Live In Care and 24-hour Care [Guide]

As your loved one ages, this can be a moment of uncertainty, confusion, and stress for you and your family. For most of you, this will be a new world filled with complex questions:

• When is the right time to find qualified in-home caregiver help for my family member?
• What if they refuse assistance?
• How do I get started, and how can I make sure I find the right caregiver for my family?
• How much does it cost?
• And, is it even safe right now to do so?

At 1+1 Cares, we hear you. We know that aging can be a difficult and complicated transition for families. This is why we exist; since 2007, our mission has been to make high-quality, affordable care accessible and to provide meaningful impact for the people who need assistance, the families who love them, and the caregivers who perform these critical services.

Our goal is to make it easy and affordable. Referring you to a qualified caregiver is our way to relieve some of your stress and uncertainty. In this article, we introduce you to two types of care— Live-in care and 24-hour care—so that you can make an informed decision on what makes the most sense for your loved one and your family.

A key benefit of professional care that is often overlooked, especially with Live-in care and 24-hour care, is the shift it brings from a family member as the primary caregiver back to a family member as the wife, the husband, the daughter, the son, the grandchild. With this welcome shift, family members can once again enjoy the company of their loved ones rather than focus on the monitoring and tasks at hand.

What’s the difference between Live-In Care and 24-hour care?

An early step in your planning process is to identify the type and level of care you need. You should also know that these needs are likely to change over time. As such, while it’s difficult if not impossible to chart a long-term plan, it is good practice to familiarize yourself with all of your options to help your planning.

Some families will need just a little help. We can refer to you qualified caregivers for hourly services for routine visits or for à la carte concierge services, like at-home salon services, special outings, meal or medication delivery, home cleaning, and pet grooming. Other families may need a bit more help, and we can do this, too.

The Basics of Live-In Care

Let’s start with Live-in care. As the name implies, with Live-in care, a caregiver will “live” with your aging loved one. However, they’re not a new roommate; a Live-in caregiver will often work for 16 hours and then take an unpaid, off-duty period of eight hours for sleep. It is important to understand that off duty means they are not required to stay there and may leave during the off duty time. Leaving during the middle of the night is not something many caregivers would want to do and it is very uncommon, but it could happen.

However, if you have a need for around-the-clock care, perhaps because of a high wander risk, fall risk, and/or frequent bathroom visits during the night, you should seek 24-hour care (see below) with caregivers that are required to remain on-premise for the full duration of the day and night. In other cases, if your loved one sleeps well through the night and faces fewer risks, you may deem it sufficient and safe for a caregiver with off-duty time, and, even though it is unlikely, who may potentially leave the premise. Remember, with all things, this is 100 percent your choice to make with your family and your aging loved one.

Caregivers typically sleep close enough to be able to respond to any needs that arise during this time, such as an adjacent room. Another option is to have a remote monitor that can alert the caregiver in another room or even down the hall.

Keep in mind that Live-in care has an added benefit of reliability, comfort, and familiarity. While dividing shifts among multiple caregivers may provide well-rested aides, a Live-in caregiver is often more affordable and better able to develop a long-term, trusting, and meaningful relationship with your loved one.

The Basics of 24-Hour Care

Now let’s look at 24-hour care. Often, with 24-hour care, two caregivers rotate in 12-hour shifts or three caregivers rotate in eight-hour shifts. Caregivers are present and awake during the entire shifts (versus Live-in caregivers who may sleep on-premise or leave during the overnight hours). Does your loved one require around-the-clock monitoring for health or safety reasons, perhaps for dementia, ALS, wandering, or from the risk of falls or self-harm? 24-hour care might be a good option for your family.

Did you know that 24-hour care can also be arranged on a temporary basis, such as recovering from illness or surgery? Often, a recovering family member, no matter their age, requires around-the-clock supervision or assistance and, if you’re not nearby nor accustomed to this level of commitment, it can be difficult, expensive, or unsafe to provide the needed level of support. This is where qualified caregivers can be of tremendous help. 24-hour care can also be set up for seniors in need of long-term full-time care. This way, a loved one can remain at home where he or she is most comfortable and surrounded by a familiar environment and loved ones.

Another benefit of having rotating shifts is that it can prevent “caregiver burnout”. You’ll have built-in backup options for caregivers who are familiar with your needs should someone take a vacation or get sick.

Questions often asked about 24-hour care

How do I set up 24-hour care for my parents? Many people use 24-hour care through a licensed, bonded agency. Setting up care with an agency lifts a weight off your shoulders because of the assistance and security they provide in the process. Planning 24-hour care should be a partnership between you and the chosen agency.

How does 24-hour care work for seniors? Seniors with dementia or physical limitations can benefit from 24-hour care with caregivers diligently monitoring their safety. 24-hour caregivers are your extra pair of eyes to watch over your loved one but also provide the assistance they need in and outside their home.

How do you know when it's time for 24-hour care?

