Short answer
The adult dependent relative route lets a parent, grandparent, adult child or sibling join a relative in the UK when they need long-term personal care for everyday tasks and that care is either unavailable or unaffordable where they live, even with the sponsor’s financial help. As of 31 October 2026 the fee from outside the UK is £3,635, there is no English requirement, and where the sponsor is a British citizen or settled the applicant is granted settlement. The sponsor signs an undertaking covering five years, and public funds used in that period may be recovered from them.
What is the adult dependent relative visa?
It is the Immigration Rules route, set out in Appendix Adult Dependent Relative, for an adult relative abroad who cannot look after themselves and whose care has to be provided by a family member in the UK. In Pakistani families it is almost always about a parent or a grandparent.
Two things make it unusual. The first is what it gives you: in most cases, settlement on arrival rather than a limited visa that needs extending. The second is how hard the test is. The rule is not whether the family would prefer to look after their relative in the UK. It is whether the required care can be obtained in Pakistan at all.
The shape of the test in one sentence
The introduction to Appendix ADR puts it like this: the applicant must require long-term personal care to perform everyday tasks due to age, illness or disability, and that care must be either not available or not affordable in the country where the applicant is living.
Everything else in the route is paperwork around that sentence. The version of Appendix ADR on gov.uk is shown as updated on 29 October 2026, so read the current text before you rely on any summary of it, including this one.
Which relatives qualify?
Paragraph ADR 4.1 lists the relationships from the applicant’s side. The applicant must be the parent, the grandparent, the son or daughter, or the brother or sister of the sponsor in the UK.
The gov.uk guide states the same thing from the other direction: you must need long-term care from a parent, grandchild, brother, sister, son or daughter who is living permanently in the UK. So a grandmother in Pakistan sponsored by her grandson in the UK fits, because she is the grandparent of her sponsor.
| The applicant abroad is the sponsor’s | So the carer in the UK is the applicant’s |
|---|---|
| Parent | Son or daughter |
| Grandparent | Grandson or granddaughter |
| Son or daughter | Parent |
| Brother or sister | Brother or sister |
Ages
Paragraph ADR 1.2(d) requires the applicant and the sponsor both to be aged 18 or over at the date of application. There is no upper age limit, and no minimum age at which an elderly parent becomes eligible. Age on its own is not the qualification; the need for personal care is.
A partner can be included
Paragraph ADR 5.1 allows the care requirement to be met by the applicant’s partner instead, where the applicant is a parent or grandparent. In practice that is the provision that lets an elderly couple be dealt with together rather than splitting them.
What does the care test actually require?
That the applicant needs long-term personal care to perform everyday tasks, because of age, illness or disability. The gov.uk guide words it as needing long-term care to do everyday personal and household tasks because of illness, disability or your age.
Tasks, not diagnoses
This is where Pakistani medical evidence usually falls short, and it is fixable. A consultant’s letter saying a patient has advanced osteoarthritis and hypertension states a diagnosis. It does not say whether the patient can wash, dress, cook, take medication on time or move around the house unaided.
The rule is about everyday tasks. Ask the treating doctors to describe function: what the person cannot do alone, how often help is needed, whether the need is permanent or improving, and what happens without help. That is the evidence the test is written for.
Long-term, not temporary
A relative recovering from surgery who will be independent again in six months does not meet a long-term care test. The evidence should be clear about the trajectory of the condition, and honest where it is uncertain.
Not available, or not affordable
This is the limb that decides most of these applications. Paragraph ADR 5.2 requires the applicant to be unable to obtain the required level of care in the country where they are living, even with the financial help of the sponsor, because either the care is not available and there is no person in that country who can reasonably provide it, or the care is not affordable.
The availability limb
Note the second half of it: and there is no person in that country who can reasonably provide it. For a Pakistani family this is the hardest sentence in the rule, because most applicants have other relatives in Pakistan.
The application has to deal with each of them, by name and by reason. A brother who lives in another city and works full time, a sister with her own ill husband, a son who has moved abroad. Not asserted, but evidenced: where they live, what their circumstances are, why the care cannot reasonably fall to them.
- list every relative in Pakistan and their situation;
- explain why each cannot reasonably provide the care;
- address paid care as well as family care, because the rule is about the required level of care, not only about relatives;
- where specialised care is needed, evidence that it does not exist within reach of where the applicant lives.
