recipients of the Ministry of Health and Welfare and have continuously used home/day care or family foster care for at least 6 months; those with a physician's diagnosis of a specified severe illness or condition; those who have employed a foreign caregiver within the past year; or those aged 80 and above with only an identity document, can be exempt from the Barthel Index assessment at a medical institution. Currently, over half of applications are exempt from the Barthel Index. (Source: Workforce Development Agency, Ministry of Labor; Ministry of Health and Welfare)
What is the process and timeline for hiring a foreign caregiver?
First-time employers must obtain employment eligibility within 6 months before the planned recruitment of a foreign worker. For renewals, the process should be initiated 4 to 5 months before the current employment period expires. The medical assessment is valid for 1 year from the assessment date. For those exempt from medical assessment, a recruitment permit application must be submitted within 60 days after the local Long-Term Care Management Center completes the referral. Actual procedures and documents are subject to the announcements of the Ministry of Labor. (Source: Workforce Development Agency, Ministry of Labor)
If I decide to move into an institution, how do I find a suitable one?
Choose the appropriate type of elderly welfare institution (nursing, long-term care, residential, or dementia care) based on the elderly person's disability and care needs. Confirm whether the institution is licensed, its evaluation rating, and the actual residents it accepts. You can browse the list on this site by city or institution type. It is recommended to visit in person, understand the staffing and fee contract before deciding.
Can foreign caregivers and institutions be used sequentially or in combination?
The two are not mutually exclusive. Some families first use home care or a foreign caregiver at home, then transfer to an institution when disability worsens or care becomes overwhelming. Others use short-term institutional or respite services while waiting for a caregiver or assessment. The actual transition method should be discussed with the Long-Term Care Management Center and medical team, and arranged according to the elderly person's condition.
· This page is a neutral compilation of information for reference only, not medical, legal, tax, or admission advice. For actual regulations and services, please refer to official announcements from competent authorities and the institutions themselves.