Finding and hiring
Attendant vs nurse vs physiotherapist: who do you need?
A plain-language comparison of home attendants, skilled nurses and physiotherapists in India — what each does, what each costs and when you need both.
Most families arrive at this question sideways. They are told a parent “needs help at home” and are then offered a package: an attendant for ₹28,000 a month, or a nurse for ₹65,000, or a live-in arrangement for ₹45,000. Nobody has written down the tasks first.
Write the tasks first. The job title follows from the list, not the other way round.
The three roles in one table
| Companion / attendant | Skilled nurse | Physiotherapist | |
|---|---|---|---|
| What they do | Bathing, toilet, dressing, mobility, meals, medicines reminders, company | Injections, drips, wound care, catheter, oxygen, tube feeding, monitoring | Assessment, exercise plan, movement and balance training |
| Qualification | Trained attendant; no compulsory licence in India | GNM, BSc nursing or equivalent, with State Council registration | Physiotherapy degree with council registration |
| How you pay | Per month, by shift | Per month (shift) or per visit | Per visit |
| Indicative cost band | ₹15,000–₹40,000 a month for a day shift | ₹40,000–₹1,40,000 a month, or ₹500–₹1,500 a visit | ₹400–₹1,200 a visit |
| Typical engagement | Daily, for months or years | Days to weeks, until the clinical phase ends | 2–3 visits a week, tapering |
All figures are indicative placeholder bands pending a local survey — see the cost guide.
How to work out which one you need
Take a sheet of paper and write every task that has to happen each day. Then sort each task into one of three columns:
- Personal care — getting up, bathing, dressing, toilet, eating, moving around the house, cooking, company, reminding about medicines already prescribed.
- Clinical — injections, IV drips, wound or pressure-sore dressing, catheter or stoma care, oxygen, tube feeding, blood-sugar checks, reporting changes to a doctor.
- Rehabilitation — standing practice, walking, stairs, balance, exercises after a stroke, fracture or surgery.
Column one is an attendant. Column two is a nurse. Column three is a physiotherapist. If you have entries in two columns, you need two people — or one nurse plus one attendant, which is the common and correct answer for post-surgery and stroke recovery.
Why “nurse for everything” is usually wrong
A full-time skilled nurse costs two to three times what a trained attendant costs, and most of the work they would be doing is personal care they are overqualified for. Nursing hours are best spent on the clinical tasks: the dressing change, the catheter care, the observation. The daily rhythm of bathing, meals and company is attendant work.
The reverse error is more dangerous: asking an attendant to do clinical work because they are willing and available. It raises the risk of infection and injury, and it exposes the family. Keep the two lists separate and post them where the caregiver can see them.
When you genuinely need two people
- Post-surgery in the first fortnight, with a wound needing dressings and a person who cannot manage the bathroom alone.
- Stroke recovery, where movement needs a physiotherapist’s plan and daily life needs an attendant.
- Bedridden care with an open pressure sore — daily personal care plus nursing visits.
- Any situation with confusion or wandering where the family also works during the day.
In each of these, the cheapest version that is still safe is: an attendant for the daily hours, a nurse on a visit schedule, and a physiotherapist two or three times a week until progress flattens.
A note on what each must not do
- An attendant must not give injections, adjust medicines, dress wounds or make medical judgements.
- A nurse must not diagnose, change the treatment plan or act as a substitute for the treating doctor.
- A physiotherapist must not push through sharp pain or continue a plan that is not working without reassessment.
Saying this out loud at the start prevents the slow drift that puts everyone at risk.
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FAQ
Common questions
Can one person do all three jobs?
Only if they hold the qualifications for the clinical part. A trained attendant can support exercises a physiotherapist has taught and remind about medicines, but cannot give injections or change a treatment plan. Mixing the roles without the qualification is the most common safety failure in home care.
What if my budget only stretches to an attendant but my parent needs nursing?
Use the nurse-visit model: a trained attendant for daily living every day, plus a nurse for the clinical tasks two to four times a week or on the days they are needed. It costs far less than a full-time nurse and keeps the clinical work with a qualified person.
How do I decide between a day shift and a live-in arrangement?
Decide by when the risk is, not by price. If the senior is safe alone at night and the problem is mornings and evenings, buy those hours. If they cannot be alone at night — wandering, needing the toilet, recent falls — you need night cover or live-in.
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