The affordability limb
The alternative is that the care is not affordable. Because the rule asks whether the care can be obtained even with the financial help of the sponsor, this limb cannot be met by saying the applicant has no money of their own. The question takes the sponsor’s resources into account.
That makes it an arithmetic argument. What does the required care actually cost in Pakistan, quoted by providers rather than estimated? What is the applicant’s income and what are the sponsor’s commitments? A sponsor who can comfortably pay for a full-time attendant in Lahore will struggle on this limb, which is uncomfortable to say and better said before the fee is paid.
The sponsor, the money and the undertaking
The sponsor is not a bystander on this route. They have to qualify by status, prove they can carry the cost, and sign a legally meaningful promise.
Who can sponsor
Paragraph ADR 4.2 requires the sponsor to be a British citizen, settled in the UK, in the UK with protection status, or an EEA national with limited leave granted under paragraph EU3 of Appendix EU. The gov.uk guide also names Irish citizens, along with people from the EU, Switzerland, Norway, Iceland or Liechtenstein with pre-settled status who started living in the UK before 1 January 2021.
Maintenance without public funds
The sponsor must show they can maintain, accommodate and care for the relative without recourse to public funds. The rules at ADR 6.1 to 6.3 set out an income evidence requirement covering six months, so the sponsor’s payslips and bank statements need to run across the same period and tell the same story.
The five-year undertaking
Paragraph ADR 6.4 requires the sponsor to sign an undertaking for five years from the date the applicant arrives in the UK where the applicant is to be granted settlement, or for the duration of the permission where temporary permission is being granted.
Paragraph ADR 6.5 gives that undertaking teeth: if the applicant uses public funds during the undertaking period, the government may seek to recover those public funds from the sponsor. Families should understand that before anyone signs. The undertaking is not a formality on a form.
What does a successful applicant get?
More than almost any other family route gives on a first grant, which is part of why the test is so strict.
Paragraph ADR 9.1 says that where the sponsor is a British citizen or settled in the UK, the applicant will be granted settlement. The gov.uk guide puts the same point as your stay being unlimited. There is no two-and-a-half-year grant to extend, and no five-year wait for indefinite leave.
Paragraph ADR 9.2 covers the other case: where the sponsor has temporary permission, the applicant is granted temporary permission that expires on the same date as the sponsor’s. So the sponsor’s status decides the shape of the grant.
| Adult dependent relative | Partner | Parent | |
|---|---|---|---|
| Fee, outside the UK | £3,635 | £2,064 | £2,064 |
| First grant | Settlement, where the sponsor is British or settled | 2 years 9 months | 2 years 9 months |
| English requirement | None | CEFR A1 | CEFR A1 |
| Income figure in the rules | None published, sponsor undertaking instead | £29,000 | None published |
| Super priority service | Not available | Available | Available |
| Decision outside the UK | Usually 12 weeks | Usually 12 weeks | Usually 12 weeks |
What does it cost, and how long does it take?
As of 31 October 2026, the gov.uk family visas overview says it costs £3,635 if you are applying from outside the UK. Where the relative in the UK has permission to stay as a refugee or with humanitarian protection, the figure falls to £452.
The Home Office fee table published for 8 October 2026 carries the same £3,635 on its route to settlement other dependant relative line, and records no change taking effect on that date. Set against the £2,064 route to settlement line that a partner or parent application uses, this is about 76 per cent more for one application.
The healthcare surcharge
Paragraph ADR 1.2(a) requires any fee and the Immigration Health Charge to have been paid, unless a fee waiver has been granted in whole or part. The gov.uk overview says you might also need to pay the healthcare surcharge as part of your application. The published rates are £1,035 a year for an adult and £776 a year for an applicant under 18. The ADR page itself does not state an amount for this route, so take the figure the application service quotes you.
Timing, and what you cannot buy
A decision outside the UK usually takes 12 weeks, and 8 weeks inside the UK. The gov.uk overview says you cannot use the super priority service if you are applying as an adult coming to be cared for by a relative. That is worth knowing in advance, because families in this situation are often in a hurry for reasons that are entirely real.
What documents does the application need?
Four bundles. The relationship, the care need, the position in Pakistan, and the sponsor.
