But Verity, all those extras add up. And sometimes there isn't a "family " to pay for them, there's just a spouse, like me, struggling on the very little left to live on! All the extras are not taken into account when assessing the costs of the nursing home. I pay extra for William's chiropody, about every eight to ten weeks, but I cut his hair myself. I always did, throughout our marriage. I consider myself very fortunate that the nursing home he's in have things like physio included, as well as a wide range of activities. Other nursing homes charge extra for activities, physio, chiropodist, hairdressers, etc.