If your loved one is experiencing these symptoms, it may be a sign to make the switch from hourly care to 24-hour care:

• Frequent falls or unsteady balance
• Confused between daytime and nighttime
• Recent hospitalization or stay in a rehabilitation facility after a stroke, heart attack, or hip fracture
• Fainting or confusion from dehydration
• Difficulty drinking and eating without assistance
• Getting lost or confused. For example, wandering from home by foot or vehicle.
• You are afraid to leave your loved one alone and have been having trouble getting sleep because you are assisting their nighttime needs.
• Confused or frightened by short absences from caregivers, family, and friends
• New or increased bathroom accidents
• Leaving the stove on unattended
• Cost of 24-hour care. Does insurance cover 24 hour Home Care? 24-hour care is usually much cheaper than a private room in a
• nursing facility. Some Long-term care insurance policies provide a daily amount to cover the cost of in-home care and many of them have 90-day waiting periods. You can check your qualifications with your insurance policy.
• Questions to ask agencies about 24-hour home care?
• Who do I speak to if there is a problem?
• How many caregivers should I expect during a shift? How will the shifts be divided? Will they rotate?
• Can I interview each caregiver and have them meet my loved one beforehand?
• How many of the caregivers are certified nursing assistants?
• What tasks is the caregiver allowed to perform?
• Will a supervisor visit my home? If so, how often?
• What happens when someone can’t make their shift?
• Can family caregivers share duties with agency caregivers? If so, how can we coordinate it?

What are the types of 24-hour home care? OR What are the different options for 24-hour home care for seniors? 24-hour care provides several different services for seniors such as the following:

• Transportation
• Personal/hygiene care
• Housekeeping
• Meal preparation
• Nursing care
• Medication reminders

Is Live-in Care expensive?

One of the most common questions we get about Live-in care or 24-hour care is, how much will it cost? Keep in mind that there is no single, one-size-fits-all answer to this question. If you’ve been struggling to identify a dollar figure, this is expected and normal.

However, there are tools and comparisons to help you estimate the costs and formulate a general budget and plan. The best place to start is to reach out to us—we can provide estimates for all levels of care that are uniquely customized to the rates and expenses in your neighborhood. One thing to know is that the cost of in-home care in metro areas or areas with a higher cost of living will have higher rates. For example, according to one measurement tool, the hourly median rate in Chico, California is about $24 compared to $33 in San Francisco. When you arrange for in-home care with one of the caregivers referred by 1+1 Cares, our costs are typically 30 percent less than traditional in-home care agencies.

We offer a range of services at affordable rates:

Basic Service, in which you download our 1+1 Cares App and self-search to find a caregiver. Depending on your location, this rate is typically $16 to $21 per hour.

Premium Service, in which we do everything for your peace of mind. Depending on location, this is typically $19 to $26 per hour. With Premium Service, a personal advocate facilitates communication, personalizes concierge services, and offers 24/7 support—essentially, we serve as your peace-of-mind cheerleader!

Additionally, because we’re consumer-directed, families and caregivers negotiate the schedule and rates, there is no minimum number of hours, and we do end-to-end background checks on all caregivers. We also offer a large pool of qualified caregivers, which means you’ll not only connect with the ideal person but you’ll also have options for backup caregivers at your service, should your main caregiver(s) be unavailable.

Keep in mind that connecting with a qualified caregiver is not the best time to shop for unqualified bargains. Here are a few pitfalls to be aware of:

Private-found caregivers:

While unvetted, private individuals may offer lower rates, but you may sacrifice protections such as background checks and identity verification. Private caregivers may also employ questionable “bait and switch” tactics in which they present and provide an affordable, personable, and quality caregiver for a short period of time (one or two days) but who is quickly replaced by a “cousin” who is less experienced, underqualified, or who may even be ineligible to work in the U.S. Often, private caregivers lack liability insurance, and most will not have access to qualified backup caregivers.

Home-care employment agencies:

Often these companies charge a higher rate for the same qualified caregivers referred by 1+1 Cares. Families can pay vastly different rates for the same caregiver doing the same things. Additionally, the agency is in control of all aspects of selecting and managing caregivers. This means that you lack the control to select and even keep the right person for your family, and the caregiver may be constrained or unsatisfied in how they’re being managed.

Newspaper or online directories/listings:

We all know the internet can be a great source for purchasing niche items or connecting with service providers. So, too, can “friend-of-a-friend” connections. But these directories and referrals have low or no standards for verification and vetting of caregivers. Cost is one thing; finding qualified people to assist your loved one is a lot of work that can not be done with a simple online posting. 1+1 Cares spends countless hours doing the work of qualifying hundreds of potential caregivers so that you don’t have to.

1+1 Cares about you. And we care equally about the qualified caregivers we work for. One of the perks of a referral from 1+1 Cares is that we help match you to the ideal caregiver, including preferred languages spoken, personality traits, specific capabilities (like driving), and hours and availability. At 1+1 Cares, we’re consumer-directed, meaning that we ensure that caregivers get the pay and schedule they desire and that they’re matched with the right family. With every family, we compare your needs with the experience and expertise of the caregivers and then empower you to decide the rest. We work for you. The result is a well-matched, fruitful, and positive environment for both your loved one and your caregiver.