The relationship and identity
- the applicant’s passport and CNIC;
- documents proving the relationship, which for Pakistani families usually means birth certificates, the family registration certificate and translations;
- the sponsor’s passport or status document;
- where the applicant’s partner is included, their identity and marriage documents.
The care need
- medical reports from the treating doctors describing the condition and its progression;
- a functional assessment: the everyday tasks the applicant cannot perform alone;
- hospital records, prescriptions and treatment history;
- where there is a disability certificate or similar Pakistani documentation, that too.
The position in Pakistan
- a full account of relatives in Pakistan, where they live and their circumstances;
- evidence for why each cannot reasonably provide the care, rather than a bare statement;
- written quotations for the care actually required, from providers in the city where the applicant lives;
- evidence about the applicant’s own income, pension and assets;
- where specialised care does not exist locally, evidence of that from the relevant institutions.
The sponsor
- six months of payslips and matching bank statements;
- an employer letter, or Self Assessment records for self-employment;
- accommodation evidence: tenancy or mortgage, rooms and current occupants;
- a plan for how the care will be provided in the UK, including who will do it and around what working hours;
- the signed undertaking.
Where do these applications fail?
Usually on one of three points, and rarely on the relationship or the fee. I am not going to put a percentage on it, because I have not seen a figure for Pakistani applications I would be willing to print.
The care need is stated but not described
Medical letters that list diagnoses without saying what the person cannot do. The test is about everyday tasks, so the evidence has to be about everyday tasks.
There is a relative in Pakistan who was never dealt with
An application that does not mention a son living in the same city is not a strong application, it is an incomplete one. Address every relative, including the ones whose situation is inconvenient for the case.
The affordability argument ignores the sponsor’s money
Families argue that the applicant cannot afford care. The rule asks whether the care can be obtained even with the financial help of the sponsor. An argument built on the applicant’s pension alone does not answer the question that was asked.
If the test cannot be met
Sometimes the honest answer is that the route is closed, and the useful work is in what comes next rather than in a hopeful application.
Visits, done properly
A visit visa lets parents spend extended periods with family in the UK, within the limits of the visitor rules, with a return home expected. It is not a route to settlement and should not be presented as one, but for many families it is what actually happens. The UK visit visa guide covers the evidence and the conditions.
What you must not do is apply for a visit visa intending to stay. That is a misrepresentation, and it damages the family’s credibility in every later application, including a genuine ADR application made years afterwards.
Care in Pakistan, supported from the UK
If the sponsor can fund care at home, that is the outcome the rule contemplates. It is not the outcome most families want, and saying so early is more use than discovering it after £3,635 is gone.
Other countries
Some countries have parent and family reunion routes that work differently from the UK’s. Several are covered in the family guides on this site, including the Canada super visa for long parent visits and German family reunion. Each has its own rules, and none of them is easy.
How do you apply, step by step?
Do the evidence work before the application, not after it. On this route more than most, the file either answers ADR 5.2 or it does not.
Check the relationship and the ages
Appendix ADR allows the applicant to be the parent, grandparent, son, daughter, brother or sister of the sponsor in the UK. Read from the applicant’s side, the carer in the UK is their child, grandchild, parent or sibling. The applicant and the sponsor must both be 18 or over at the date of application.
Check the sponsor’s status
Paragraph ADR 4.2 requires the sponsor to be a British citizen, settled in the UK, in the UK with protection status, or an EEA national with limited leave under paragraph EU3 of Appendix EU. The gov.uk guide also names Irish citizens. The sponsor’s status decides whether the applicant is granted settlement or temporary permission.
Get the medical and care evidence
Obtain medical evidence from the treating doctors in Pakistan setting out the condition and the level of personal care the applicant needs for everyday tasks. The rules speak of long-term personal care required because of age, illness or disability, so the evidence has to describe tasks, not just diagnoses.
Evidence that the care is not available in Pakistan
Paragraph ADR 5.2(a) asks whether the care is unavailable and there is no person in that country who can reasonably provide it. Deal with every relative living in Pakistan and why they cannot provide the care, and with the local care options and why they cannot meet the need.
Or evidence that the care is not affordable
Paragraph ADR 5.2(b) is the alternative limb: the care is not affordable. The test asks whether the required care can be obtained even with the financial help of the sponsor, so quote the real cost of the care in Pakistan and set it against what the family can actually pay.
