Live-In Care: Often More Affordable than 24/7

When mom or dad need a constant caregiving presence, live-in care can sometimes be a more affordable option vs. 24/7 care.

Live-in care is when a caregiver lives in the home for an extended period of time.  It differs from 24/7 care.  In 24/7 care, the client has  multiple caregivers who are typically awake at all times in order to attend to client needs.  24/7 care is common, for example, when someone has just had surgery and must be monitored day and night.  Caregivers are paid on an hourly basis and every hour is available for the client.

In live-in assignments, caregivers are allowed to have a reasonable amount of uninterrupted sleep.  The Department of Labor guideline is eight hours of sleep/night, with at least five hours uninterrupted.   Caregivers are also allowed personal time because they are, in effect, living in the client’s home.  They  also expect to have a reasonable amount of time for activities like checking email, talking by phone and watching TV.  The caregiver is available for the client, as required, but is also allowed to take care of  personal needs.

In addition to the base pay, most live-in caregivers receive their food at the expense of the client. If the live-in caregiver goes grocery shopping, she would often be allowed to purchase reasonable amounts of items for herself.  The live-in caregiver might eat the same food that the client eats, or may have certain things which she alone enjoys.  While this is common practice in our market area, all details are negotiable. What constitutes “reasonable” is a matter of discussion between the caregiver and the client.

For live-in assignments to be successful, it helps if the caregiver has a private bedroom or area where she can sleep.  Ideally, she will also have a private bathroom.

When a client needs live-in care, the client and their family should pay close attention to the personality of the caregiver.  Even more than with hourly assignments, it is critical that the caregiver get along with the client.  Caregiving skills are important, but the success of the caregiver and client to enjoy each other’s company may be even more critical.  Some clients enjoy lots of conversation.  Others like their quiet time and prefer less interaction with the caregiver.  Getting this chemistry right is key to a successful live-in arrangement.

Depending on the expected duration of care, there may be multiple caregivers who take turns assisting the client.  This helps ensure that the caregiver(s) have adequate time off and take care of personal errands.  Sometimes there is one primary caregiver who works five days/week, with a secondary caregiver covering the other two.  Sometimes there is a three-day/four-day schedule.  One week on and one week off is another option.  What works depends on the needs and desires of the client and caregiver availability.

Families should appreciate that live-in care is not always a suitable replacement for 24/7 care.  If mom or dad need constant help with ADLs (toileting, feeding, bathing, etc.), if their dementia is advanced or if they are up many times though the night, the workload in a 24-hour period might be too much to ask of one caregiver.  There is no easy measure to determine this, aside from what the caregiver says she finds acceptable.

Many live-in cases start out when mom or dad are in reasonably good shape and only need modest assistance.  Over time, as care needs increase, families sometimes bring in an hourly caregiver to provide respite for a few nights/week so the live-in can get adequate rest.  All cases are unique and depend on the needs and desires of the client, and the expectations and capabilities of the caregivers.