Prepare the maintenance evidence and the undertaking
The sponsor must show they can maintain, accommodate and care for the applicant without public funds, with income evidence covering six months. The undertaking runs for five years from arrival where settlement is granted, and public funds used during that period may be recovered from the sponsor.
Apply from outside the UK
Apply from outside the UK. As of 31 October 2026, the fee is £3,635, or £452 where the relative in the UK has protection status. The super priority service is not available on this route, and a decision outside the UK usually takes 12 weeks.
What goes wrong most often?
Treating old age as the qualification
Being elderly, and being alone, is not the test. The test is long-term personal care for everyday tasks, and care that cannot be obtained locally. Many loving, well-funded applications fail on this alone.
Medical evidence from the wrong angle
Diagnoses instead of function. Ask the doctor to write about tasks, frequency of help and what happens without it.
Hiding relatives in Pakistan
It never works, and it converts a weak case into a dishonest one. Deal with them openly.
Not understanding the undertaking
Five years of maintenance, accommodation and care without public funds, with public funds recoverable from the sponsor. Some families sign that without reading it. Read it.
Expecting to buy speed
The super priority service is not available on this route, and the usual wait outside the UK is 12 weeks. Plan around that rather than against it.
Applying from inside the UK after a visit
The application is made from outside the UK, apart from an extension by someone already on the route. A parent who arrives as a visitor and then tries to switch has used the wrong door.
A realistic example
This is a hypothetical illustration, not a real client. Mrs Akhtar is 78 and lives alone in Multan. She had a stroke 14 months ago, cannot dress or wash without help, cannot manage her own medication and cannot walk unaided. Her only son, Kamran, is a British citizen in Leeds. Her daughter lives in Canada.
- The first question. Is there anyone in Pakistan who can reasonably provide the care? She has a nephew in Karachi with his own family and no household able to take her in. There is no sibling left in Multan.
- The medical evidence. Her neurologist and her GP write about function: the tasks she cannot perform, the help she needs through the day and night, and the permanence of the deficit after 14 months.
- The care costing. Kamran obtains written quotations from two agencies in Multan for the level of attendance the doctors describe, including overnight cover, and sets them against his income and his own commitments in Leeds.
- The sponsor file. Six months of payslips and matching bank statements, a letter from his employer, his tenancy agreement and the number of rooms, and a written plan for who provides the care around his working hours.
- The undertaking. Kamran reads ADR 6.4 and 6.5, and signs the undertaking understanding that public funds used in the next five years may be recovered from him.
- Application. Filed from Pakistan at £3,635, with no English test required. A decision arrives inside the 12 weeks gov.uk quotes. Because Kamran is a British citizen, the grant under ADR 9.1 is settlement.
The file is strong because it answers the rule’s question rather than the family’s feelings. It names everyone in Pakistan, prices the care, and describes what she cannot do.
The version that goes wrong
Now a different family. Mr and Mrs Shah are in their late sixties in Lahore, in reasonable health, living in their own house with a daughter-in-law nearby and a full-time domestic helper. Their son in London wants them with him and pays an agent, who writes an application saying they are elderly and need their family. There is no functional medical evidence, the daughter-in-law is not mentioned, the helper is not mentioned, and the affordability argument rests on the parents’ pension while the son earns well. The £3,635 is spent. The application does not meet ADR 5.2, and nothing in the file was ever going to make it meet it.
Key takeaways
- Appendix ADR 4.1 allows the applicant to be the parent, grandparent, son, daughter, brother or sister of the sponsor in the UK, and both must be 18 or over.
- The applicant must need long-term personal care for everyday tasks because of age, illness or disability.
- ADR 5.2 then asks whether that care can be obtained in the country where they live, even with the sponsor’s financial help, so family money counts against the affordability limb.
- The availability limb requires that there is no person in that country who can reasonably provide the care, so every relative in Pakistan has to be addressed.
- As of 31 October 2026 the fee from outside the UK is £3,635, or £452 where the sponsor has protection status, against £2,064 for a partner or parent application.
- There is no English language requirement on this route, and the super priority service is not available on it.
- Where the sponsor is a British citizen or settled, ADR 9.1 grants the applicant settlement rather than a limited visa.
- The sponsor signs an undertaking for five years from arrival, and ADR 6.5 allows public funds used in that period to be recovered from them.
Frequently asked questions
Who can apply for a UK adult dependent relative visa?
Paragraph ADR 4.1 of Appendix Adult Dependent Relative allows the applicant to be the parent, grandparent, son, daughter, brother or sister of the sponsor in the UK. Put the other way round, the gov.uk guide says you must need long-term care from a parent, grandchild, brother, sister, son or daughter living permanently in the UK. The applicant and sponsor must both be 18 or over at the date of application.
What is the care test, exactly?
Two parts. First, the applicant must require long-term personal care to perform everyday tasks because of age, illness or disability. Second, under ADR 5.2, they must be unable to obtain the required level of care in the country where they live, even with the financial help of the sponsor, because either the care is not available and there is no person there who can reasonably provide it, or the care is not affordable.
How much does it cost from Pakistan?
As of 31 October 2026, the gov.uk family visas overview says it costs £3,635 if you are applying from outside the UK, falling to £452 where the relative in the UK has permission to stay as a refugee or with humanitarian protection. The Home Office fee table published for 8 October 2026 lists the same £3,635 as the route to settlement other dependant relative line, with no change on that date.
Why is it so much more expensive than a spouse or parent visa?
The fee table simply prices it on a separate line. A partner, parent or child application from outside the UK is £2,064 on the route to settlement line, while the other dependant relative line is £3,635. That is about 76 per cent more for a single application, and it buys a route where you cannot use the super priority service at all.
Do you get indefinite leave straight away?
It depends on the sponsor. Paragraph ADR 9.1 says that where the sponsor is a British citizen or settled in the UK, a successful applicant is granted settlement. Paragraph ADR 9.2 says that where the sponsor has temporary permission, the applicant is granted temporary permission expiring on the same date as the sponsor’s. The gov.uk guide puts the first case as your stay being unlimited.
What does the sponsor have to sign?
An undertaking to maintain, accommodate and care for the relative without recourse to public funds. Paragraph ADR 6.4 sets the period at five years from the date the applicant arrives in the UK where settlement is being granted, or the duration of the permission granted in a temporary case. Paragraph ADR 6.5 says that if public funds are used during that period, the government may seek to recover them from the sponsor.
Is there an English language requirement?
No. The gov.uk knowledge of English page lists adults coming to be cared for by a relative among those who do not need to prove their knowledge of English or take a test. Appendix ADR does not mention English either. It is one of the few family routes with no language requirement at all.
How long does a decision take?
The gov.uk guide says that if you apply outside the UK you will usually get a decision within 12 weeks, and within 8 weeks if you apply in the UK. The same overview says you cannot use the super priority service if you are applying as an adult coming to be cared for by a relative, so the fastest options available on other routes are closed here.
Does the healthcare surcharge apply?
Paragraph ADR 1.2(a) requires any fee and the Immigration Health Charge to have been paid, unless a fee waiver has been granted in whole or part, and the gov.uk overview says you might also need to pay the healthcare surcharge as part of your application. The published rates are £1,035 a year for an adult and £776 a year for an applicant under 18. Check the amount the application service quotes you for your own case.
Can my elderly parents come on a visit visa instead and then switch?
No. The ADR application is made from outside the UK, apart from an extension by someone already on the route, and a visitor cannot switch into it. A visit visa is a legitimate way for parents to spend time with family in the UK, but it is a visit, with a return expected. Applying for one while intending to stay is a misrepresentation that damages every later application.
Can care paid for by the family in Pakistan defeat the application?
It can, and that is the design of the rule. ADR 5.2 asks whether the applicant can obtain the required level of care in Pakistan even with the financial help of the sponsor. If suitable care exists in Pakistan and the family in the UK could pay for it, the affordability limb is not met. The affordability argument has to be made on real figures, not asserted.
Can Ch. Bilal Rasheed help with an adult dependent relative application?
In part. A consultation can be booked in Lahore, on WhatsApp or by phone, and as an immigration advisor in Pakistan he can help you gather the medical records, the care costings and the family evidence the test turns on. He is not registered with the UK Immigration Advice Authority, formerly the OISC, so for advice on the application itself you may need a regulated UK adviser or solicitor. No one can guarantee a visa.
